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1.
《Journal of hand therapy》2020,33(2):229-234
IntroductionMobile devices can be incorporated into therapy as an engaging alternative to traditional therapy options. The use of mobile devices and smartphone applications can enhance the quality of care provided by health care professionals.PurposeTo find mobile apps that can be incorporated into hand therapy practice.MethodsHand therapy evaluation, interventions, proprioception, laterality, and home exercise program applications can be incorporated into practice. Patient education can also be provided via the use of mobile applications.ConclusionSmartphone applications can be a valuable intervention and impact performance in individuals with impaired hand function. Smartphone applications offer a client-centered, and potentially motivating, activity option that can be utilized to aid the hand therapist. 相似文献
2.
Diane W. Chen Rachel W. Davis Courtney J. Balentine Aaron R. Scott Yue Gao Nicole M. Tapia David H. Berger James W. Suliburk 《The Journal of surgical research》2014
Background
The value of routine postoperative visits after general surgery remains unclear. The objective of this study was to evaluate the utility of routine postoperative visits after appendectomy and cholecystectomy and to determine access to mobile technology as an alternative platform for follow-up.Methods
Retrospective review of 219 appendectomies and 200 cholecystectomies performed at a safety net hospital. One patient underwent both surgeries. Patient demographics, duration of clinic visit, and need for additional imaging, tests or readmissions were recorded. Access to mobile technology was surveyed by a validated questionnaire.Results
Of 418 patients, 84% percent completed a postoperative visit. At follow-up, 58 patients (14%) required 70 interventions, including staple removal (16, 23%), suture removal (4, 6%), drain removal (8, 11%), additional follow-up (20, 28%), medication action (16, 21%), additional imaging (3, 4%), and readmission (1, 1%). Occupational paperwork (62) and nonsurgical clinic referrals (28) were also performed. Average check-in to check-out time was 100 ± 54 min per patient. One intervention was performed for every 7.8 h of time in the clinic. Additionally, 88% of the surveyed population reported access to cell phone technology, and 69% of patients <40 y had smartphone access.Conclusions
Routine in-person follow-up after surgery consumes significant time and resources for patients and healthcare systems but has little impact on patient care. Most of the work done in the clinic is administrative and could be completed using mobile technology, which is pervasive in our population. 相似文献3.
目的:探讨针灸治疗脑瘫患儿语言障碍的研究进展。方法选择2013年1~12月我院收治的脑瘫患儿30例,将这30例患儿随机分成两组,每组15例患儿,分别命名为治疗组和对照组,对照组的15例患儿采取常规语言训练,治疗组的15例患者在采取常规语言训练的基础上,进行针灸治疗,观察两组患儿的临床治疗效果。结果治疗组临床治疗的总有效率为96.8%。对照组临床治疗的总有效率为77.4%。治疗组患儿临床治疗的总有效率明显的高于对照组。两组总有效率比较,差异有统计学意义(P<0.05)。结论针灸治疗脑瘫患儿的语言障碍具有良好的效果,该种方法值得临床推广。 相似文献
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Mariano E. Menendez Kyle R. Eberlin Chaitanya S. Mudgal David Ring 《Hand (New York, N.Y.)》2015,10(2):279-284
BackgroundAlthough upper-extremity disability has been shown to correlate highly with various psychosocial aspects of illness (e.g., self-efficacy, depression, kinesiophobia, and pain catastrophizing), the role of language in musculoskeletal health status is less certain. In an English-speaking outpatient hand surgery office setting, we sought to determine (1) whether a patient’s primary native language (English or Spanish) is an independent predictor of upper-extremity disability and (2) whether there are any differences in the contribution of measures of psychological distress to disability between native English- and Spanish-speaking patients.MethodsA total of 122 patients (61 native English speakers and 61 Spanish speakers) presenting to an orthopaedic hand clinic completed sociodemographic information and three Patient-Reported Outcomes Measurement Information System (PROMIS)-based computerized adaptive testing questionnaires: PROMIS Pain Interference, PROMIS Depression, and PROMIS Upper-Extremity Physical Function. Bivariate and multivariable linear regression modeling were performed.ResultsSpanish-speaking patients reported greater upper-extremity disability, pain interference, and symptoms of depression than English-speaking patients. After adjusting for sociodemographic covariates and measures of psychological distress using multivariable regression modeling, the patient’s primary language was not retained as an independent predictor of disability. PROMIS Depression showed a medium correlation (r = −0.35; p < 0.001) with disability in English-speaking patients, while the correlation was large (r = −0.52; p < 0.001) in Spanish-speaking patients. PROMIS Pain Interference had a large correlation with disability in both patient cohorts (Spanish-speaking: r = −0.66; p < 0.001; English-speaking: r = −0.77; p < 0.001). The length of time since immigration to the USA did not correlate with disability among Spanish speakers.ConclusionPrimary language has less influence on symptom intensity and magnitude of disability than psychological distress and ineffective coping strategies. Interventions to optimize mood and to reduce pain interference should be considered in patients of all nationalities.Type of study/level of evidence: Prognostic II. 相似文献
6.
