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1.
Wong P Murray S Ramsewak A Robinson A van Heyningen C Rodrigues E 《Postgraduate medical journal》2007,83(977):200-205
Objective
To investigate the frequency, diagnosis and outcome of patients admitted to hospital with acute coronary syndrome (ACS) or other conditions associated with raised levels of cardiac troponin T.Design
Observational study.Setting
A large university hospital.Patients
Consecutive patients admitted over an 8‐week period who had a serum troponin T test as part of their clinical assessment were included. Patients were separated into those with raised (⩾0.01 μg/l) or normal (<0.01 μg/l) troponin T levels, and further categorised into those with or without a diagnosis of ACS.Main outcome measures
In‐hospital mortality in all patients; and 6‐month hospital re‐admissions and all‐cause mortality in patients without or with ACS and raised levels of troponin T.Results
Of 1021 patients, 118 patients had no ACS but raised troponin T levels, 195 had ACS with raised troponin T, 80 had ACS with normal troponin T and 628 had no ACS with normal troponin T. Their in‐hospital all‐cause mortalities were 36%, 18%, 0% and 3%, respectively (p<0.001, highest mortality v other groups). 6‐month all‐cause mortality remained higher in patients without ACS and with raised levels of troponin T than in those with ACS and raised troponin T (42% v 29%; p = 0.020).Conclusions
Patients without ACS but with raised levels of troponin T comprised 38% of all hospitalised patients found to have raised troponin T. These patients had worse in‐hospital and 6‐month outcome than those having ACS with raised levels of troponin T. 相似文献2.
Cremer R Binoche A Noizet O Fourier C Leteurtre S Moutel G Leclerc F 《Journal of medical ethics》2007,33(3):128-133
Objective
To evaluate feasibility of the guidelines of the Groupe Francophone de Réanimation et Urgence Pédiatriques (French‐speaking group of paediatric intensive and emergency care; GFRUP) for limitation of treatments in the paediatric intensive care unit (PICU).Design
A 2‐year prospective survey.Setting
A 12‐bed PICU at the Hôpital Jeanne de Flandre, Lille, France.Patients
Were included when limitation of treatments was expected.Results
Of 967 children admitted, 55 were included with a 2‐day median delay. They were younger than others (24 v 60 months), had a higher paediatric risk of mortality (PRISM) score (14 v 4), and a higher paediatric overall performance category (POPC) score at admission (2 v 1); all p<0.002. 34 (50% of total deaths) children died. A limitation decision was made without meeting for 7 children who died: 6 received do‐not‐resuscitate orders (DNROs) and 1 received withholding decision. Decision‐making meetings were organised for 31 children, and the following decisions were made: 12 DNROs (6 deaths and 6 survivals), 4 withholding (1 death and 3 survivals), with 14 withdrawing (14 deaths) and 1 continuing treatment (survival). After limitation, 21 (31% of total deaths) children died and 10 survived (POPC score 4). 13 procedures were interrupted because of death and 11 because of clinical improvement (POPC score 4). Parents'' opinions were obtained after 4 family conferences (for a total of 110 min), 3 days after inclusion. The first meeting was planned for 6 days after inclusion and held on the 7th day after inclusion; 80% of parents were immediately informed of the decision, which was implemented after half a day.Conclusions
GFRUPs procedure was applicable in most cases. The main difficulties were anticipating the correct date for the meeting and involving nurses in the procedure. Children for whom the procedure was interrupted because of clinical improvement and who survived in poor condition without a formal decision pointed out the need for medical criteria for questioning, which should systematically lead to a formal decision‐making process.In developed countries, ⩾70% of children die in hospital, mainly in paediatric intensive care units (PICUs).1,2 Decisions on forgoing life‐sustaining treatment are made for 30–40% of dying children.3,4,5Although formal guidelines in the English language for withholding or withdrawing treatment in critically ill children have been available since the 1990s, recommendations in French were lacking until recently.6,7,8 Because of this lack and because several studies have shown that French‐speaking doctors in the intensive care units did not follow US guidelines,9 the French‐speaking group of the intensive care unit organised a workshop, including PICU nurses and doctors, parents of patients, palliative care specialists, philosophers and people who had conducted ethics research. This group worked from 1999 to 2000 and its conclusions were published in July 2002 as a book that was disseminated to all French PICUs.10 Recently, French paediatric guidelines were derived directly from this text and validated by the ethics commission of the French Paediatric Society; the proposed procedure is summarised in box 1.11 Contrary to English guidelines that regard parents as the most appropriate bearers of decisional authority, French guidelines are more doctor centred, recommending that parents choose their level of participation, without shifting the weight of responsibility for the decision on them.The purpose of this study was to evaluate the feasibility of the procedure, to record related medical and paramedical time, and to point out ethical problems that could be implied by the procedure itself. 相似文献3.
