Reducing chronic medical complications due to failure of patient safety using Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) method

BACKGROUND: Human errors in the medical profession can lead to irreparable errors in people's lives, damage, and heavy costs. Among health care workers, nurses spend more time with patients compared to other personnel; hence, they are more prone to human error. Therefore, the purpose of this study was to identify and evaluate human errors using the Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) method in nursing staff of a general hospital in Qazvin Province, Iran.METHODS: This cross-sectional study was conducted in a general hospital in Qazvin during last 6 months of 2016 and first 6 months of 2017. The target population in the present study was nursing groups based on their highest work experience, from each section in hospital. The SPAR-H method was used to investigate human error in the population and the collected data were analyzed using SPSS software.RESULTS: The highest error related to inappropriate venipuncture with probability of 0.7, and the least probable error related to error in entering the numbers of vital signs with the probability of 0.0045.CONCLUSION: Due to the sensitivity of the role of nurses in hospitals, the need for increased workforce, the use of people with higher work experience in sensitive sectors, reducing overtime even for those who volunteered to work overtime, scientific scheduling of the personnel’s work shifts, and providing practical training such as stress control methods in case of emergencies can be effective in reducing the probability of an error

High-performance ceramics in musculoskeletal surgery : current use and future perspectives

Osteoarthritis (OA) is a prevalent disease among the elderly population, necessitating effective treatment options. Total joint arthroplasty (TJA) is a reliable surgical procedure that has shown good long-term clinical outcomes for OA. However, certain challenges, such as implant failure caused by particle-induced aseptic loosening or hypersensitivity to metal ions, remain unresolved in TJA. High-performance ceramic implants have emerged as a promising solution to address these persistent implant-related issues. This review article provides an overview of the composition and characteristics of ceramics used in TJA, highlighting their potential advantages and associated risks. While ceramic implants have demonstrated excellent performance in vivo for hip and knee arthroplasty, their bioinert behaviour is still considered a crucial factor regarding cementless options. Therefore, novel methods are investigated that seem to be able to combine the benefits of ceramic materials with an excellent osseointegration behaviour, which makes ceramics as implant materials an even stronger option for future applications

Effects of mobile learning on writing panoramic radiograph reports: a quasi-experimental trial in dental education

Abstract Background In dentistry, the reporting of panoramic radiographs is particularly challenging, as many structures are depicted in one image and pathologies need to be identified completely. To enhance the learning process for these interpretations, the advantages of the increasingly popular education method of mobile learning could be used. Therefore, this study aimed to determine the effectiveness of learning to report panoramic radiographs using an application (app) on a mobile device. Methods The existing e-learning programme ‘PantoDict’ was further developed into a mobile app with a new training section. Participants of a dental radiology course were divided into two groups, one of which additionally had the chance to practise reporting panoramic radiographs using the app. A test to assess the knowledge gained was conducted at the end of the semester; the course and the app were also evaluated. Results The group that used the app showed significantly better results in the test than the control group ( p  < 0.05). Although the app group approved a high satisfaction using the app as an additional supplement to the course, this did not result in a higher overall satisfaction with the course. Further, these students observed that the traditional face-to-face seminar could not be replaced by the app. Conclusion By using the PantoDict app, students were offered better training options for writing reports on panoramic radiographs, which resulted in significantly better test results than the results of the control group. Therefore, the mobile app is a useful supplement to classical education formats within the context of a blended learning approach

ВПЛИВ КОРПОРАТИВНОГО УПРАВЛІННЯ НА ЕКОНОМІЧНЕ ЗРОСТАННЯ

Проведено комплексний аналіз теоретичних та емпіричних досліджень взаємозв’язку між корпоративним управлінням та економічним зростанням. Визначено основні напрямки та фактори впливу корпоративного управління на економічне зростання через механізми підвищення економічної ефективності.; The article lights up complex analysis of theoretical and empirical researches of a correlation between corporate governance and economic growth. The main directions and factors of the corporate governance impact on the economic growth are defined through the mechanisms of increasing of economic efficiency

Microcirculation After Trochanteric Femur Fractures: A Prospective Cohort Study Using Non-invasive Laser-Doppler Spectrophotometry

