bluuebunny/crossref_metadata_2025 huggingface dataset:
Organizational Prevention and Intervention Services
Authors: Kelly Jennifer , Walsh William D.
Published: April 2021

Improving the opportunities for enhanced health and wellness in first responders has gained national attention in recent years. Employers and other stakeholders striving to improve employee utilization of available resources will need to increase transparency in the process and improve understanding between first responders and clinicians. One potential process, early warning systems (EWS) are primarily designed to alert management to an at-risk employee. However, the continuing goal of any effort should be to identify and remedy any employee issue before the employee exhibits the predetermined number of events that trigger an early warning alert. Although many organizations are adopting an EWS by either choice or mandate, they are largely separate and distinct from the agency's health and wellness programming. Administrators are not only unsure of what data to consider, but also what to do when an alert is activated. Ideally, agencies move toward early intervention systems that themselves are conceptualized within the larger framework of wellness programming.
Application and Integration of Psychological First Aid in First Responder Organizations
Authors: Brucia Emily F. , Cordova Matthew J. , Finestone Angelique , Ruzek Josef I.
Published: April 2021

First responders are exposed to many potentially traumatic events throughout their careers. Given the risk of adverse mental and physical health outcomes secondary to frequent trauma exposure, access to culturally-sensitive, evidence-informed early intervention is paramount. Critical Incident Stress Management (CISM) and components therein (e.g., Critical Incident Stress Debriefing, peer support) represent the most commonly utilized early interventions within first responder organizations. Limited research has evaluated these models, and evaluation of early interventions presents many challenges due to characteristics of first responder cultures and organizational demands and constraints. Psychological First Aid (PFA) is a widely endorsed and promising evidence-informed early intervention model grounded in research on trauma recovery and resilience. This chapter examines the theoretical underpinnings and core actions of PFA and describes the potentially diverse applications of PFA within first responder organizations and concludes by discussing recommendations and future directions.
Barriers to Practitioners' Endorsement of a Recovery Perspective
Authors: Kram-Fernandez Debra
Published: April 2021

This chapter is concerned with the impact of practitioner biases on the experience of a meaningful life for individuals who live with serious mental illness (SMI). Professional biases, systemic biases that originate in societal fear and lack of knowledge, and internalized stigma taken on by the consumer affect life decisions. Following a history of treatment initiatives experienced by consumers as abusive, it is important to understand how a system envisioned to protect and treat was often experienced as harmful. In the 1980s a movement emerged to transform the nature of mental health treatment to a client-centered, recovery-oriented model. In 1999, the Surgeon General proclaimed that all agencies serving this population should be recovery oriented. Yet, the shift to this approach to understanding people with SMI has not been complete. While there are many explanations why practitioners may not fully embrace this perspective, this chapter introduces the concept of “schemas” from cognitive behavioral theory as a way of examining professional biases in the field of SMI.
Fighting Stigma in the Community
Authors: Bosco Nicolina , Giaccherini Susanna , Petrini Fausto , Castagnoli Stefano , Meringolo Patrizia
Published: April 2021

This chapter will discuss action research conducted in Tuscany to fight stigma surrounding mental illness. Public mental health services (PMHS) in Italy are perceived as ascribing a mentally ill label to individuals who utilize these programs. Local associations, especially sports associations, can be used to fight this stigma. This chapter will present key aspects and results of a community social innovation intervention jointly performed by a PMHS and the University of Florence. The research will explore perceptions surrounding the role and value of the community sports association, participants' perceived improvements, effects of sports participation, and the role of the sports association as an instrument to promote mental health. Results will show that the sports association is perceived as an agent of social capital to reduce social barriers emerging from mental illness. In addition, stigma is deconstructed through improvements to individual and social wellbeing.
Understanding and Addressing the Stigma in Mental Health Within the Asian and Asian-American Culture
Authors: Tran Ben
Published: April 2021

Mental health stigma can be defined as the display of negative attitudes, based on prejudice and misinformation, in response to a marker of illness. Stigma creates mental distress for individuals, which furthers stigmatizing attitudes, thereby making it a relentless force and as incompetent in achieving life goals such as living independently or having a good job. Over the years, researchers have consistently highlighted the problem of mental health service underutilization within the Asians and Asian-Americans communities. As such, understanding the cultural contexts that facilitate good outcomes may offer a lever or stigma reduction. Thus, the purpose of this chapter is to understand and address the sociocultural and psychological paradigms of the stigma in mental health within Asians and Asian-Americans. This chapter will cover the history of stigma within the Asian culture, Asian's mental health, mental health services utilization within the Asian culture, and methods of addressing the stigma within the Asian culture to promote the utilization of mental health services.
Violence
Authors: Teague Samuel , Robinson Peter
Published: April 2021

This chapter explores the extent to which journalists draw on long-standing mental health narratives when telling their stories about the “mentally ill” and, in particular, their tendency to depict the mentally ill as violent and dangerous. The chapter is divided into three sub-categories based on the perpetrators of violent crime committed against members of their immediate family. These were “fathers,” of which 24 articles were dedicated to the stories of 11 men; “mothers,” where 22 articles documented the stories of 24 mothers who harmed their children; and finally, “progeny,” where 58 articles presented 17 cases of sons or daughters who killed, or planned to kill, one or both of their parents. Despite differences in the way Australian journalists explain the violence depicted in these stories, particularly when the perpetrator was a female, they continually drew on mental health as an explanatory device to account for how and why these crimes took place. This provides evidence for a continuation of the confinement narrative presented in Chapter 1.
Finding Strength in the Struggle
Authors: Crumb Loni , Clark Madeline , Long Susan M.
Published: April 2021

