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PubMed2003

Exploring willingness and related factors by using the healthcare report cards for hospitals in Taiwan.

BACKGROUND: During the past decade, there has been growing a trend to develop and disseminate report cards to the public in the healthcare industries of the United States. The purposes of this article were to understand the willingness of hospitals in Taiwan to use report cards and to explore the factors that influence the willingness of hospitals to use them. METHODS: A postal survey study was conducted on 495 hospitals to explore factors influencing the willingness of hospitals to use report cards. A multiple logistic regression was performed to identify statistically significant factors related to the willingness of the hospitals to use report cards. RESULTS: In total, 52.0% of the sampled hospitals were "very willing" or "willing" to use report cards. The top three factors which respondents felt most influenced the willingness of hospitals to use report cards were the provision for incorrect data, the upgrading of the image of the hospital, and the increase in administrative costs. Multiple logistic regression analysis revealed that the willingness of hospitals to use report cards was positively significantly associated with the score of the factor "to upgrade the image of the hospital" (OR = 8.0; 95% CI 1.8-36.0), and it was negatively associated with the score of the factor "to increase the possibility of malpractice suits" (OR = 0.5; 95% CI 0.2-0.9). CONCLUSIONS: It was also found that more than half of hospitals were willing to use report cards. Thus, it is recommended that mandatory hospital report cards be initiated in order to allow consumers to make fair and accurate comparisons among hospitals.

Delivery of Health Care↗

PubMed2002

[Continuous determination of Cu, Cr, Co, Ni, Pb, Cd of geo-chemical exploration samples by HG-AAS].

The method of analysis to the determination of Cu, Cr, Co, Ni, Pb, Cd in the phase analysis of geo-chemical exploration samples by the HG-AAS has been introduced. In recent years, the workers of geo-chemical exploration are more interested in technology of phase analysis with the development of search for mineral in geology. In phase analysis, contents of the same element with different phase are largely differ so that it brings difficulties for extracting, preparation and determination of the solution. In addition, the exist of many-common elements, especially Ca, Mg, Mn, Fe, are very easy to bring effects. But the contents of Cu, Cr, Co, Ni, Pb, Cd in the analysis solution of water-extractable phase and ion phase, are low and difficult to determination. During the extracting of the phase, to carry out parallel samples analysis, one sample will prepare eight solution at least and large work. So it is necessary to search for a simple and quickly liable method of analysis. On determination, using phosphoric acid as matrix modifier, it not only eliminated the effect of matrix, but also improved the precision of all kinds of elements.

English Abstract↗

PubMed2003

The Chameleon Suit--a liberated future for space explorers.

Mankind's spacefaring future demands the ability to work freely and frequently in space. Traditional spacesuit systems burden both the spacefarer and the mission, limiting the extent to which this is possible. The spacefarer is burdened by a pressure suit designed for isolation from the environment and a life support system designed to replace everything our environment normally provides. The space mission is burdened by this equipment and the expendable materials to operate and maintain it. We aren't free to work in space as frequently, as long, or in all of the locations envisioned. The NASA Institute for Advanced Concepts (NIAC) has sponsored research on an alternative concept, the "Chameleon Suit", that seeks to liberate future explorers and missions from these limitations. The Chameleon Suit system works with the environment in an adaptive fashion to minimize hardware and expendable materials. To achieve this, functions of the life support system are integrated with the pressure suit using emerging materials and design technology. Technologies under study include shape change polymers and electroemissive materials to modify heat transfer characteristics of the spacesuit "skin" achieving thermoregulation analogous to that in natural biological systems. This approach was shown to be feasible for many space missions during the Phase 1 study program. The current Phase 2 program is investigating more aggressive concepts aimed at eliminating most of the hardware currently included in the spacesuit's life support backpack. This paper describes the concept, study results to date, and possible impacts on future human space exploration.

Biomimetic Materials↗

PubMed1992

[Comparative results of flowmeter studies before and after urodynamic exploration].

Results of flowmeter studies in 145 patients before and then immediately after urodynamic exploration were unchanged in 80% of women and 72% of men. Abnormal results on flowmetric examination, detected in 18% of cases prior to urodynamic studies, were assessed as normal during follow-up urodynamic tests. These findings raise the question of the validity of flowmeter parameters determined during urethrocystometric exploration.

Adolescent↗

PubMed2003

[Exploration of olfactory difficulties].

Sense-of-smell disorders are a frequent occurrence at ORL clinics. The clinical exploration must include a thorough and comprehensive interview to discover the etiology. The clinical examination is easily performed using cold-light endoscopes, which can reveal anatomical or mucous membrane pathologies, even in far- situated anatomical parts. The access to olfactometric examinations is limited by the small number of health centers which have the proper equipment and trained staff. Guided by the initial interview and clinical exploration, the diagnosis of smell disorder can benefit from the conclusive and factual contribution of the CAT scan and MRI.