Turley AJ Roberts AP Davies A Rowell N Drury J Smith RH Shyam-Sundar A Stewart MJ 《Postgraduate medical journal》2007,83(977):206-208
Purpose
To evaluate the predictive value of N‐terminal pro B‐type natiuretic peptide (NT‐proBNP) reference cut‐off values as diagnostic markers for left ventricular systolic dysfunction (LVSD).Study design
A retrospective study assessing the use of NT‐proBNP in the diagnostic algorithm for the investigation of patients with suspected signs and symptoms of LVSD presenting to primary care.Results
A generic NT‐proBNP cut‐off (150 ng/l) value has similar negative and positive predictive valves, specificity and sensitivity compared to age and sex specific cut‐off values.Conclusion
When using NT‐proBNP as a triage tool for screening patients with signs and symptoms suggestive of LVSD, a simple generic cut‐off level is as effective as more complex age sex specific cut‐off values. 相似文献4.
Wong P Ramsewak A Murray S Robinson A Robinson D Rodrigues E 《Postgraduate medical journal》2007,83(979):332-337
Objective
To examine the effects of comorbidity and hospital care on mortality in patients with elevated cardiac troponin T.Design
Observational study.Setting
A large university hospital with on‐site diagnostic cardiac catheter laboratory.Patients
All hospitalised patients with elevated cardiac troponin T level (⩾0.01 μg/l) over an 8‐week period.Main outcome measures
6‐month all‐cause mortality.Results
Among 313 patients with elevated cardiac troponin T, 195 had acute coronary syndrome and 118 had other conditions. Multivariate analysis showed that among patients with acute coronary syndrome, increasing comorbidity score (odds ratio (OR) 1.23 per point increase, 95% confidence interval (CI) 1.00 to 1.51; p = 0.048), age (OR 1.08 per year, 95% CI 1.04 to 1.13; p<0.001), raised troponin T level (OR 2.22 per 10‐fold increase, 95% CI 1.27 to 3.89; p = 0.005), and ST depression (OR 3.12, 95% CI 1.38 to 7.03; p = 0.006) were independent adverse predictors, while cardiologist care (OR 0.22, 95% CI 0.09 to 0.51; p<0.001) was associated with a better survival. Increasing troponin T level (OR 3.33 per 10‐fold increase, 95% CI 1.24 to 8.91; p = 0.017) was found to predict a worse prognosis among patients without acute coronary syndrome, and cardiologist care did not affect outcome in this group. Among hospital survivors with acute coronary syndrome, increasing comorbidity score, age and a lack of cardiologist care were independently associated with lesser use of effective medications.Conclusions
Comorbidity was associated with a higher 6‐month mortality in patients having acute coronary syndrome, and lesser use of effective medicines among hospital survivors. Cardiologist care was associated with better 6‐month survival in patients with acute coronary syndrome, but not in those without acute coronary syndrome.Prognostic indices including the original Charlson''s comorbidity index1 have shown that comorbidity was important in determining the short and long term outcome in patients with various medical conditions, including those with acute myocardial infarction.2,3,4,5 Among patients admitted to hospital with suspected acute coronary syndrome, an abnormally raised cardiac troponin level can be found in patients with, and also without, acute coronary syndrome.6,7 An increasing cardiac troponin level was associated with increasing mortality in patients with acute coronary syndrome,8 and also those without acute coronary syndrome.9 Despite the availability of international management guidelines, care provided for patients with acute coronary syndrome varied in hospitals with or without interventional facilities, and was affected by whether patients received cardiologist care.10 We examine the effects of comorbid diseases, including a validated comorbidity index,11 and hospital care on the 6‐month outcome among patients with elevated cardiac troponin T, caused by acute coronary syndrome and other conditions. 相似文献5.
