A Survey Study Evaluating and Comparing the Health Literacy Knowledge and Communication Skills Used by Nurses and Physicians

Health literacy (HL) is considered as an interaction between the demands of health systems and the skills of individuals. The current global approach demands health professionals to be more accountable for universal precautions approach and improve communication skills, and employ strategies to confirm patients' understanding. The aim of this study is to assess the knowledge and attitude of health care professionals (HCPs) about HL and their communication skills, and its effect on their practices, and to compare the findings among subgroups of HCPs. An online cross-sectional survey involving 29 items was developed for sociodemographic and professional characteristics and knowledge, attitude, and practices evaluation. Health care professionals reached by occupational organizations and social media platforms. Among the 277 participants that answered the questions, 184 were physicians and 78 were nurses, and 37.99% of physicians and 18.42% nurses heard about the term "HL" through this survey. Most of the participants stated their willingness to receive information/training on the subject and that knowing HL level would change their approach to and outcomes of the patients. Nurses were using a variety of methods that improve communication with patients and considered HCPs' lack of knowledge of the concept of "HL" and their neglect of HL as obstacles to its evaluation more than physicians. These results emphasize the urgent need of initiatives to be taken to improve the awareness of HCPs of HL and the subsequent incorporation of these initiatives into the daily health care services they provide. Nurses' awareness of HL is higher and they are already better at incorporating HL-sensitive items into their practices. Both graduate and continuing education programs need to be modified to improve HL knowledge of all HCPs and its positive effects on health care. The current structure of the roles and responsibilities of these professions needs to be improved to make it more HL sensitive

Identifiability Evaluation of Crucial Parameters for Grid Connected Photovoltaic Power Plants Design Optimization

This paper aims to assess the impact of different key factors on the optimized design and performance of grid connected photovoltaic (PV) power plants, as such key factors can lead to re-design the PV plant and affect its optimum performance. The impact on the optimized design and performance of the PV plant is achieved by considering each factor individually. A comprehensive analysis is conducted on nine factors such as; three objectives are predefined, five recent optimization approaches, three different locations around the world, changes in solar irradiance, ambient temperature, and wind speed levels, variation in the available area, PV module type and inverters size. The performance of the PV plant is evaluated for each factor based on five performance parameters such as; energy yield, sizing ratio, performance ratio, ground cover ratio, and energy losses. The results show that the geographic location, a change in meteorological conditions levels, and an increase or decrease in the available area require the re-design of the PV plant. A change in inverter size and PV module type has a significant impact on the configuration of the PV plant leading to an increase in the cost of energy. The predefined objectives and proposed optimization methods can affect the PV plant design by producing completely different structures. Furthermore, most PV plant performance parameters are significantly changed due to the variation of these factors. The results also show the environmental benefit of the PV plant and the great potential to avoid green-house gas emissions from the atmosphere

Prevalence of inflammatory bowel disease among coeliac disease patients in a Hungarian coeliac centre

BACKGROUND: Celiac disease, Crohn disease and ulcerative colitis are inflammatory disorders of the gastrointestinal tract with some common genetic, immunological and environmental factors involved in their pathogenesis. Several research shown that patients with celiac disease have increased risk of developing inflammatory bowel disease when compared with that of the general population. The aim of this study is to determine the prevalence of inflammatory bowel disease in our celiac patient cohort over a 15-year-long study period. METHODS: To diagnose celiac disease, serological tests were used, and duodenal biopsy samples were taken to determine the degree of mucosal injury. To set up the diagnosis of inflammatory bowel disease, clinical parameters, imaging techniques, colonoscopy histology were applied. DEXA for measuring bone mineral density was performed on every patient. RESULTS: In our material, 8/245 (3,2 %) coeliac disease patients presented inflammatory bowel disease (four males, mean age 37, range 22-67), 6/8 Crohn's disease, and 2/8 ulcerative colitis. In 7/8 patients the diagnosis of coeliac disease was made first and inflammatory bowel disease was identified during follow-up. The average time period during the set-up of the two diagnosis was 10,7 years. Coeliac disease serology was positive in all cases. The distribution of histology results according to Marsh classification: 1/8 M1, 2/8 M2, 3/8 M3a, 2/8 M3b. The distribution according to the Montreal classification: 4/6 Crohn's disease patients are B1, 2/6 Crohn's disease patients are B2, 2/2 ulcerative colitis patients are S2. Normal bone mineral density was detected in 2/8 case, osteopenia in 4/8 and osteoporosis in 2/8 patients. CONCLUSIONS: Within our cohort of patients with coeliac disease, inflammatory bowel disease was significantly more common (3,2 %) than in the general population

Bullous myringitis: A cause of hearing loss

Bullous myringitis is defined by the presence of blisters on the tympanic membrane which has generally a severe otalgia as a first symptom of presentation. This clinical picture sometimes may be accompanied by sensori-neural hearing loss. In this study, we aimed to share visual content of a patient with Bullous myringitis admitted to the emergency department. Case presentation: A 24-year-old male patient complained of a right severe pain in the right ear and hearing loss was admitted to the emergency department. On physical examination the right tympanic membrane was oedematous, hyperaemic and blisters were seen. The patient was referred to ENT department for evaluation of hearing loss. Bullous myringitis with sensori-neural hearing loss in the right ear was diagnosed. For treatment, pain control and warm compression was recommended. Antibiotic therapy has been also planned for middle ear infection. ENT follow-up were planned for the assessment of hearing loss. Results and discussion: Many microorganisms, especially viruses, m.pneumoniae, chlamydia may cause Bullous myringitis. In the literature bullous myringitis cases that admitted to ED with sensori-neural hearing loss have been reported. Diagnosis is made by clinical examination. Pain control and mild compression may be sufficient for treatment. If concomitant otitis media is present, antibiotics should be added to treatment

Formation of a parenchymal pseudocyst following a blunt thoracic trauma

Pulmonary pseudocyst is an uncommon condition that may occur after blunt thoracic trauma. Traumatic pulmonary pseudocysts develop in less than 3% of patients after blunt thoracic trauma. In this study we share a “formation of a pulmonary pseudocyst following a blunt thoracic trauma” case. Case presentation: A 34-year-old male patient suffering from a motor vehicle accident, who had admitted to another medical unit, was referred to our ED for advanced treatment after the first intervention. Due to wide hemopneumothorax, bilateral tube thoracostomy had been performed when patient arrived. Thorax CT revealed a pulmonary pseudocyst in the right lung beside diffuse bilateral pulmonary contusions, hemopneumothorax and rib fracture. Following necessary medical treatments, patient was admitted to the intensive care unit. After three months with clinical and radiological follow-up, traumatic pulmonary pseudocyst in the right lung was fully healed. Discussion and Conclusion: Pulmonary pseudocysts are air cysts that may occur in the lung parenchyma after blunt thoracic trauma. Around 85% of cases reported in the literature involved young and male patients. Tears occurring in the lung parenchyma are one of the underlying mechanisms of pseudocyst formation. In these cases there is no need for further treatment of these cysts which are known to recede spontaneously unless no complication occurs