Poverty is an intersectional issue, as children; women; men; people of color; people who identify as lesbian, gay, or transgender; and immigrant groups are all prone to experience the multifaceted impact of poverty. People who live in rural poverty are likely to experience more severe and persistent mental health disorders. This chapter provides an overview of how rural poverty impacts the mental health and wellbeing of diverse children and families. The authors discuss issues faced by residents living in rural poverty and provide multiple strength-based strategies that behavioral service providers can use to provide culturally relevant mental healthcare in impoverished rural communities. Lastly, the authors offer suggestions for future research.
Advocating for the Mental Health Needs of Children Living in Rural Poverty
Authors: Lenares-Solomon Denise , Conti Christina , George Christina
Published: April 2021

A person's mental health involves their social, psychological, and emotional wellness, all of which are important to their development. Lack of resources and access to effective mental health services can have a negative impact on the mental health of children residing in poverty-stricken rural communities. In advocating for this population, the authors have highlighted five factors that work as barriers in the mental health of children living in rural poverty. These factors were identified as early development, healthcare accessibility, parental/caretaker's educational level, educational system, and mental health stigma and stress. Furthermore, the authors presented a multi-layered approach for addressing these barriers. The components of the multi-layered approach include school-based resources, community-based resources, medical-based resources, and government-based resources. A case illustration is used to demonstrate the practical application of one aspect of the multi-layered approach – the school-based resources. Lastly, the authors stated that more research is needed for this population in regard to the effects of rural poverty on the mental health of children.
Occupational Risk Factors and the Mental Health of Women Firefighters
Authors: Hollerbach Brittany Sara
Published: April 2021

Firefighting is an inherently dangerous occupation, yet little is known about the mental health of firefighters, and even less is known about women firefighters specifically. The purpose of this chapter is to examine relevant literature pertaining to firefighters and mental health with a specific focus on behavioral health aspects that may impact the mental health of women firefighters. There are key issues women in the fire service face that are likely related to their mental health including bullying and harassment, substance use, job satisfaction, fitness, protective gear, and injury. By identifying issues related to the mental health of women firefighters, the authors provide direction for future research and guidance for policy guidelines for the fire service.
Adolescent and Adult Mass Shooters
Authors: Mallett Christopher A.
Published: April 2021

Understanding why people commit mass shootings in the United States is perplexing and discerning perpetrators' motivations is difficult because there have been a fairly limited number of shootings. In addition, there is incomplete research on mitigating historical evidence about the perpetrators. Thus, this chapter takes a broader approach to understanding why these shootings may have happened by reviewing the empirical literature to identify possible correlations from childhood and adolescent trauma experiences (and subsequent mental health problems) to later adult violence. This review supports a hypothesis that these experiences are potential links to explaining mass shooting outcomes. The trauma experiences that are identified to be most impactful include maltreatment, poverty, witnessing violence, domestic violence, deaths (violent and non-violent) of family and friends, and adolescent bullying.
Medical Students' Quest Towards the Long White Coat
Authors: Smith Christina Ramirez
Published: April 2021

Every year across the globe, thousands of students begin the quest towards becoming a medical doctor and donning a long white coat. Global research indicates that after beginning medical education, medical students' mental health and well-being dramatically declines. The loss of well-being continues into the residency and practice of medicine. The aim of this chapter is to broadly examine the pressures unique to medical students within the context of medical education training, higher education, and the general population. A call for medical education to adopt innovative policy, plans, and administrative and curricular changes designed to foster a culture conducive to the long-term positive mental health and well-being of medical students during training and into the internship and long-term practice of medicine concludes the chapter.
Springback Behavior of High Strength Titanium Tube after Bending under Variations of Material Property Parameters
Authors: Fang Jun , Lu Shi Qiang , Liang Chuang , Min Xu Guang
Published: April 2021

In order to reveal the springback behavior of high strength TA18 tube after numerical control (NC) bending under the variations of material property parameters, the finite element (FE) model of the whole process for the high strength TA18 tube during NC bending was established under ABAQUS code and its stability was evaluated. Then, using the model, the springback behavior after tube bending under the variations of material property parameters was studied, and the significance of material property parameters on springback was revealed. The results show that the springback angle decreases with the increase of the Young’s modulus, hardening exponent and thickness anisotropy exponent or with the decrease of the strength coefficient and yield stress. The significance of material property parameters on springback of the high strength TA18 tube after NC bending from high to low are the yield stress, Young’s modulus, strength coefficient, thickness anisotropy exponent and hardening exponent.
Reliability Analysis of Flexural Deflection of Reinforced Concrete Members under Ultra-Low Temperature
Authors: Tan Meng Xi , Li Yang
Published: April 2021