Sivakumar R Wellsted D Parker K Lynch M Ghosh P Khan SA 《Postgraduate medical journal》2006,82(965):220-223
Objective
To evaluate the utility of N terminal pro brain natriuretic peptide (NT‐proBNP) as a diagnostic marker for diastolic dysfunction or failure, systolic dysfunction, and significant valve disorders in patients over 75 years.Design
Cohort study.Setting
Outpatient echocardiography service in a district general hospital.Participants
100 consecutive patients.Main outcome measures
Sensitivity, specificity, positive predictive values, negative predictive values, and area under receiver operating characteristic curve for NT‐proBNP assay in the diagnosis of left ventricular diastolic dysfunction or failure, systolic dysfunction, and significant valve disorders.Results
For diagnosis of systolic dysfunction NT‐proBNP level of 424 pg/ml had a sensitivity of 96%, specificity of 45%, positive predictive value of 36%, and negative predictive value of 96%. The area under the curve was 0.71 (95% confidence intervals: 0.69 to 0.89). In valve heart disease, level of 227 pg/ml had sensitivity of 91%, specificity of 43%, positive predictive value of 40%, and negative predictive value of 92%. Patients with diastolic dysfunction/failure had lower plasma concentrations.Conclusions
This study showed that NT‐proBNP had excellent negative predictive value for systolic dysfunction and significant valve disorders in very elderly patients. It increased significantly in systolic dysfunction, valve heart disease, and atrial fibrillation. NT‐proBNP is not useful in the diagnosis of diastolic dysfunction or diastolic heart failure using standard echocardiography criteria. 相似文献6.
Aims
To study the cardioprotection of recombinant human erythropoietin (rhEPO) preconditioning (EPC) and to investigate the role and possible mechanism of cyclooxygenase (COX)‐2 in the delayed phase of EPC.Methods
In phase 1, myocardial ischaemia reperfusion (I‐R) rat model was established by 30 minutes ligation of left descending coronary and three hours of reperfusion. Rats were given 0.9% saline solution or rhEPO 24 hours before I‐R protocol. COX‐2 selective inhibitor celecoxib was given for further investigation of the cardioprotection of EPC. At the end of I‐R protocol, infarct sizes were measured and ultrastructural organisations were studied. In phase 2, myocardial COX‐2 mRNA expressions and prostaglandins (PGs) contents were studied in different groups after euthanasia.Results
It was found that EPC could elicit potent cardioprotection against I‐R injury, shown by reduction of infarct size and improvement of ultrastructural organisation; whereas administration of celecoxib resulted in complete loss of this protection. EPC resulted in robust increase in COX‐2 mRNA and PGs levels that were also abrogated by celecoxib.Conclusions
COX‐2 plays an essential part in cardioprotection of the delayed phase of EPC in rats, which might be related to actions of PGE2 or PGI2, or both. 相似文献7.