Perceived barriers to mammography among underserved women in a Breast Health Center Outreach Program
Oluwadamilola M. Fayanju Susan Kraenzle Bettina F. Drake Masayoshi Oka Melody S. Goodman 《American journal of surgery》2014
Background
To investigate perceived barriers to mammography among underserved women, we asked participants in the Siteman Cancer Center Mammography Outreach Registry–developed in 2006 to evaluate mobile mammography's effectiveness among the underserved–why they believed women did not get mammograms.Methods
The responses of approximately 9,000 registrants were analyzed using multivariable logistic regression. We report adjusted odds ratios (OR) and 95% confidence intervals (CI) significant at 2-tailed P values less than .05.Results
Fears of cost (40%), mammogram-related pain (13%), and bad news (13%) were the most commonly reported barriers. Having insurance was associated with not perceiving cost as a barrier (OR .44, 95% CI .40 to .49), but with perceiving fear of both mammogram-related pain (OR 1.39, 95% CI 1.21 to 1.60) and receiving bad news (OR 1.38, 95% CI 1.19 to 1.60) as barriers.Conclusion
Despite free services, underserved women continue to report experiential and psychological obstacles to mammography, suggesting the need for more targeted education and outreach in this population. 相似文献7.
G A Akers 《Clinics in plastic surgery》1986,13(3):509-511
Data entry and control of equipment are existing applications of speech recognition technology in medicine and surgery. Specialized dictation tasks, such as radiographic reporting, are feasible using isolated speech, speaker dependent, large vocabulary devices. General dictation will be possible using an automatic dictation device. Vocabulary size varies from a few to many thousand words, but most data entry, command, and control applications require 200 words or less, whereas specialized dictation tasks require about 1000 words and general dictation for a given user requires on the order of 10,000 words. 相似文献
8.
Studies looking at resection in high-grade gliomas have had mixed results. The authors briefly review the literature regarding the value of the extent of resection. They proceed to the preoperative and intraoperative tools available to the neurosurgeon to distinguish eloquent from noneloquent language cortex and fibers, including the emerging roles of functional magnetic resonance imaging diffusion tensor imaging tractography and direct cortical/subcortical stimulation in the surgical management of tumors in eloquent areas. Finally, the authors evaluate the postoperative course of these patients and the effect of language deficits on their quality of life. 相似文献
9.
Diabetes mellitus is the fourth most common comorbid condition among hospitalized patients, and 30% of patients undergoing open-heart surgery have diabetes. The link between hyperglycemia and poor outcome has been well described, and large clinical trials have shown that aggressive control of blood glucose with an insulin infusion can improve these outcomes. The barriers to implementing an insulin infusion protocol are numerous, despite the fact that doing so is paramount to clinical success. Barriers include safety concerns, such as fear of hypoglycemia, insufficient nursing staff to patient ratios, lack of administrative and physician support, various system and procedural issues, and resistance to change. Key steps to overcome the barriers include building support with multidisciplinary champions, involving key staff, educating staff, and administrators of the clinical and economic benefits of improving glycemic control, setting realistic goals, selecting a validated insulin infusion protocol, and internally marketing the success of the protocol. 相似文献
10.
