Multiple Bony Injuries on Bone Scan in a Case of Unsuspected Child Abuse

This case is described of an eleven-month-old infant with lower limbs swelling and the left elbow skeletal malformation following a fall. The radionuclide bone scan was performed to exclude bone infection or congenital skeletal anomaly. The images unexpectedly showed multiple increased radioactive foci throughout the whole body. It was a strong probability of child abuse. All lesions are readily apparent on the following plain film radiographs and MRI

The Study of Therapeutic Effect of Hill's Dream Work in Art Therapy

AbstractThe purpose of the study is to realize Hill's the application of Dream work used in art therapy and to explore the treatment outcome. Then the research result can be applied in clinical work. In the study, Grounded therapy was adopted to investigate the effectiveness of Hill's Dream work applied in Art therapy process. Qualitative research was applied to realize 22 participants’ understanding of therapy process and content of therapeutic agents of this work model template. Participants were interviewed after receiving six to eight therapy sessions. Materials obtained from the interviews which were transcribed and then analyzed by Grounded Theory methodology. The results indicated that three stages, before therapy process, the formal therapy process, after therapy process, with differed therapeutic effects. Among which, therapeutic factors can be further categorized to the client's personal awareness factor, therapist's factor, and art material factors which affected on the therapy process. Client's personal factors included to make sure motivation, relationship with dream and change within art therapy and dream work. Therapist's factors were to provide safe environment, empathetic, positive attitude, interpretation of dream picture, encourage and to be a guide. Art material factors were meant to use different colour, the characteristic of art material, to change the art tools in art therapy process, to be aware of the dream meaning in art, and to make sense of creative behaviour. The subsequent therapeutic effect were to be applied in daily life, more interest in creation, to extend the insight of dream and positive attitude for life, and to be a reminder after therapy session. According to the research results, the model of change mechanism on therapy processes and therapeutic agents were then provided. Finally, findings in this research were discussed and implications and suggestions for practice art work, clinical counselling work and future study were also provided

Career Adapt-Abilities Scale -Taiwan Form: Psychometric properties and construct validity

The present study tested the reliability and validity of the Career Adapt-Ability Scale -Taiwan Form (CAAS-Taiwan Form). The CAAS consists of four scales, each with six items, which measure concern, control, curiosity, and confidence as psychosocial resources for managing occupational transitions, developmental tasks, and work traumas. Internal consistency estimates for the subscale and total scores were excellent. The factor structure was quite similar to the one computed for combined data from 13 countries. The CAAS-Taiwan Form is identical to the International Form 2.0. Based on the results, the CAAS-Taiwan Form, appears ready for use by researchers and practitioners who wish to measure adaptability resources among adults

The Effectiveness of the Buzzy Device for Pain Relief in Children During Intravenous Injection: Quasirandomized Study

BackgroundIntravenous injection is the most common medical treatment and the main cause of pain in hospitalized children. If there is no appropriate health care for pain relief, the proportion of moderate and severe pain often exceeds 70%. With nonpharmaceutical-based pain management, Buzzy is recognized as an effective device for rapidly relieving injection pain in hospitalized children. However, Buzzy is not widely used in Asia and very few experimental studies in Asia have addressed the effectiveness of the Buzzy device at treating needle pain in hospitalized children. ObjectiveThe main purpose of this study was to investigate the effectiveness of the Buzzy device for diminishing pain levels among hospitalized children in Taiwan. MethodsWe applied a quasiexperimental design with random assignment. According to the time of admission, child participants were randomly assigned to treatment and nontreatment groups. The Buzzy device was applied as an intervention in this study. The samples size was 30 per group. The study participants were recruited from the pediatric ward of a medical center in northern Taiwan. The research data were collected longitudinally at three time points: before, during, and after intravenous injection. Three instruments were used for assessment: a demographic information sheet, the Wong-Baker Face Scale (WBFS), and the Faces Legs Activity Cry Consolability (FLACC) scale. The data were analyzed by descriptive analysis, the Mann-Whitney U test, the Wilcoxon signed-rank test, and the χ2 test. ResultsA total of 60 hospitalized children aged 3 to 7 years participated in this study, including 30 participants in the treatment group and 30 participants in the nontreatment group. The average age of children in the treatment and nontreatment groups was 5.04 years and 4.38 years, respectively. Buzzy significantly mitigated pain in children during intravenous injection with a significant difference between the two groups in pain-related response (FLACC) and actual pain (WBFS) (Z=–3.551, P<.001 and Z=–3.880, P<.001, respectively). The children in the treatment group had a significantly more pleasant experience than those in the nontreatment group (Z=–2.387, P=.02). When Buzzy was employed, the children experienced less pain than they did during previous intravenous injections (Z=–3.643, P<.001). ConclusionsThe intervention of using the Buzzy device was effective in reducing pain levels of intravenous injection among hospitalized children. The specific focus on children in Asia makes a valuable contribution to the literature. For clinical application, the reliable pain relief measure of Buzzy can be used in other Asian children to help health care providers improve noninvasive care among children. For future applications, researchers could integrate Buzzy into therapy-related games and a technology-based app to increase the efficiency of use and provide more data collection functions

Image and Speech Recognition Technology in the Development of an Elderly Care Robot: Practical Issues Review and Improvement Strategies