Background and Aims
Butyrate enemas have been shown to be effective in treatment of ulcerative colitis, but the mechanism of the effects of butyrate is not totally known. This study evaluates effects of topical treatment of sodium butyrate (NaB) and 5‐aminosalicylic acid (5‐ASA) on the expression of trefoil factor 3 (TFF3), interleukin 1β (IL1β), and nuclear factor κB (NFκB) in trinitrobenzene sulphonic acid (TNBS) induced colitis in rats.Methods
Distal colitis was induced in male Wistar rats by colonic administration of TNBS and colonically treated with NaB, 5‐ASA, combination of NaB and 5‐ASA, and normal saline for 14 consecutive days. Colonic damage score, tissue myeloperoxidase (MPO) activity, TFF3 mRNA expression, serum IL1β production, and tissue NFκB expression were determined, respectively.Results
Treatment of NaB, 5‐ASA, and the combination improved diarrhoea, colonic damage score, and MPO activities, increased TFF3 mRNA expression, and decreased serum IL1β production and tissue NFκB expression. The combination therapy of NaB and 5‐ASA had better effects than any other single treatment.Conclusions
The combination of topical treatment of NaB and 5‐ASA was effective for relieving and repairing colonic inflammation and the effects were related to stimulation of TFF3 mRNA expression and down‐regulation of IL1β production and NFκB expression. 相似文献8.
Lundy C Hill N Wolsley C Shannon M McClelland J Saunders K Jackson J 《The Ulster medical journal》2011,80(1):21-27
Introduction
There is no consensus as to the best method of assessing vision in children with neurological disability. There are a variety of tests and approaches that can be used. It is important to look at models of assessment that identify the visual diagnosis and provide appropriate feedback and explanation to parents, carers and educational professionals.Methods
This study reports on the results of comprehensive visual assessments of fifty children with neurological disability over a three year period. It focuses on the feedback from families and professionals after the assessment report was disseminated.Results
The majority of families and professionals strongly agreed that a specialist assessment was needed in this population. Parents and professionals particularly valued the written report which provided guidance on appropriate visual material including advice relevant to education.Conclusion
This study highlights the importance of specialist teams engaging with local child development services and indicates how partnership working can potentially be emotionally supportive as well as developmentally beneficial. 相似文献9.
Objective
To examine the 21 month clinical outcome and bleeding complications in hospital survivors with non‐ST segment elevation acute coronary syndromes (NSTEACS) who were discharged with combined clopidogrel and aspirin anti‐thrombotic therapy, and compare with those having ST segment elevation myocardial infarction (STEMI) who were discharged with aspirin alone.Design
Observational study.Setting
A large university hospital.Patients
224 patients were admitted to hospital with either NSTEACS or STEMI, and survived to discharge between 1 October 2001 and 31 December 2002.Main outcome measures
Cardiovascular death, total death, new myocardial infarction, unstable angina requiring hospitalisation, stroke or transient ischaemic attack, coronary revascularisation; and fatal, life threatening, major and minor bleeding over 21 months after discharge.Results
Despite having no or small infarct (median maximum creatine kinase 155 v 1295 u/l; p<0.001) and taking more antianginal drugs, patients with NSTEACS had similar rates of cardiovascular death (9.5% v 8.3%; p = NS), new myocardial infarction (9.5% v 6.5%; p = NS) or unstable angina requiring hospitalisation (15.5% v 10.2%; p = NS) when compared with STEMI. Fatal, life threatening or major bleeding were <1% in both groups (p = NS); and minor bleeding occurred in 4.3% NSTEACS and 2.8% STEMI patients respectively (p = NS).Conclusions
Patients with NSTEACS had a similar and unfavourable long term outcome when compared with STEMI. There was no difference in serious bleeding complications between both groups. 相似文献10.
Objective
To determine the degree of adherence to legislation introduced in 1998 restricting the availability of over the counter paracetamol.Design
A prospective observational study.Setting
An emergency department in an inner city London teaching hospital. Pharmacy and non‐pharmacy outlets in south London.Main outcome measures
(1) The source of paracetamol ingested by 107 patients presenting with an acute paracetamol overdose (2001–2003) and (2) the ability to purchase paracetamol from pharmacy and non‐pharmacy outlets in a manner contravening paracetamol pack size legislation (2004).Results
Potentially toxic amounts of paracetamol in excess of pack size restrictions were purchased in 70% (17 of 24) of outlets. Forty six per cent of patients who had ingested a potentially toxic dose of paracetamol obtained the tablets in a manner contravening the 1998 legislation.Conclusion
Legislation limiting the availability of over the counter paracetamol is not being adhered to in south London. A significant number of patients ingesting a potentially toxic dose of paracetamol report purchasing the tablets in a manner contravening the legislation. Studies that attempt to assess the impact of the legislation need to be interpreted in the context of these results. Measures to enforce current legislation may help to reduce the severity of paracetamol poisoning in the UK. 相似文献11.