Based on the Monte Carlo method, the functional function under the normal use limit state given by the specification introduces the concrete tensile strength of each temperature gradient under ultra-low temperature, and the coefficient of change of concrete elastic modulus. By changing the temperature of the member, the thickness of the protective layer, the bending moment effect ratio, the reinforcement size,the concrete grade and the length of the bending beam. Analyze the reliable index of the deflection control of the flexural member under ultra-low temperature to obtain: When the reinforced concrete flexural member is reduced from normal temperature 20°C to-160°C, the reliable deflection index of the component increases non-linearly, reaches the maximum value at-130°C, and then decreases slightly, the concrete strength grade and the thickness of the protective layer under each temperature gradients have the greatest influence on the deflection control of the bending beam under ultra-low temperature, followed by beam length, steel bar size, load effect ratio,which is different from normal temperature.
The Influence of Different Natural Fibers on the Mechanical Properties of Geopolymer
Authors: Zhou Sheng Jie , Zhang Yan , Feng Zi Hao , Bi Fei , Fan Liang
Published: April 2021

Geopolymers can effectively deal with construction waste disposal problems, achieving resource recycling and higher strength than normal cement concrete. However, natural defects make geopolymer concrete difficult to apply in actual construction. This paper aims to make up for the natural defects of geopolymers while maintaining environmentally friendly materials. The low-calcium fly ash and blast furnace refining slag powder are used as raw materials, sodium silicate and sodium hydroxide are used as alkali activators, and chopped natural fibers are added as reinforcing materials to prepare natural fiber reinforced low-calcium fly ash and blast furnace refining slag base. Polymeric composites were used to investigate the effects of different natural fibers on the workability, compressive strength, tensile strength, water absorption, shrinkage and microstructure of geopolymer composites.
The Assessment of the Strength and Water Stability of Waste-Based Solidification of Binzhou Saline Soil
Authors: Hou Jia Lin , Zhou Sheng Jie , Zhang Yan , Fan Liang
Published: April 2021

This document takes saline soil in Binzhou as the research object using smelter slag as the soil stabilizer to solid saline soil in Binzhou, which has been proved achieving good performance of saline soil solidification. The results show that the soil solidification developed indoors can be used in combination with low-dose lime to achieve good performance in solidification of saline soil. The 7d strength is relatively higher than that of both ordinary lime stabilized soil and lime-fly ash stabilized soil, which completely meet the unconfined compressive strength requirements of the base layer in the current technical specifications. The soil stabilizer can improve the unconfined compressive strength of the saline soil, especially the post-14-day strength, and improve the immersion compressive strength and water stability of the cured saline soil. As the dosage of curing agent gets higher than seven percent, the 28d strength change of cured soil is no longer significant. The test result demonstrates that the dosage of curing agent should be less than seven percent.
Applications of Nanomaterials in Wellbore Fluids in Oil and Gas Fields
Authors: Di Wei Na
Published: April 2021

The application of nanomaterials in oil and gas fields development has solved many problems and pushed forward the development of petroleum engineering technology. Nanomaterials have also been used in wellbore fluids. Nanomaterials with special properties can play an important role in improving the strength and flexibility of mud cake, reducing friction between the drill string and wellbore and maintaining wellbore stability. Adding nanomaterials into the cement slurry can eliminate gas channeling through excellent zonal isolation and improve the cementing strength of cement stone, thereby facilitating the protection and discovery of reservoirs and enhancing the oil and gas recovery. This paper tracks the application progress of nanomaterials in wellbore fluids in oil and gas fields in recent years, including drilling fluids, cement slurries. Through the tracking and analysis of this paper, it is concluded that the applications of nanomaterials in wellbore fluids in oil and gas fields show a huge potential and can improve the performance of wellbore fluids.
Comparison Study on the Effect of Traction Speed on the GAE and Traditional Extrusion Forming of Four-Lumen Plastic Micro-Catheter
Authors: Ren Zhong
Published: April 2021

In this paper, the effect of traction speed on the four-lumen plastic micro-catheter (FLPMC) was numerically studied. Moreover, the numerical simulations of FLPMC based on two kinds of extrusions, i.e., traditional extrusion and gas-assisted extrusion were performed and compared. Numerical results show that with the increase of traction speed, the sizes of FLPMC for both extrusions all decrease. The sizes of FLPMC based on gas-assisted extrusion are sightly larger than those of the traditional extrusion. To ascertain the reasons, the flow velocities, pressure, shear stress and first normal stress difference distributions of melt based on both extrusions under two different traction speeds were obtained and compared. Results show that with the increase of traction speed under the fixed volume inlet flow rate, the radial flow velocities of melt at the outlet of die decrease but the axial flow velocities increase, which results in the decrease of the die swell at the outlet of die and the size shrinkage of exit face for the FLPMC based on both extrusions. However, for the gas-assisted extrusion, the axial velocities are larger, and the pressure, shear stress and first normal stress difference are far less than those of traditional extrusion, which results in the larger unit volume flow rate, then the sizes of cross-section face are larger than those of the traditional extrusion.
Intensive short-term dynamic psychotherapy provided by novice psychotherapists: effects on symptomatology and psychological structure in patients with anxiety disorders
Authors: Rocco Diego , Calvo Vincenzo , Agrosì Vito , Bergami Francesca , Busetto Luce Maria , Marin Silvia , Pezzetta Giovanna , Rossi Luca , Zuccotti Lorenzo , Abbass Allan
Published: April 2021