Diagnostic Imaging↗

PubMed1992

[Surgical exploration for renal cyst: two-case report].

A 59-year-old male was admitted to our clinic for further examination of the calcified renal cyst discovered incidentally on medical workup elsewhere. CT showed a left renal cyst associated with calcification. Ultrasound-guided puncture of the renal cyst was not successful because of thickness of the cystic wall. Renal angiography showed hypervascularity of the cystic wall. Association of renal cell carcinoma could not be ruled out, therefore the exploration was performed. Histological examination revealed benign renal cyst with calcification. A 27-year-old male presented with the chief complaint of left flank pain. Following examinations by US, CT and MRI, a renal cyst associated with renal cell carcinoma was highly suspected. Subsequent exploration revealed cluster of cysts with a yellowish lesion a few mm in diameter. Frozen section revealed no malignancy, and cystic fluid was not hemorrhagic. Therefore as many cystic walls as possible were removed without nephrectomy. Histological examination of the permanent specimen revealed renal cell carcinoma. Renal cyst associated with renal cell carcinoma was regarded as rare clinical entity, but such cases are reported in increasing number in recent years. We report such cases and review the pertinent literature in this paper.

Adult↗

PubMed2004

[Exploration of multigene, multistep and multipathway model of nasopharyngeal and colorectal carcinogenesis].

OBJECTIVE: To construct tree models for nasopharyngeal carcinoma (NPC)and explore the oncogenesis process of NPC. METHODS: Based on the software which Desper et al developed, tree models were constructed for colorectal carcinoma (CC) from the comparative genomic hybridization (CGH) data of 118 CC patients and for NPC from the CGH data of 140 southern Chinese patients, respectively. RESULTS: Tree models for CC suggested that changes in -18q and +20q were important early events in colorectal carcinogenesis. As changes in -18q occurred prior to those in -17p, there might be some cause-effect relationship. Tree models for NPC suggested that change in -3p was an important early event in nasopharyngeal carcinogenesis, and those in -11q, -14q, -16q, -9p were also non-random genetic events in carcinogenesis, suggesting that there might be tumor-associated genes existing on these chromosome arms. The tree model also suggested the existence of oncogene on the short arm of chromosome 12. CONCLUSION: Constructing tree models based on the CGH data to demonstrate the initiation and progression of NPC might help elucidate its multigene, multistep and multipathway development. It may provide valuable clues to explore the mechanism of tumorigenesis.

Chromosome Aberrations↗

PubMed2004

[Laparoscopic exploration of the common bile duct].

Since the first laparoscopic common bile duct exploration in Hungary published in 1999 the authors use the technique themselves. We review and analyse our activity between 1 June 1999 and 31 August 2003. The minimally invasive approach was selected in twelve patients with obstructive jaundice for suspected bile duct stones. Eight of these patients underwent preoperative endoscopy, but either the number and/or size of stones or various complications prevented successful endoscopic stone extraction; five sphincterotomies--two followed by stenting--were performed. The four other patients did not consent to endoscopy. During surgery the biliary tract was visualised by choledochoscope (a bile duct endoscope with video connection) in four cases via the distended cystic duct and in eight cases via longitudinal choledochotomy. In one case there was no occlusion at all, in another one dilatation was performed because of a structure. In nine patients stones were removed either through the choledochotomy/cystic duct or by passing them into the duodenum. In one patient we converted to open procedure due to a stone impacted in the papilla of Vater. After choledochotomy intracorporal suturing and knot tying techniques were used to close the incision. On six occasions a cystic drain, three occasions a T-tube and on three occasions primary closure was used. Two bile leaks were treated by endoscopic stenting and in one patient a laparotomy was needed. There was no mortality. We believe that laparoscopic common bile duct exploration can be successful even in complicated situations.

Adult↗

PubMed2004

[EEG and video-EEG explorations in refractory partial epilepsy].

The assessment of drug -resistant partial epilepsy by electrophysiological explorations (based on non-invasive EEG) involves two types of analysis: the study of the seizures, primarily by video-EEG exploration, and the study of interictal activities based on visual analysis, and in some centers on techniques of source localization (high resolution EEG and magnetoencephalography, MEG). Seizure recording can be used to confirm the focal nature and the epileptic origin of the seizure as well as other features such as severity (secondary generalization, frequency, falls etc.). In the pre-surgical approach, the video-EEG recordings enable study of the electro-clinical correlations and allow assumptions on the anatomical localization of the epileptogenic zone. Precise analysis of the localization of the interictal activities (especially within the framework of extra-temporal epilepsies) based on source localization methods, makes it possible to put forth assumptions on the localization of the irritative zone.