Background
Septic shock commonly leads to death in critically ill patients. Severe hypotension resistant to conventional catecholamine leads to multiorgan failure. We studied the effectiveness of low dose vasopressin in resistant septic shock.Methods
Thirty critically ill patients with catecholamine resistant hypotension were included in the study. After adequate fluid resuscitation, infusion of norepinephrine and dobutamine was started. If the patient remained hypotensive, vasopressin was infused at a fixed rate of 0.04 unit/minute for 24 hours. Haemodynamic parameters and mortality rates were recorded.Result
There was a significant improvement in systolic and mean arterial pressure within four hours of starting vasopressin. This improvement continued throughout the 24-hour period. In addition, it was possible to withdraw dopamine in all the patients and significantly reduce infusion rates of dobutamine and norepinephrine. No significant complication was noted.Conclusion
Low dose vasopressin at the rate of 0.04 unit/minute is an effective vasopressor in adult patients with catecholamine resistant septic shock.Key Words: Severe sepsis, Septic shock, Vasopressin 相似文献12.
SL Dorman SM Graham J Paniker S Phalira WJ Harrison 《Malawi medical journal : the journal of Medical Association of Malawi》2014,26(4):119-123
Background
BEIT CURE International Hospital (BCIH) opened in 2002 providing orthopaedic surgical services to children in Malawi. This study reviews the hospital''s progress 10 years after establishment of operational services. In addition we assess the impact of the hospital''s Malawi national clubfoot programme (MNCP) and influence on orthopaedic training.Methods
All operative paediatric procedures performed by BCIH services in the 10th operative year were included. Data on clubfoot clinic locations and number of patients treated were obtained from the MNCP. BCIH records were reviewed to identify the number of healthcare professionals who have received training at the BCIH.Results
609 new patients were operated on in the 10th year of hospital service. Patients were treated from all regions; however 60% came from Southern regions compared with the 48% in the 5th year. Clubfoot, burn contracture and angular lower limb deformities were the three most common pathologies treated surgically. In total BCIH managed 9,842 patients surgically over a 10-year period. BCIH helped to establish and co-ordinate the MNCP since 2007. At present the program has a total of 29 clinics, which have treated 5748 patients. Furthermore, BCIH has overseen the full or partial training of 5 orthopaedic surgeons and 82 orthopaedic clinical officers in Malawi.Conclusion
The BCIH has improved the care of paediatric patients in a country that prior to its establishment had no dedicated paediatric orthopaedic service, treating almost 10,000 patients surgically and 6,000 patients in the MNCP. This service has remained consistent over a 10-year period despite times of global austerity. Whilst the type of training placement offered at BCIH has changed in the last 10 years, the priority placed on training has remained paramount. The strategic impact of long-term training commitments are now being realised, in particular by the addition of Orthopaedic surgeons serving the nation. 相似文献13.
Sushil Chawla M. Nakra S. Mohan B.C. Nambiar Raju Agarwal A. Marwaha 《Medical Journal Armed Forces India》2013,69(2):134-137
Background
Pregnant women are at risk to develop complications due to illness related to pregnancy or due to aggravation of pre-existing disease. These patients also require critical care and ICU admissions in some cases. To determine the current spectrum of diseases in an obstetric population resulting in admission to the intensive care unit (ICU) at a tertiary care hospital.Methods
A retrospective case series study and analysis of data from obstetric patients admitted for critical care management.Results
0.26% of the total obstetric patients admitted to the hospital required ICU admissions. 46% of patients were admitted to ICU for ventilator support. Pre-eclampsia and obstetrical hemorrhage were the common diagnosis for these patients.Conclusion
Critically ill obstetric patients require a team approach of the obstetrician, anesthesiologist and intensive care specialist for the optimal care of these patients. 相似文献14.
