Scholarly

Investigation of the Medical Malpractice Tendency of Student Nurses

Year: 2019 Volume: 13 Issue: 8 408 - 413 Pages

Abstract: Introduction: Medical malpractice can be defined as health workers neglecting the expected standard or intentionally not implementing it, doing it wrong and/or incomplete, not being able to implement the accurate practice due to personal or systemic reasons despite desiring to do it correctly and the condition that causes permanent or temporary damage to the patient as a result. If the training periods in which health workers improve their knowledge and skills are passed efficiently, they are expected to have a low rate of error in their professional lives. Aim: Aim of the study is to determine the medical malpractice tendencies of students studying in nursing department. Material and Methods: This descriptive research has been performed with 454 students who study in 3rd and 4th years in the Nursing Department of the Faculty of Health Sciences in a state university in normal and evening education and go out for clinical practice during the 2017-2018 academic year. The sample consisted of 454 students who agreed to participate in the study. Ethics committee approval, the permission of the institution and the verbal consent of the participants were obtained. In collection of data, ‘Personal Information Form’ developed by the researchers and the Malpractice Tendency Scale (SMT) were used. The data were analyzed using SPSS 20 package program. 0.05 was used as the level of significance. Results: The Cronbach’s alpha internal consistency coefficient of the scale was 0.94 and the total mean value of the scale was 211.69 ± 22.14. The mean age of the participants was 22,08 ± 1,852 years; 165 (36,4%) were male and 288 (63,6%) were female. Their mean General Point Average (GPA) was 2.65 ± 0.454 (min 1.03 - max 3.90). Students' average duration of self study per week was 2.89 ± 3.81 (min 0 - max 30) hours. The mean score (80.73) of the 4th year students in the sub-dimension of Drug and Transfusion Applications was significantly higher than the mean score (79.20) of 3rd year students (p < 0.05). The mean score (81.01) of the Drug and Transfusion Applications sub-dimension of those who willingly chose the profession was higher than the mean score (78.88) of those who chose the profession unwillingly. The mean average score (21.48) of Fallings sub-dimension of students who cared for 3 to 4 patients per day was lower than the mean score (22.41) of those who cared for 5 patients and over daily on average (p < 0.05). Conclusion: As a result of this study, it was concluded that malpractice tendency of nursing students was low, and an inverse relationship was found between the duration of education and malpractice tendency.

Sustainability of Healthcare Insurance in India: A Review of Health Insurance Scheme Launched by States in India

Year: 2019 Volume: 13 Issue: 8 402 - 407 Pages

Abstract: This paper presents an overview of the accessibility, design, and functioning of health insurance plans launched by state governments in India. In recent years, the governments of several states in India have come forward to provide health insurance coverage for the low-income group and rural population to reduce the out of pocket expenditure (OPE) on healthcare. Different health insurance schemes have different structures and offerings which differ in the different demographic factors. This study will portray a comparative analysis of the various health insurance schemes by analyzing different offerings and finance generation of the schemes. The comparative analysis will explain the lesson to be learned from these schemes and extend the existing knowledge of the health insurance in India. This would help in recognizing tension between various drivers and identifying issues pertaining to the sustainability of health insurance schemes in India.

Active Imagination: The Effective Factor in the Practice of Psychotherapy

Year: 2019 Volume: 13 Issue: 8 396 - 401 Pages

Authors:
Sonia Regina Lyra

Abstract: The desire for unequivocal clarity is understandable, but this can make one forget that things of the soul are experiential processes, or transformations, which should never be designated unilaterally if it is not wanted to transform something that moves, a living thing, into something static. Among the so-called ‘things of the soul’ there are especially spontaneous fantasies, that emerge during the processes, as a result from the use of the active imagination technique, for when fantasy is not forced, violated, or subjugated by an illegitimate, intellectually preconceived idea, then it is a legitimate and authentic product of the unconscious mind. This is how one can gain access to unadulterated information about everything that transcends the conscious mind. However, it is vital to discern between ego and non-ego, because this principle will result in a release of energy and a renewal of life, which will come to have meaning. This study will deal with the active imagination as a knowledge that depends on the individual experience of the therapist because the patient will be taken just to reach where the unconscious of the therapist was assimilated to his own conscience. In this way, the therapist becomes the method itself, being his personality, a fundamental part of an effective factor.