This study examines the effectiveness of psychotherapy provided by novice therapists, in an attempt to clarify the controversial relationship between treatment effectiveness and therapist experience. To achieve this, we examined the short- and long-term effectiveness of intensive short-term dynamic psychotherapy (ISTDP) in the treatment of patients with the Diagnostic and Statistical Manual of Mental Disorder, IV edition - Text Revision anxiety disorders, as provided by novice psychology trainees. Twenty-two patients with anxiety disorders were provided ISTDP. Patients improved significantly on all outcome indices, including the global assessment of functioning, the symptom checklist and the inventory of interpersonal problems, at the end of the treatment and at 6 and 12 month follow-up. In addition to these results, there was marked structural personality change as evidenced by ratings on the Shedler Westen assessment procedure (SWAP-200), at the same assessment moments; the SWAP-200 psychological health index score showed a meaningful increase in adaptive psychological resources and capacities, while the mean number of personality diagnoses decreased from the beginning to the end of therapy, and all patients maintaining their gains in 6-12 month follow-up. We conclude that ISTDP provided by novice psychotherapists is efficacious in bringing broad and in-depth change to pathology that can perpetuate anxiety disorders and other psychiatric conditions.
Audit of Drug Wastage and its Financial Cost
Authors: D'souza Veena Reshma , Geevergese Nikku Mathew , Palatty Princy Louis , Mathai Naveen Joseph , Baliga Manjeshwar Shrinath
Published: April 2021

Background:

Drug wastage is a major concern in healthcare and more so in an orthopedic setup where musculoskeletal ailments form a major proportion. The principal objective of this study was to ascertain the extent of drug wastage and its financial costs in orthopedics.

Materials and Methods:

This was a prospective pilot study and was conducted to ascertain the quantity of drug wastage in the orthopedic unit of a tertiary care hospital. The study was conducted in the outpatient facilities where the list of drugs prescribed and the wastage was recorded by telephoning the patients after a week of consultancy. The cost evaluation for the actual use and wastage was undertaken and audit was done to understand which drug generated the maximum wastage.

Results:

The highest drug wastage was observed in paracetamol (80%), diclofenac (38.36%) glucosamine + diacerein (53.33%), methylcobalamin + folic acid + alpha-lipoic acid (53.33%), methylcobalamin + folic acid (28.57%), and rabeprazole + domperidone (12.5%). Highest cost for wastage of drug was observed for diclofenac (INR434.1) and accounted for 44.72% of the drug cost.

Conclusion:

As far as the authors are aware, this is the first study addressing the financial impact of drug wastage in orthopedics. Attempts should be directed at minimizing wastage and at cost saving.
Acute Quadriparesis in Dengue - A Rare Presentation of a Common Disease
Authors: Nagpal Swapan , Nagpal Amar Jeet Singh
Published: April 2021

Dengue fever commonly presents with electrolyte abnormalities including hypokalemia. Hypokalemic quadriparesis is a very rare manifestation of this common arboviral infection. We report a case of acute reversible quadriparesis caused by hypokalemia in a patient with dengue. Such a presentation has been reported very few times. Various mechanisms have been proposed to explain hypokalemia in dengue, and it is still not completely known why some patients develop motor weakness and others do not. Most such cases have a very good prognosis and the weakness resolves on potassium supplementation.
Estimation and change of edentulism among the Korean population: Korea National Health and Nutrition Examination Survey 2007-2018
Authors: Yu Na-Hyeon , Shin Ah Ra , Ahn Song Vogue , Song Keun-Bae , Choi Youn-Hee
Published: April 2021

OBJECTIVES: To estimate the prevalence of edentulism according to the socio-demographic variables of Korean adults between 2007 and 2018 and to analyze the trends.METHODS: This study was conducted using raw data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2018. Edentulism was defined as the absence of upper and lower teeth or the retained root of the missing teeth. To obtain the prevalence of edentulism, complex sample frequency analysis and regression analysis were performed according to the socio-demographic variables to represent the national population. The Korean population structure in 2005 was exploited as a standard population to calculate age-standardized edentulism.RESULTS: The prevalence of edentulism in 2016-2018 was 9.7% in the Korean elderly, and the change of age-standardized edentulism steadily declined over time from 2007, 12.8%. In particular, it decreased by approximately 20% in the period between 2016 and 2018 compared to that in 2007 for those in their 80s. The trend of the prevalence according to gender decreased significantly in women. According to the level of education, the greatest decrease was seen in the group with the lowest education, although the prevalence itself was higher than that seen in those who were more educated.CONCLUSIONS: The prevalence of edentulism among the older Korean population has decreased over time. However, the concern is on those with lower education and men as these groups are still at higher risk for edentulism.
Un nuevo camino
Authors: Pulido Pulido Juan Francisco , Arribas-Cobo Patricia , Pulido Agüero Francisca , González García Fernando
Published: April 2021

Queridos compañeros Ya de lleno metidos en ésta nueva andadura, queremos de nuevo desde aquí transmitir nuestra ilusión ante todo aquello que vislumbramos en el horizonte más cercano. Somos conscientes en gran parte de las dificultades que aparecen cuando se intenta poner en marcha cualquier proyecto, y que muchas de éstas son ajenas a nuestras decisiones. En estas circunstancias, nuestro compromiso y sentido de la responsabilidad emergen más a flor de piel, a pesar de vivir momentos complicados.
Percepción del dolor según el modo de punción de la fístula arteriovenosa en pacientes sometidos a hemodiálisis. Revisión sistemática
Authors: Pabón Carrasco Manuel , Martínez Alfonso Eva del Rocío , Vilar Palomo Samuel , López Leiva Mª Inmaculada
Published: April 2021