Gaurav Kaithwas Raju Gautam Sanjay M Jachak Arvind Saklani 《Asian Pacific Journal of Tropical Biomedicine》2012,2(3):185-188
Objective
To evaluate the antiarthritic activity of Ajuga bracteosa using albino rats.Methods
The antiarthritic activity of 70% ethanolic extract of Ajuga bracteosa (EEAB) was evaluated against turpentine oil- and formaldehyde- induced acute non immunological and complete freund''s adjuvant (CFA)-induced chronic immunological arthritis in albino rats.Results
EEAB showed a significant (P<0.05) and dose dependent inhibitory effect against acute and chronic models of arthritis. EEAB exhibited better antiarthritic activity than the standard aspirin.Conclusions
EEAB exhibits a significant and promising antiarthritic activity against acute and chronic arthritis and supports the traditional use of Ajuga bracteosa for rheumatism and other inflammatory diseases. 相似文献15.
S Chaudhury PL Prasad R Zacharias T Madhusudan R Saini 《Medical Journal Armed Forces India》2007,63(2):144-146
Background
There is a paucity of Indian studies on psychiatric morbidity in children. Present work was undertaken in a child guidance clinic in armed forces.Methods
Retrospective analysis of 213 patients who attended a child guidance clinic was done.Results
Majority (n=138) were boys. 55.9% were referred from paediatric outpatient department while medical officers in periphery referred 38.5%. The diagnoses was mental retardation in 30.97%, behavioral and emotional disorders in 23.06% and neurotic, stress related and somatoform disorders in 15.98% cases.Key Words: Child psychiatry, Attention-deficit hyperactivity disorder, Mental retardation 相似文献16.
Purpose:
Studies undertaken in England and Scotland have identified a decrease in the number of circumcision operations being performed during childhood. The aims of this study were two-fold. Firstly, to determine the trend in circumcision operations performed in boys in Northern Ireland over a ten year period. Secondly, to compare the number of operations performed by paediatric surgeons with the number performed by general surgeons over the same period.Method:
Data were collected from the Northern Ireland Department of Health and Social Services and Public Safety. A retrospective analysis was conducted of the number of circumcisions performed in boys aged between 0 and 13 years for the year beginning 1st September 1991 to the 1st of September 1992 and for the year beginning 1st September 2001 until the 1st of September 2002.Results:
769 circumcisions were performed in the year 1991 to 1992 compared with 264 in the year 2001 to 2002, representing a 66% decrease. In the ten year study period, the number of circumcisions performed by general surgeons fell by 71% whilst specialist paediatric surgeons performed 56% less.Conclusions:
The decrease in rates of circumcision in boys aged 0 to 13 years in Northern Ireland is consistent with trends in the remainder of the United Kingdom. The results also suggest a greater decrease in the proportion of circumcisions being performed by general surgeons in district general hospitals compared to those performed by paediatric surgeons. 相似文献17.