Clinical Utility of Salivary Cytokines for Children with Attention Deficit Hyperactivity Disorder

Year: 2019 Volume: 13 Issue: 8 392 - 395 Pages

Abstract: The goal of this study was to examine the possibility of salivary cytokines for the screening of attention deficit hyperactivity disorder (ADHD) in children. We carried out a case-control study, including 19 children with ADHD and 17 healthy children (controls). A multiplex bead array immunoassay was used to conduct a multi-analysis of 27 different salivary cytokines. Six salivary cytokines (interleukin (IL)-1β, IL-8, IL12p70, granulocyte colony-stimulating factor (G-CSF), interferon gamma (IFN-γ), and vascular endothelial growth factor (VEGF)) were significantly associated with the presence of ADHD (p < 0.05). An informative salivary cytokine panel was developed using VEGF by logistic regression analysis (odds ratio: 0.251). Receiver operating characteristic analysis revealed that assessment of a panel using VEGF showed “good” capability for discriminating between ADHD patients and controls (area under the curve: 0.778). ADHD has been hypothesized to be associated with reduced cerebral blood flow in the frontal cortex, due to reduced VEGF levels. Our study highlights the possibility of utilizing differential salivary cytokine levels for point-of-care testing (POCT) of biomarkers in children with ADHD.

Keywords:
Cytokine
saliva
attention deficit hyperactivity disorder
child
biomarker.

Evaluation of the Role of Advocacy and the Quality of Care in Reducing Health Inequalities for People with Autism, Intellectual and Developmental Disabilities at Sheffield Teaching Hospitals

Year: 2019 Volume: 13 Issue: 8 383 - 391 Pages

Abstract: Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Association of Smoking with Chest Radiographic and Lung Function Findings in Retired Bauxite Mining Workers

Year: 2019 Volume: 13 Issue: 8 379 - 382 Pages

Abstract: Inhalation hazards are associated with potentially injurious exposure and increased risk for lung diseases, within the bauxite mining industry, especially for the smelter workers. Smoking is related to decreased lung function and leads to chronic lung diseases. This study had the objective to evaluate whether smoking is related to functional and radiographic respiratory changes in retired bauxite mining workers. Methods: This was a retrospective and cross-sectional study involving the analysis of database information of 140 retired bauxite mining workers from Poços de Caldas-MG evaluated at Worker’s Health Reference Center and at the Social Security Brazilian National Institute, from July 1st, 2015 until June 30th, 2016. The workers were divided into three groups: non-smokers (n = 47), ex-smokers (n = 46), and smokers (n = 47). The data included: age, gender, spirometry results, and the presence or not of pulmonary pleural and/or parenchymal changes in chest radiographs. Chi-Squared test was used (p < 0,05). Results: In the smokers’ group, 83% of spirometry tests and 64% of chest x-rays were altered. In the non-smokers’ group, 19% of spirometry tests and 13% of chest x-rays were altered. In the ex-smokers’ group, 35% of spirometry tests and 30% of chest x-rays were altered. Most of the results were statistically significant. Results demonstrated a significant difference between smokers’ and non-smokers’ groups in regard to spirometric and radiographic pulmonary alterations. Ex-smokers’ and non-smokers’ group demonstrated better results when compared to the smokers’ group in relation to altered spirometry and radiograph findings. These data may contribute to planning strategies to enhance smoking cessation programs within the bauxite mining industry.

From Electroencephalogram to Epileptic Seizures Detection by Using Artificial Neural Networks

Year: 2019 Volume: 13 Issue: 8 372 - 378 Pages

Abstract: Seizure is the main factor that affects the quality of life of epileptic patients. The diagnosis of epilepsy, and hence the identification of epileptogenic zone, is commonly made by using continuous Electroencephalogram (EEG) signal monitoring. Seizure identification on EEG signals is made manually by epileptologists and this process is usually very long and error prone. The aim of this paper is to describe an automated method able to detect seizures in EEG signals, using knowledge discovery in database process and data mining methods and algorithms, which can support physicians during the seizure detection process. Our detection method is based on Artificial Neural Network classifier, trained by applying the multilayer perceptron algorithm, and by using a software application, called Training Builder that has been developed for the massive extraction of features from EEG signals. This tool is able to cover all the data preparation steps ranging from signal processing to data analysis techniques, including the sliding window paradigm, the dimensionality reduction algorithms, information theory, and feature selection measures. The final model shows excellent performances, reaching an accuracy of over 99% during tests on data of a single patient retrieved from a publicly available EEG dataset.

International Journal of Medical, Medicine and Health Sciences

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