Anticonvulsants↗

PubMed2004

Gathering, structuring and describing information needs in home care: a method for requirements exploration in a "gray area".

The aim of our research is to develop a method for "requirements exploration"--gathering, structuring and describing requirements for information systems in previously weakly understood areas. In health care, information systems are usually developed for a single organization, or for information flow from one organization to another. In our case domain, multi-professional and multi-organizational home care, this approach is not very helpful. Moreover, home care takes place in "no-man's-land"; outside the organizations' infrastructure, in the customer's home, and technology is used scarcely. In this paper, we describe how information requirements were explored in this scantly understood domain by using an activity-theoretical approach. We also explain how this approach served our purposes. The method proved useful in grasping the network of activities and the information needs. The holistic nature of the method was particularly important, since technology is not the only solution to the needs we discovered.

Finland↗

PubMed2004

An exploration of the views of people with leprosy in Nepal concerning the quality of leprosy services and their impact on adherence behaviour.

Based on a qualitative interview study conducted in eastern Nepal, this paper explores the quality of services received by people with leprosy and the impact of quality of services received on adherence behaviour. The study found that a person's status within the family and community influenced the quality of care, which in turn affected adherence to treatment. Five major types of deficiency in the quality of care experienced were identified, particularly by the poor people and by women. These were the attitude and behaviour of the health worker, the practitioner-centeredness of the care and lack of information sharing, the organization of the health services, barriers in accessibility of the leprosy services, and lack of, or carelessness in, patient referral. This paper explores these types of deficiencies and the way people affected by leprosy cope with them. People of a higher status had access to enabling factors which allowed them to continue treatment, people of a lower status had to endure many disadvantages which had a great influence on their adherence behaviour.

Adaptation, Psychological↗

PubMed1976

Anatomico-physiological considerations in exploration of the fourth ventricle.

The advancement of surgical techniques has enabled the neurosurgeon to undertake a continually more aggressive approach toward lesions within the fourth ventricle. Laboratory and clinical observations have enabled us to conclude that (1) exploration of the fourth ventricle is feasible without anatomical disruption of the vermis, (2) controlled ventilation during such explorations is physiologically most desirable, and (3) irrigation of neural structures must consider acid-base and ionic parameters in order to maintain physiologic stability.

Adolescent↗

PubMed2004

[Preliminary exploration on the medical literature in "The 17th volume of great canon of Yongle newly discovered overseas"].

During our exploration on the history of compilation, spread, reprinting of Yong le da dian (Great Canon of Yongle) and the analysis made on the materials of medicine; history of medicine, and medical literature in the "17th Volume of Great Canon of Yongle Newly Discovered Overseas", we found that there are materials cited over 10 kinds of literature of the Song, Jin, and Yuan dynasties and other fragmentary materials. The academic value of the materials include; for the proofreading and collation of available extant medical literature; for the supplement of lost medical books or remained medical books; for the exploration of new medical historical materials; and for the correction of errors in modern tool books in TCM.

China↗

PubMed2004

An exploration of the relationships between health promotion practices, health work, and felt stigma in families headed by adolescent mothers.

The purpose of this study was to examine the relationship between stigma and health promotion in families with preschool children headed by adolescent mothers, by: (a) testing hypotheses derived from the Developmental Model of Health and Nursing, and (b) descriptively exploring the experience of stigma in a community sample of 63 adolescent mothers in southwestern Ontario, Canada. The mothers verbally responded to established measures of felt stigma, family health work, healthy lifestyle practices, and a demographic questionnaire during a structured interview. Then their experiences of stigma were explored during a brief dialogic interview. Consistent with the theory, a moderate positive relationship was observed between family health work and mothers' healthy lifestyle (r = .52, p < .001). Felt stigma was not related to either health work or global healthy lifestyle. Stigma did not appear to affect family health promotion efforts directly but influenced other aspects of the participants' lives in both positive and negative ways. Implications for practice and future research are identified.

Adolescent↗

PubMed2001

[Ammonia-gas poisoning: respiratory troubles evaluated by functional exploration].