Emma C. Hamilton Faiez Saiyed Charles C. Miller Arturo Eguia Alexandra C. Fonseca George P. Baum KuoJen Tsao Mary T. Austin 《Journal of pediatric surgery》2018,53(8):1478-1493
Purpose
The purpose of this study was to identify mobile Health (mHealth) technology utilization among caregivers of pediatric surgery patients.Methods
We provided a modified version of the 2012 mobile health survey from the Pew Research Center to English and Spanish-speaking caregivers of children aged < 18 years presenting to pediatric surgical outpatient clinics from June to July of 2016.Results
A total of 171 caregivers completed the survey and included 57 (34%) whites, 30 (18%) blacks, 75 (44%) Hispanics, and 6 (4%) other races. Among these, 160 (94%) were smartphone owners. mHealth users were identified as individuals who used their phone to look up health information online, receive text updates from healthcare providers or pharmacists, or use any health-related smartphone applications. On univariate ordered logistic regression, race/ethnicity, primary language, education level, and income quartile were associated with level of mHealth technology use. The majority of responders (n = 126, 76%) said that they would be very or moderately interested in trying a new smartphone app related to management of their child's health.Conclusion
While the majority of pediatric caregivers are smartphone owners, there are significant racial and socioeconomic differences in mHealth usage. Understanding these differences may be important in identifying barriers to adoption of mHealth technology.Level of Evidence
Level IV case series with no comparison group. 相似文献11.
目的:探讨 Gesell 在基层医院语言发育迟缓儿童中应用效果。方法随机选取我院2007年1月~2012年12月在儿科门诊就诊的2~3岁语言发育迟缓儿童,共计52例。采用 Gesell 婴幼儿发育量表,对每个儿童进行发育评估。按运动能、应物能、语言能、应人能4个能区,将研究对象的评估结果统计对比。结果52例儿童的 Gesell 发育评估结果:按运动能、应物能、语言能、应人能4个能区,将研究对象的评估结果统计。3岁以下语言发育迟缓儿童 Gesell 检查,动作和应物能区平均 DQ 尚在正常范围内,而语言及应人能区平均 DQ 落后于正常;语言能发育落后(12.1±4.8)月,发育异常52例(100.00%)。结论 Gesell 在基层医院语言发育迟缓儿童中应用效果显著,Gesell 中应物能是小儿对外界刺激的分析和综合的能力,是预示智慧潜力的主要基础。可通过日常适应其发育水平的语言训练并定期随访即可,对于应物 DQ 低于正常的患儿,需至专门的康复治疗科室治疗。 相似文献
12.
Evidence based medicine (EBM) is an expanding field that combines clinical intuition with the best available evidence in clinical decision making. The shift to evidence based rationale encourages educating future physicians to formulate appropriate research questions and develop critical appraisal skills that are needed to practice EBM.This article identifies areas where clinicians may struggle with epidemiological terminology when critically appraising the literature. A review of the relevant terminology encountered in studies that focus on therapy, harm, diagnosis and prognosis can be beneficial to the clinician and are explained within this article. 相似文献
13.
This article summarizes the current state of technology as it pertains to quality in the operating room, ties the current state back to its evolutionary pathway to understand how the current capabilities and their limitations came to pass, and elucidates how the overlay of information technology (IT) as a wrapper around current monitoring and device technology provides a significant advance in the ability of anesthesiologists to use technology to improve quality along many axes. The authors posit that IT will enable all the information about patients, perioperative systems, system capacity, and readiness to follow a development trajectory of increasing usefulness. 相似文献
14.
Stephanie Sogg Allison Grupski John B. Dixon 《Surgery for obesity and related diseases》2018,14(5):682-692
Language is powerful. Our words convey our impressions, attitudes, and worldview. Language not only reflects, but also shapes, the way that we think. In the field of bariatric-metabolic surgery, it is critical for clinicians to choose our language thoughtfully. In this paper, we demonstrate the importance of language choices in our clinical work and our professional communications; explore the potential pitfalls of words and phrases commonly used in the field of obesity; and encourage the use of more productive language choices in our communications with patients and professional colleagues, both within and outside of our field. 相似文献
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N. W. Basta M. A. Mital O. Bonadio A. Johnson S. Y. Kang J. O'Connor 《International orthopaedics》1977,1(2):143-148
Summary A clinical and radiological study in 50 children with symptomatic mobile flat feet treated with varying combinations of shoes, custom-made arch supports, and pads over a period of four years is presented. It was concluded that children with symptomatic mobile flat feet should be fitted initially with laced high top shoes containing a steel shank and firm counter. A custom-made navicular pad should be added if adequate symptomatic relief is not obtained from the recommended shoes. Navicular cookies were found to be ineffective.