Robins GG Sarwar MS Armstrong MJ Armstrong M Denyer ME Bush S Hassan T Everett SM 《Postgraduate medical journal》2007,83(986):768-772
Aims
To audit the safety of differing protocol‐driven early‐discharge policies, from two sites, for low‐risk acute upper gastrointestinal (GI) bleeding and determine if default early (<24 h) in‐patient endoscopy is necessary.Methods
All patients with low‐risk acute upper GI bleeding presenting to two separate hospital sites in Leeds from August 2002 to March 2005 were identified. Both hospitals operate nurse‐led process‐driven protocols for discharge within 24 h, but only one includes default endoscopy. Relevant information was obtained from patients'' notes, patient administration systems, discharge letters and endoscopy records.Results
120 patients were admitted to site A and 74 to site B. Median length of stay on the clinical decisions unit was 12.6 h at site A and 9.4 h at site B (p = 0.045). Oesophagogastroduodenoscopy was performed on 89/120 (74%) patients at site A compared with only 7/74 (9%) at site B (p<0.001). Six of 120 (5%) patients from site A were admitted to hospital for further observation compared with 6/74 (8%) from site B (p = 0.38). Of the remaining patients, all were discharged within 24 h, and 8/114 (7%) at site A vs 17/68 (25%) at site B were given hospital clinic follow‐up (p<0.001). None of the 194 patients had further bleeding or complications within 30 days.Conclusions
Patients admitted with a low‐risk acute upper GI bleeding can be managed safely by a nurse‐led process‐driven protocol, based on readily available clinical and laboratory variables, with early discharge <24 h. Avoiding in‐patient endoscopy appears to be safe but at the price of greater clinic follow‐up. 相似文献18.
Richard J Holden Roger L Brown Matthew C Scanlon Ben-Tzion Karsh 《J Am Med Inform Assoc》2012,19(6):1050-1058
Objective
To identify predictors of nurses'' acceptance of bar coded medication administration (BCMA).Design
Cross-sectional survey of registered nurses (N=83) at an academic pediatric hospital that recently implemented BCMA.Methods
Surveys assessed seven BCMA-related perceptions: ease of use; usefulness for the job; social influence from non-specific others to use BCMA; training; technical support; usefulness for patient care; and social influence from patients/families. An all possible subset regression procedure with five goodness-of-fit indicators was used to identify which set of perceptions best predicted BCMA acceptance (intention to use, satisfaction).Results
Nurses reported a moderate perceived ease of use and low perceived usefulness of BCMA. Nurses perceived moderate-or-higher social influence to use BCMA and had moderately positive perceptions of BCMA-related training and technical support. Behavioral intention to use BCMA was high, but satisfaction was low. Behavioral intention to use was best predicted by perceived ease of use, perceived social influence from non-specific others, and perceived usefulness for patient care (56% of variance explained). Satisfaction was best predicted by perceived ease of use, perceived usefulness for patient care, and perceived social influence from patients/families (76% of variance explained).Discussion
Variation in and low scores on ease of use and usefulness are concerning, especially as these variables often correlate with acceptance, as found in this study. Predicting acceptance benefited from using a broad set of perceptions and adapting variables to the healthcare context.Conclusion
Success with BCMA and other technologies can benefit from assessing end-user acceptance and elucidating the factors promoting acceptance and use. 相似文献19.
Marslin Gregory B. Divya Revina Ann Mary M. M. Hipolith Viji V. K. Kalaichelvan V. Palanivel 《Asian Pacific Journal of Tropical Biomedicine》2013,3(7):554-556
Objective
To evaluate the anti-ulcer activity and acute toxicity of Ficus religiosa (F. religiosa) leaf ethanolic extract in animal models.Methods
Anti-ulcer activity of F. religiosa ethanolic extract (250 and 500 mg/kg body weight) was studied on stress induced ulcer animal models. Ranitidine was used as standard. The anti-ulcer activity of F. religiosa was evaluated with the help of ulcer area and histopatholgical examination. Preliminary phyto-chemical screening and acute toxicity studies of F. religiosa also carried out.Results
Results showed that the extract treatments prevented ulcer area and gastric secretion in a dose-dependent manner. Administration of 2 000 mg/kg extract did not show any acute toxicity in albino mice. Preliminary phytochemical analysis identified the presence of flavonoids in the ethanolic extract of F. religiosa.Conclusions
The extract is non-toxic even at relatively high concentrations. The anti-ulcer activity is probably due to the presence of flavanoids. 相似文献20.
Collins Minyaliwa Chiwoza Bandawe Richman James Mwale 《Malawi medical journal : the journal of Medical Association of Malawi》2012,24(1):1-4