As the world&rsquo;s population is aging and there is a shortage of sufficient caring manpower, the development of intelligent care robots is a feasible solution. At present, plenty of care robots have been developed, but humanized care robots that can suitably respond to the individual behaviors of elderly people, such as pose, expression, gaze, and speech are generally lacking. To achieve the interaction, the main objectives of this study are: (1) conducting a literature review and analyzing the status quo on the following four core tasks of image and speech recognition technology: human pose recognition, human facial expression recognition, eye gazing recognition, and Chinese speech recognition; (2) proposing improvement strategies for these tasks based on the results of the literature review. The results of the study on these improvement strategies will provide the basis for using human facial expression robots in elderly care

Latino/Hispanic Community Adults’ Healthcare Experience in a New Mexico Borderland Region

This study identifies factors associated with Latino/Hispanic adults’ healthcare experiences in a county along the U.S.-Mexico Border designated by the government as a geographic primary care, mental health, and dental health professional shortage area. An interpretative phenomenological approach was applied to analyze qualitative data collected through focus group interviews with ten Latino/Hispanic healthcare patients. Factors associated with positive healthcare experiences included short wait times, availability of same-day appointments, team-based care, and good interpersonal communication. Factors associated with negative healthcare experiences included long wait times, deficient communication (e.g., lack of provider-patient, provider-provider, and agency-patient communication), providers’ poor interpersonal skills, and perceived discrimination by healthcare professionals based on patient age, race/ethnicity, linguistic capability, and socioeconomic status. Latino/Hispanic patients negotiate challenging barriers related to receiving effective healthcare services. Healthcare providers and administrators may improve the quality of care for Latinos/Hispanics by attending to these factors

Multimedia-assisted instruction on pain assessment learning of new nurses: a quasi-experimental study

Abstract Background Pain assessment and treatment are key factors affecting the quality and safety of care for patients and capabilities related to them are crucial for new nursing staff. Consequently, we developed a multimedia-assisted teaching program for nursing newcomers’ pain assessment learning to facilitate their practical pain assessment ability. The goal of this study was to evaluate a multimedia instructional program to boost new nurses’ ability to conduct pain assessment and treatment, through simulated scenario instruction. Methods A quasi-experimental, pretest-posttest design with purposive sampling was used in this study. Eighty-six nurses were enrolled (control group, n = 39; experimental group, n = 47). Both groups underwent traditional pain assessment training in the classroom. The control group received lectures using PowerPoint files; while the experimental group undertook pain assessment training with the same content but delivered via multimedia-assisted instruction based on the ADDIE model. Pre- and post-instruction questionnaires relating to pain knowledge were completed. Participants’ competence in performing pain assessment was subsequently evaluated one-month post instruction. Results The experimental group had significantly higher satisfaction scores (27.67 ± 3.76 vs. 31.36 ± 3.42, p < .01, respectively), and demonstrated greater knowledge of pain assessment (7.73 ± 0.67 vs. 7.08 ± 0.90, p < .05, respectively) than did the control group. Additionally, when evaluated at the one month follow-up, newcomers in the experimental group had better communication ability to perform pain assessment (26.58 ± 3.01 vs. 25.08 ± 3.32, p < .05, respectively). Conclusions The program can improve nurses’ pain assessment knowledge and competence. Newcomers were able to better respond to patients in pain, which is essential for pain assessment. This pilot study thus suggests a new, multimedia program for training nursing newcomers in pain assessment

A Journey from Hospital to Home: A Grounded Theory Study of Family Caregivers of Hospitalized Persons with Cognitive Impairment

[[abstract]]Background: Hospitalization rates for persons with cognitive impairment are projected to increase in Taiwan. They are more likely to use inpatient services, psychotropic drugs, and have higher in-hospital mortality than persons without cognitive impairment. When this population is hospitalized, their family caregivers often experience strain, anxiety, and stress in their relationships with the care recipient and healthcare providers. Objectives: This study purposes were: (1) to explore experiences of family caregivers of persons with cognitive impairment during hospitalization, and (2) to develop a model explaining the patientcaregiver dyads’ acute hospitalization and discharge process from the caregivers’perspectives. Methods: Grounded theory was used to generalize a model. We recruited 11 caregivers and 10 persons with cognitive impairment. Data were collected in individual semi structured interviews with caregivers. Interviews occurred during patients’ hospital stay or at home in the first year of discharge. Data were audio-taped and analysed by content analysis and constant comparative analysis. Results: The dyads’ hospitalization and post discharge experiences were captured by four main themes: 1) early planning, 2) hospitalization issues piling up, 3) preparing for discharge, and 4) post-discharge experiences. During early planning, caregivers prepared for postdischarge caregiving and performed health-related and support tasks for the patient. During hospitalization, issues piled up, e.g. i.e. patients’ challenging behaviours, unfamiliar hospital environment, difficulty distinguishing patients’ delirium from cognitive impairment, and dissatisfaction with nursing care. When preparing for discharge, caregivers were concerned about the patients’ readiness for discharge and their self-efficacy for managing patients’ needs. If patients were not adequately prepared to return home, after discharge the patients’ condition rapidly spiralled down leading to unplanned re-admissions, which negatively affected caregivers’ health. Conclusions: Caregivers and cognitively impaired patients were challenged by the patients’ hospitalization due to factors that could have been minimized by skilled nursing dementia care. Nursing education to improve caregivers’ self-efficacy in patient care, could also have reduced postdischarge challenges