Proximal femur fractures represent a major healthcare problem in the aging society. High rates of post-operative infections are linked to risk factors that seem to affect local microcirculation. Patterns and time courses of alterations in microcirculation have, however, not been previously investigated. The aim of this prospective cohort study was to evaluate perioperative changes in microcirculation after trochanteric femur fractures using non-invasive laser-Doppler spectrophotometry to analyze how oxygen saturation (SO2), hemoglobin content (Hb) and blood flow changed before and after surgery, and how these parameters were altered by implant type, gender, smoking, diabetes and age. Measurements were separately recorded for nine locations around the greater trochanter in 2, 8, and 15 mm depths, before surgery and 8, 24, 48 h, 4, 7, and 12 days after surgery in 48 patients. Three implants were compared: Dynamic Hip Screw, Gamma3 Nail, and Percutaneous Compression Plate. Surgery resulted in significant differences between the healthy and injured leg in SO2, Hb and flow. Each parameter showed comparable values for both legs prior to surgery. Significantly higher values in SO2 and flow were registered in women compared to men before and after surgery. Smoking caused significant increases in SO2, Hb, and flow only in the superficial layer of the skin after surgery. Diabetes decreased blood flow at 2 and 8 mm depth and increased SO2 at 8 and 15 mm depth after surgery. Age revealed a significant negative correlation with flow. The ability to increase the flow rate after surgery decreased with age. Comparison of implants indicated the minimally invasive implant PCCP altered microcirculation less than the DHS or the Gamma3 nail. Overall, the proximal femur fracture alone did not alter local skin microcirculation significantly in a way comparable to the effect caused by surgery. In conclusion, microcirculation after proximal femur fractures is highly affected by surgery, gender, smoking, diabetes, age and implant in ways specified in this study

Adjuvant Radiotherapy in Patients with Squamous Cell Carcinoma of the Oral Cavity or Oropharynx and Solitary Ipsilateral Lymph Node Metastasis (pN1) : A Prospective Multicentric Cohort Study

(1) Background: Evaluation of impact of adjuvant radiation therapy (RT) in patients with oral squamous cell carcinoma of the oral cavity/oropharynx (OSCC) of up to 4 cm (pT1/pT2) and solitary ipsilateral lymph node metastasis (pN1). A non-irradiated group with clinical follow-up was chosen for control, and survival and quality of life (QL) were compared; (2) Methods: This prospective multicentric comprehensive cohort study included patients with resected OSCC (pT1/pT2, pN1, and cM0) who were allocated into adjuvant radiation therapy (RT) or observation. The primary endpoint was overall survival. Secondary endpoints were progression-free survival and QL after surgery; (3) Results: Out of 27 centers, 209 patients were enrolled with a median follow-up of 3.4 years. An amount of 137 patients were in the observation arm, and 72 received adjuvant irradiation. Overall survival did not differ between groups (hazard ratio (HR) 0.98 [0.55–1.73], p = 0.94). There were fewer neck metastases (HR 0.34 [0.15–0.77]; p = 0.01), as well as fewer local recurrences (HR 0.41 [0.19–0.89]; p = 0.02) under adjuvant RT. For QL, irradiated patients showed higher values for the symptom scale pain after 0.5, two, and three years (all p < 0.05). After six months and three years, irradiated patients reported higher symptom burdens (impaired swallowing, speech, as well as teeth-related problems (all p < 0.05)). Patients in the RT group had significantly more problems with mouth opening after six months, one, and two years (p < 0.05); (4) Conclusions: Adjuvant RT in patients with early SCC of the oral cavity and oropharynx does not seem to influence overall survival, but it positively affects progression-free survival. However, irradiated patients report a significantly decreased QL up to three years after therapy compared to the observation group

CD8+ T Cells as a Source of IFN-γ Production in Human Cutaneous Leishmaniasis

Cutaneous leishmaniasis (CL) is usually a self-healing skin lesion caused by different species of Leishmania parasite. Resistance and susceptibility of mice to Leishmania major infection is associated with two types of CD4+ T lymphocytes development: Th1 type response with production of cytokine IFN-γ is associated with resistance, whereas Th2 type response with production of cytokines IL-4 and IL-5 is associated with susceptibility. A clear Th1/Th2 dichotomy similar to murine model is not defined in human leishmaniasis and we need as much information as possible to define marker(s) of protection. We purified CD4+/CD8+ T cells, stimulated them with Leishmania antigens and analysed gene and protein expression of Th1/Th2 cytokines in volunteers with a history of self-healing CL who are presumed to be protected against further Leishmania infection. We have seen significant upregulation of IFN-γ gene expression and high IFN-γ production in the Leishmania stimulated CD4+ T cells and CD8+ T cells. We concluded that both antigen-specific IFN-γ producing CD4+ Th1 cells and IFN-γ producing CD8+ T cells contribute to the long term protection in individuals with a history of CL. This proves the importance of CD8+ T cells as a source of IFN-γ in Th1-like immune responses