Résumé Les résultats d'une étude clinique et radiologique de pieds plats réductibles chez l'enfant sont présentés.Dans cette série, 50 enfants suivis pendant 4 ans ont été traités en combinant de façon variée les chaussures, les semelles orthopédiques et les contreforts.Les auteurs concluent que l'enfant présentant un pied plat réductible sera bien soutenu au début par le port de bottines lacées, armées d'une empeigne en acier et de contrefort solide.Un contrefort scaphoïdien fait sur mesure doit être ajouté, si le tableau douloureux n'est pas amendé par les souliers préconisés.Les pelotes scaphoïdiennes paraissent être inefficaces.相似文献
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Takao Suzuki Hiroshi Haga Seiji Yasumura Harumi Nagai Hidenori Amano Hiroshi Shibata 《Journal of bone and mineral metabolism》1994,12(1):9-16
The present paper describes a population survey of bone mineral density (BMD) on the third lumbar vertebra (L3) using dual
X-ray absorptiometry fixed in a van (mobile DXA) with lateral projection. Subjects were 387 persons aged 65 to 84 years living
in Koganei City, a western suburb of Tokyo. This is the baseline survey of the 10-year project “Longitudinal Interdisciplinary
Study on Aging” supported by Tokyo Metropolitan Institute of Gerontology (TMIG-LISA).
As for the pattern of age-related BMD calculated in the range-of-interest (ROI) being set in the center of vertebral body
to eliminate the posterior segment of vertebra and/or secondary hyperostotic changes with aging, the mean BMD of L3 declined
in females from 0.514±0.121g/cm2 (mean±standard deviation) in age-group 65–69 to 0.377±0.137 g/cm2 in age-group 80–84. In males, it showed a decrease from 0.731±0.155 in 65–69 to 0.613±0.158 in 75–79 but a slight (insignificant)
increase at age-group 80–84. There were significant differences of mean BMD between males and females in each age-group and
in average. BMD was significantly associated with age (negatively) and body mass index (positively) in the multiple regression
analysis. 相似文献
19.
Kai Siang Chan Yam Meng Chan Audrey Hui Min Tan Shanying Liang Yuan Teng Cho Qiantai Hong Enming Yong Lester Rhan Chaen Chong Li Zhang Glenn Wei Leong Tan Sadhana Chandrasekar Zhiwen Joseph Lo 《International wound journal》2022,19(1):114-124
There is a lifetime risk of 15% to 25% of development of diabetic foot ulcers (DFUs) in patients with diabetes mellitus. DFUs need to be followed up on and assessed for development of complications and/or resolution, which was traditionally performed using manual measurement. Our study aims to compare the intra- and inter-rater reliability of an artificial intelligence-enabled wound imaging mobile application (CARES4WOUNDS [C4W] system, Tetsuyu, Singapore) with traditional measurement. This is a prospective cross-sectional study on 28 patients with DFUs from June 2020 to January 2021. The main wound parameters assessed were length and width. For traditional manual measurement, area was calculated by overlaying traced wound on graphical paper. Intra- and inter-rater reliability was analysed using intra-class correlation statistics. A value of <0.5, 0.5–0.75, 0.75–0.9, and >0.9 indicates poor, moderate, good, and excellent reliability, respectively. Seventy-five wound episodes from 28 patients were collected and a total of 547 wound images were analysed in this study. The median wound area during the first clinic consultation and all wound episodes was 3.75 cm2 (interquartile range [IQR] 1.40–16.50) and 3.10 cm2 (IQR 0.60–14.84), respectively. There is excellent intra-rater reliability of C4W on three different image captures of the same wound (intra-rater reliability ranging 0.933–0.994). There is also excellent inter-rater reliability between three C4W devices for length (0.947), width (0.923), and area (0.965). Good inter-rater reliability for length, width, and area (range 0.825–0.934) was obtained between wound nurse measurement and each of the C4W devices. In conclusion, we obtained good inter-rater and intra-rater reliability of C4W measurements against traditional wound measurement. The C4W is a useful adjunct in monitoring DFU wound progress. 相似文献
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Peter J. Siska Kathryn E. Beckermann W. Kimryn Rathmell Scott M. Haake 《Urologic oncology》2017,35(3):102-110