Objetivo: Valorar la posible asociación entre la forma de punción de la fístula arteriovenosa y el dolor que siente el paciente por la inserción de la aguja.
Metodología: Se ha seguido la declaración PRISMA para revisiones sistemáticas. Se han consultado 6 bases de datos; Medline, Scopus, Cuiden, CINAHL, SciELO, y Cochrane PLUS. Además, se realizó una búsqueda secundaría manual para detectar literatura gris no encontrada en las bases de datos o mediantes las estrategias definidas. Criterios de inclusión; estudios de nivel de evidencia 1 en la escala Scottish Intercollegiate Guidelines Network, publicados en los últimos 10 años, idiomas español/inglés, y temática relacionada con las técnicas utilizadas en hemodiálisis para el abordaje de la fistula. Los artículos se evaluaron de forma crítica para detectar cualquier riesgo de sesgo mediante el instrumento CASPe y el manual Cochrane para Revisiones Sistemáticas de Intervenciones.
Resultados: Se identificaron un total de 150 resultados, seleccionándose finalmente 9 estudios. Los resultados han sido muy heterogéneas, encontrándose resultados para el dolor, tasas de infección, número de intentos de canalización, flujo sanguíneo, presión venosa, tiempo de hemostasia, seguridad, dilataciones aneurismáticas, estética del brazo portador de la fístula y calidad de vida del paciente.
Conclusiones: La evidencia no respalda el uso preferencial de la técnica del ojal sobre la canalización tradicional. Por tanto, se necesita mejorar el rigor metodológico y un mayor tamaño muestral para dilucidar que técnica da mejores prestaciones respecto al dolor, permitiendo por tanto mejorar la calidad de vida de los pacientes de hemodiálisis.
Subjective wellbeing, sense of humor and psychological health in hemodialysis patients
Authors: Mota Sousa Luis Manuel , Antunes Ana Vanessa , Alves Marques-Vieira Cristina Maria , Lopes Silva Paulo César , Martins de SousaValentim Olga Maria , Guerreiro José Helena Maria
Published: April 2021

Objective: To investigate the relationship between satisfaction with life in general, sense of humor, and anxiety, depression and stress with subjective happiness in chronic kidney disease patients undergoing hemodialysis. Material and Methods: A cross-sectional and correlational study was developed in two units of the Diaverum dialysis clinic and one hospital unit, with 183 chronic kidney disease patients undergoing hemodialysis. An instrument was used to characterize the sociodemographic and clinical profile of the sample (age, gender, nationality, education, occupation, marital status, dialysis sessions length, presence of hypertension and diabetes): the subjective happiness scale; the satisfaction with life in general; depression, anxiety and stress scale 21; and multidimensional sense of humor scale. Inferential procedures included Spearman correlation coefficients, and multiple linear regression adjusting to age, marital status, professional activity and diabetes. Results: Subjective Happiness was positively correlated with satisfaction with life in general, and the three dimensions of Sense of Humor. Nevertheless, subjective happiness was negatively correlated with stress / anxiety and depression. Satisfaction with life in general, humor production and social use of humor, and attitude towards humor had a positive relationship with subjective happiness. However, depression had a negative relationship with subjective happiness. Conclusions: Higher levels of subjective happiness were associated with higher levels of satisfaction with life in general, and sense of humor, however they were also associated with lower levels of depression in patients undergoing hemodialysis.
Valoración de la elección de tratamiento conservador en la enfermedad renal crónica
Authors: Aguilera-Flórez Ana Isabel , Alonso-Rojo Ana Cristina , Linares-Fano Blanca , Prieto Fidalgo Sara , García Martínez Lidia , Prieto-Velasco Mario
Published: April 2021

Introducción: El tratamiento conservador es una opción de tratamiento en la enfermedad renal crónica. Esta elección es decisión del paciente y/o familia. Objetivo: Analizar el proceso de elección de tratamiento conservador, identificar el perfil de paciente que lo elige, su supervivencia y quien comunica la elección. Material y Método: Estudio observacional, retrospectivo. Se incluyeron pacientes que eligieron tratamiento conservador entre 2010-2017. Los datos se obtuvieron de los registros de enfermería en historia clínica. Se recogieron variables demográficas, supervivencia, Índice de Comorbilidad de Charlson, índice de Barthel y valores de los pacientes utilizando la herramienta Tarjetas de valores. Resultados: Se estudiaron 95 pacientes: 41,05% hombres, edad media 82,36±9 años, 27,37% institucionalizados. La familia comunicó la elección en el 62,11% de los casos. La media del filtrado glomerular al inicio de la información fue 11,53±2,73ml/min, mediana del Charlson 8(13-3), Barthel 55 (100-0) puntos. En el proceso de evidenciar valores, la tarjeta más elegida fue “personal sanitario responsable del tratamiento”. La supervivencia media fue 496,19 días±553,8. Viven menos los hombres y los institucionalizados, sin diferencia significativa. El riesgo de muerte es mayor, al aumentar el Charlson y disminuir el filtrado glomerular (p=0,01). La familia comunicó la elección de seguir tratamiento conservador en el 62,11% de los casos. Conclusiones: El paciente que opta por tratamiento conservador es, una persona anciana, dependiente, con comorbilidades, supervivencia media en torno a 18 meses y en más de la mitad de los casos es la familia quien comunica la decisión de optar por ese tratamiento.
Repensando o ato de educar nossos pacientes
Authors: Figueredo Elisabeth
Published: April 2021