The objective of our research is first to evaluate the defects in the respiratory function which have been noticed among patients suffering from ammonia poisoning during the accident at the SONACOS factory of Dakar in 1992. Secondly it is to set precisely the seriousness of the problem. This retrospective study is carried out on 50 patients examined at the Physiology and Functional Exploration Laboratory of the faculty of Medicine of Dakar University from March 1993 to October 1995. These patients have been submitted to at least two respiratory functional explorations. Ten of them have been treated for two years, thus benefiting from a spirographic control of these respiratory troubles already noticed. 58 % of the patients have developed an obstruction syndrome with the following specifities : fourteen patients out of 29 revealed a serious stoppage of the bronchi, twelve had a moderate bronchial obstruction, and three showed a minor bronchial obstruction. Besides, 34 % of the patients have developed a mixed syndrome with a minor restrictive component and a severe obstructive component. 8 % of the poisoned have presented a normal lung function testing. About the localisation of the respiration disorders at the level of the bronchial system, 61 % of the patients have shown an obstruction of the proximal, medial and distal bronchi. 26 % have presented obstruction of the distal bronchi, 13 % have shown an attack at their medial and distal bronchi. 5 patients out of 10 have shown any modification in their respiratory troubles while 3 of 10 have shown significant improvement. Then 2 out of 10 have shown degradation in their respiratory problems with an extension of bronchial obstruction. The ammonia poisoning has caused serious respiratory disorders related to the general and local toxic action of ammonia on the respiratory tract, its retention at their level and its effects on the respiratory function. The severity of the patent injuries incites to issue recommendations concerning the prevention of ammonia poisoning and the quick and efficient taking charge of the casualties in case of any accidental intoxication.

Adolescent↗

PubMed2005

Exploration of health-related quality of life areas that may distinguish between continent diversion and ileal conduit patients.

OBJECTIVES: We explored the specific impact of urinary diversion type on HRQOL in men after cystectomy for bladder cancer. Our intent was to provide a basis for the development of a diversion-specific instrument. METHODS: We invited 13 ileal conduit and 12 orthotopic urinary diversion (neo-bladder) male patients to several open-ended interviews. We explored HRQOL domains that may have been affected by cystectomy and urinary diversion, and that could then be used to form a basis for a diversion-specific HRQOL measure. RESULTS: The average age of neo-bladder patients was 59 versus 65 years for ileal conduit patients. We identified 10 HRQOL domains, ranging from involuntary urine leakage to dietary modifications, which were recognized as important by ileal conduit and neobladder patients. Within each domain, a sufficient amount of overlap existed to allow developing a measure that might be applied to both groups of patients. CONCLUSIONS: Ten HRQOL domains were identified as important by ileal conduit and neobladder patients. These demonstrated a significant amount of overlap between conduit and neobladder patients. Potentially, these domains could be used to develop scales for distinguishing between conduit and neobladder-specific HRQOL detriments.

Aged↗

PubMedDate not supplied

[Testicular torsion--a diagnostic dilemma. Diagnosis confirmed by exploration in only 9 per cent of cases, color ultrasound more accurate].

The diagnosis was confirmed in only 9% of 170 patients surgically explored for suspected testicular torsion over a period of 2 years at four Swedish hospitals. In only every second case of testicular torsion was it considered meaningful to leave the testicle in situ. The high number of explorations, where the preoperative suspicion could not be verified, suggests that the preoperative diagnostic work-up should be improved. The use of power or colour ultrasound is suggested as a way of achieving this.

Adolescent↗

PubMed2003

An exploration of the role that expert knowledge plays in the assessment of undergraduate clinical competence: registered nurses' experiences.

INTRODUCTION: This phenomenological study, conducted in rural Australia, explored the experiences of registered nurses (RNs) responsible for assessing the clinical competence of undergraduate nursing students. The purpose of the study was to gain insight into the experiences of a group of registered nurses who assess student competence by exploring how they perform the assessment process. A key assumption on which this study was based is that the participants are 'expert nurses', as defined by Benner. METHOD: Participants were recruited using purposive sampling from a population of registered nurses who assessed the clinical performance of undergraduate nursing students studying at a rural university in New South Wales, Australia. Individual unstructured interviews were conducted and audiotaped with the participants' permission. The analysed data were given to all participants to check for accuracy and validation and a thematic analysis of the data was conducted. RESULTS: Four themes were identified; the major theme, described in this article, was identified in all the narratives. The participants all acknowledged that they use their expert nursing knowledge to assist them when assessing the clinical competence of nursing students. The participants used a variety of terms to describe this type of knowledge such as intuition, instinct, gut feeling and 'just knowing'. CONCLUSION: While the findings of this study confirmed that experienced nurses unconsciously use their expert nursing knowledge when making decisions about students' competence, the findings also indicated a lack of awareness or underestimation of the value of expert clinical knowledge. These findings reinforce the need for further investigation to determine the role of expert nursing knowledge in the clinical competency assessment process. This is particularly significant for rural registered nurses employed in small health-care facilities, who often assume the role of assessors of student clinical competence.

Journal Article↗