O ato de educar pacientes faz parte do processo de trabalho do enfermeiro: assistir; no entanto quantos de nós nos sentimos adequadamente preparados para ensinar nossos pacientes para o autocuidado? Não tenho dúvidas, que sabemos o necessário e também o que deve ser ensinado aos pacientes, a pergunta é, estamos preparados para ensinar? Num primeiro momento a resposta que me vem é que não somos preparados para esta atividade. Neste contexto podemos ainda acrescentar que a atividade de treinamento/educação dos pacientes não é valorizada adequadamente e que muitos ainda acreditam que expertise vem com a prática, e que qualquer um que sabe fazer sabe ensinar, o que discordo completamente. Alguns conceitos básicos são fundamentais para a nossa qualificação, o entendimento de que ensinar e aprender são diferentes, que as pessoas aprendem de maneiras diversa e que o nosso modo de aprender pode interferir no nosso modo de ensinar. Segundo Knowles1, os adultos aprendem baseado em seis princípios dentre eles: a motivação, as experiências passadas influenciam a aquisição de novos conhecimento, precisam de objetivos claros e relevância prática para o aprendizado e gostam de serem respeitados. O aprendizado se concretiza quando há algum tipo de mudança (conhecimento, atitude, hábitos, comportamento). No entanto, devemos considerar que nosso paciente além de adulto, na maioria das vezes, são portadores de doenças crônicas que podem ter diversas manifestações inclusive sintomas depressivos, atenção reduzida e diminuição do nível de concentração, necessitando muitas repetições2 tornando a atividade de ensinar um desafio.
Factores asociados a la satisfacción del paciente en diálisis
Authors: Romero-Ruiz Ana Belén , Sevillano-Jiménez Alfonso , Cardador-Trocoli Cristina
Published: April 2021

Introducción: La satisfacción del paciente es uno de los grandes retos que persigue conseguir el sistema sanitario y que repercute de forma positiva en la esfera biopsicosocial del paciente. Constituye una prioridad de los profesionales sanitarios el velar por dicha satisfacción y ello pasa por conocer las necesidades del paciente para luego marcar objetivos que el personal debe cumplir. Objetivo: Analizar la satisfacción del paciente en diálisis a partir de la producción científica existente. Material y Método: Se ha realizado una revisión integrativa mediante una búsqueda en las bases de datos Pubmed, Cuiden, Google académico y Medes. Se incluyeron artículos científicos originales y de revisión, en inglés y español, excluyendo aquellos artículos que no presentaban resultados o que no estuviesen en texto completo. Resultados: Se revisaron 17 artículos que se ajustaron a los criterios de selección. Los principales resultados encontrados se agruparon en los siguientes aspectos: factores determinantes en el nivel de satisfacción del paciente, herramientas de valoración de la satisfacción, rol de enfermería y áreas de mejora. Conclusiones: Los factores más influyentes en la satisfacción del paciente en diálisis son, principalmente, la confianza transmitida y disposición del personal sanitario, trato personalizado, amabilidad y seguridad transmitida, la destreza para puncionar, entre otros. Respecto a los instrumentos de medida, no existe un instrumento de medida específico, para evaluar la satisfacción del paciente en diálisis. Los atributos más satisfactorios que destacan en la enfermería, son amabilidad, disposición e interés, preparación técnica profesional, trato personalizado, confianza y seguridad clínica.
Diseño y validación de un nuevo registro clínico de enfermería, para la continuidad de los cuidados y seguridad del paciente en hemodiálisis
Authors: Cuevas Budhart Miguel Ángel , González Martínez Blanca Ruth , Álvarez Bolaños Elsa , Barrera García María Juana , Almeida Souza Alina de , Gómez del Pulgar García Mercedes , González Jurado Máximo A.
Published: April 2021

Introducción: Diseñar y Validar una herramienta para la mejora del proceso de atención en enfermería en una unidad de hemodiálisis de un hospital de segundo nivel. Material y Método: Se desarrolló un estudio de mejora de la calidad de la atención, en el Hospital General Regional nº 1 “Vicente Guerrero” en Guerrero, (México), entre mayo-agosto de 2017. Se modificó la hoja de registros clínicos de enfermería de la unidad de hemodiálisis en dos etapas. Para la etapa de diseño se realizó un grupo focal con expertos y para la validación de contenido se aplicó el método Delphi. Los datos recolectados se procesaron y analizaron en el programa estadístico SPSS V.22. Resultados: El 70% de los expertos consideró el instrumento como bueno en cuanto a la calidad del registro. Hubo una discrepancia en el diseño encontrándose como parcialmente eficiente (70%) ya que cada experto evaluó de acuerdo al área que dominaba. Se incorporaron todas las observaciones realizadas en el diseño final. Conclusión: El instrumento se considera válido, proporcionando información adecuada del paciente previo al tratamiento hemodialítico, lo cual satisface los requerimientos legales respecto a la continuidad de los cuidados.
Efecto del uso del humor en el bienestar, depresión y sentido del humor en pacientes en hemodiálisis
Authors: Mota de Sousa Luís Manuel , Antunes Ana Vanessa , Alves Marques-Vieira Cristina Maria , Lopes Silva Paulo César , Pedro Severino Sandy Silva , Guerreiro José Helena Maria
Published: April 2021

Objetivo: Evaluar si la visualización de películas de humor durante las sesiones de hemodiálisis mejora el bienestar subjetivo y el sentido del humor, al tiempo que disminuye los niveles de estrés / ansiedad y depresión, en pacientes con hemodiálisis. Material y Método: Se realizó un estudio pre-post intervención con un grupo de control no equivalente, en pacientes con enfermedad renal crónica en hemodiálisis, en dos unidades de hemodiálisis de Diaverum Clinics. El estudio incluyó a 34 pacientes en el grupo de intervención y 33 pacientes en el grupo de control. La intervención consistió en la visualización de películas de humor durante diez sesiones de hemodiálisis en un período de cuatro semanas. El grupo control vio películas neutrales. Los datos se recogieron mediante un cuestionario de información sociodemográfica y de salud (edad, sexo, nacionalidad, educación, ocupación, estado civil, duración de la sesión de diálisis, presencia de hipertensión y diabetes); la escala subjetiva de felicidad; la escala de satisfacción general con la vida; la escala de depresión, ansiedad y estrés (DASS-21) y la escala multidimensional de sentido del humor. Se emplearon pruebas t-Student y pruebas t para muestras pareadas. La respuesta al cambio se evaluó utilizando: el porcentaje de cambio, el efecto pico y el efecto base, el tamaño del efecto y la media de respuesta estandarizada. Resultados: Los niveles de felicidad subjetiva y de sentido del humor aumentaron en el grupo de intervención, pero no hubo aumento significativo en la satisfacción general con la vida. Solo los niveles de depresión disminuyeron significativamente en el grupo de intervención. Conclusiones: La visión de las películas de humor como una intervención de enfermería mejoró los niveles de felicidad subjetiva y de sentido del humor, al tiempo que disminuyó la percepción de los síntomas depresivos.
Eficacia de la creación de un programa de Escuela de pacientes en la detección de necesidades en pacientes con Poliquistosis Renal Autosómica Dominante
Authors: García-Llana Helena , Peces Serrano Ramón , Ruiz Álvarez Mª Paz , Santana Valeros María José , Castillo Plaza Ana Isabel , Parejo Fernández Carmen , Trocolí González Filomena , Julián-Mauro Juan Carlos , López Cuesta Emilio , Selgas Gutiérrez Rafael
Published: April 2021

Introducción: La Poliquistosis Renal Autosómica Dominante es una enfermedad renal crónica responsable del 10% de los casos de insuficiencia renal terminal. La participación y los grupos de apoyo entre iguales son herramientas que mejoran el bienestar, evitando complicaciones y retrasando el avance de la enfermedad. Objetivos: Detectar necesidades informativas, así como recursos de apoyo, en este grupo de pacientes mediante la puesta en marcha de una Escuela de Pacientes con poliquistosis renal autosómica dominante.
Material y Método: Se utilizó un diseño mixto (cuantitativo y cualitativo). El estudio se desarrolló mediante cuatro fases: 1) Grupo focal: pacientes con poliquistosis renal y sus cuidadores; 2) Selección de los pacientes expertos; 3) Elaboración de los contenidos del programa de la Escuela de pacientes con poliquitstosis renal autosómica dominante; 4) Pilotaje del programa.
Resultados: Se detectaron necesidades de información referentes al tratamiento oral y al afrontamiento de la poliquistosis renal que no están cubiertas por los equipos de nefrología. Conclusiones: La Escuela de Pacientes ha demostrado ser una herramienta útil para detectar necesidades y recursos en pacientes con poliquistosis renal autosómica dominante que han de enfrentarse a una enfermedad crónica donde se requiere la participación del paciente para garantizar la adhesión al tratamiento.
Trastornos del sueño en el paciente con enfermedad renal crónica avanzada
Authors: Serrano Navarro Irene , Mesa Abad Patricia , Tovar Muñoz Lucía , Crespo Montero Rodolfo
Published: April 2021

Objetivo: Conocer las alteraciones y/o trastornos del sueño en los pacientes con Enfermedad Renal Crónica Avanzada. Método: Se realizó una búsqueda en las bases de datos Google Académico, Scielo, Science Direct, PubMed y Scopus. Se incluyeron artículos científicos en español e inglés y texto completo disponible. Se analizaron aquellos artículos que trataban sobre alteraciones del sueño en los pacientes en prediálisis, y en tratamiento renal sustitutivo: Hemodiálisis, Diálisis Peritoneal y Trasplante Renal. Resultados: Se han incluido 30 artículos publicados entre los años 2013 y 2018. Los pacientes con Enfermedad Renal Crónica Avanzada presentan una alta prevalencia de alteraciones del sueño, llegando a alcanzar una prevalencia de casi el 90% en pacientes en hemodiálisis y diálisis peritoneal, y 62% en pacientes con trasplante renal; y entre el 44% y el 77% en la etapa prediálisis. Las alteraciones del sueño más frecuentes encontradas, fueron: insomnio, síndrome de piernas inquietas, apnea del sueño y somnolencia diurna excesiva. Como principales medidas y tratamientos utilizados para las alteraciones del sueño en estos pacientes se han encontrado terapias tanto farmacológicas, como no farmacológicas y la combinación de ambas. Conclusiones: Las alteraciones del sueño tienen una alta prevalencia en los pacientes con Enfermedad Renal Crónica Avanzada, tanto en prediálisis como en tratamiento renal sustitutivo; siendo las más frecuentes el insomnio, el síndrome de piernas inquietas, la apnea obstructiva del sueño y la somnolencia diurna excesiva. Entre los factores de riesgo más influyentes destacan: ansiedad y depresión, Diabetes Mellitus, hipertensión arterial, problemas respiratorios y tiempo en diálisis.
Asociación de estrategias de afrontamiento y calidad de vida relacionada con la salud en pacientes en diálisis peritoneal
Authors: Cabrera Delgado Ana Miriam , Rodríguez Zamora Mª Cristina , Ventura García María de Jesús , Santillán-Torres Torija Carolina , Amato Dante
Published: April 2021

Objetivo: Evaluar la relación entre estrategias de afrontamiento y calidad de vida relacionada con la salud en pacientes incidentes en diálisis peritoneal. Métodos: Estudio transversal en 106 pacientes incidentes en diálisis peritoneal, en cuatro centros de Ciudad de México. Se usaron los instrumentos Kidney Disease Quality of Life Short Form (KDQOL-SF36) y Coping Strategies Inventory para evaluar la calidad de vida relacionada con la salud y las estrategias de afrontamiento, respectivamente. Se evaluó la correlación de puntuaciones de estrategias de afrontamiento y calidad de vida. Se comparó la calidad de vida relacionada con la salud entre los pacientes con estrategia de afrontamiento activa y pasiva. Resultados: La estrategia de afrontamiento activa mostró correlación positiva con componentes físico y mental, efectos de la enfermedad renal y carga de la enfermedad renal del KDQOL-SF36, en tanto que el puntaje de estrategia pasiva correlacionó negativamente con componente mental y carga de la enfermedad renal en el KDQOL-SF36. Los puntajes de componentes físico y mental, efectos de enfermedad renal, carga de enfermedad renal y problemas por síntomas del KDQOL-SF36 fueron significativamente más altos en pacientes con estrategia de afrontamiento activa que en los que presentaron estrategia pasiva. Conclusiones: A partir de los resultados encontrados podemos concluir que los pacientes con estrategia de afrontamiento activa presentan mejor calidad de vida relacionada con la salud, tanto en las dimensiones del cuestionario específico de las alteraciones renales como en el genérico de calidad de vida, en comparación con los pacientes con estrategia de afrontamiento pasiva.
3B YAZICIDA ÜRETİLEN DÜZ DİŞLİ ÇARKLARIN RTV2 SİLİKONU KULLANILARAK ÇOĞALTILMASI
Authors: KARTAL Fuat , NAZLI Celal , YERLİKAYA Zekeriya , KAPTAN Arslan
Published: April 2021

Eklemeli üretim olarak da bilinen üç boyutlu yazdırma, bilgisayar kontrolü altında bir nesne oluşturmak için bir nesnenin ardışık katmanlarının oluşturulduğu üç boyutlu bir nesneyi sentezlemek için kullanılan süreçleri ifade eder. Nesneler neredeyse her şekil veya geometriyi oluşturabilir. Başka bir elektronik veri kaynağından veya 3B modelden dijital model verileri kullanılarak oluşturulur. Bu çalışmada, üç boyutlu yazıcıda üretilen düz dişli çarkların silikon kalıplama tekniği ile kalıbı alınarak oluşturulmuş bir kalıba epoksi dökülerek bir parçanın çoğaltılması işlemi yapılmıştır. Tüm parçaların boyutsal doğruluğu, Bilgisayar Destekli Tasarım verileri, üç boyutlu yapılan parçalar ve silikon kalıplar kullanılarak çoğaltılan parçalar için karşılaştırma yapılmıştır. Deneysel çalışmalar ile başarılı imalat işlemleri gerçekleştirilmiştir. Diş üstü çapının %2,5 diş dibi çapının %5 ölçü farklılığı ile imal edilebildiği belirlenmiştir. Ölçü toleranslarının ortalama %5’e kadar müsaade edildiği imalat işlemlerinde ve restorasyon çalışmalarında başarılı bir şekilde kullanılabileceği ortaya konulmuştur. Profesyonel makine-teçhizat ve personele ihtiyaç duymadan gerçekleştirilebilmesi, çok sayıda imalat ihtiyaçlarını karşılayabildiği gibi bir defa kullanılabilecek tamir işlemleri için de uygulanabilir en ucuz metot olduğu belirlenmiştir.
Effectiveness of the Strategic Planning and Academic Performance among the Public Secondary Schools in Babati District, Tanzania
Authors: Kwaslema Peter , Onyango Daniel
Published: April 2021

This study sought to establish teachers’ perception on the schools’ effectiveness in the development of the strategic plan, the perception of teachers on how the implementation of the strategic plan affects the academic performance and what should be done to ensure an effective strategic planning. The study used a mixed research approach while employing the convergent parallel design. The study population consisted of 2,844 stakeholders from 5 sampled schools whereby 185 respondents were drawn. The study concluded that there was effectiveness in the development of the Strategic Plan; the implementation of the strategic plan contributed to improved academic performance and various strategies were used by heads of schools to ensure that strategic plans were implemented. The study recommends that to be more effective in developing strategic plans, heads of schools should involve all stakeholders and hire experts to facilitate strategy formulations. Secondly, school heads should educate the school communities about benefits derived from effective implementation of strategic plans so that they can fully be committed to its implementation. Finally, school heads should come up with new strategies that will minimize resistance by school community members so as to speed up adoption as opposed to being pushed all the time by heads of schools in order for them to comply.