Prevention of infections in hyposplenic and asplenic patients: an update

Patients with functional or anatomic asplenia are at a significantly increased risk of overwhelming infection, particularly involving the encapsulated bacteria Streptococcus pneumoniae and Haemophilus influenzae. The risk is highest in infants and young children, but adults also have an increased risk of infection. Preventive strategies are very important and fall into three major categories: immunoprophylaxis, antibiotic prophylaxis and education. Studies have shown that many asplenic patients are unaware of their increased risk for serious infection and the appropriate health precautions that should be undertaken. In this article we emphasise the need for preventive measures in hyposplenic and asplenic patients. We discuss the value of newly developed conjugate vaccines and the need for revaccination. Finally we draw up a recommendation for the preventive management in functional and anatomical asplenic patients

A sucata como avesso complementar da contemporaneidade

Este artigo objetiva discutir os significados da sucata na contemporaneidade, apresentando o relato de uma experiência com sucata em oficina de criação espontânea, realizada em uma universidade, como parte de uma investigação sobre os sentidos atribuídos à sucata. Propõe-se, então, a sucata – cujo significado etimológico é objeto sem valor – e as relações que ela mantém, tanto no plano econômico quanto no plano das relações sociais, como objeto e, também, como método de investigação científica. Observamos que a sucata deixa de ser apenas um objeto sem valor para se tornar um meio, um caminho que abre possibilidades de leituras de mundo, de interferências no mundo, de desdobramentos, de vias de escape. Conclui-se, assim, que em toda sua complexidade, a sucata da história (história pessoal e social), pode proporcionar, por meio de sua característica maior – a falta de significado –, a possibilidade de ressignificação, tornando-se um modo, um método, às avessas, em negativo, do contemporâneo

A sucata como avesso complementar da contemporaneidade

Este artigo objetiva discutir os significados da sucata na contemporaneidade, apresentando o relato de uma experiência com sucata em oficina de criação espontânea, realizada em uma universidade, como parte de uma investigação sobre os sentidos atribuídos à sucata. Propõe-se, então, a sucata – cujo significado etimológico é objeto sem valor – e as relações que ela mantém, tanto no plano econômico quanto no plano das relações sociais, como objeto e, também, como método de investigação científica. Observamos que a sucata deixa de ser apenas um objeto sem valor para se tornar um meio, um caminho que abre possibilidades de leituras de mundo, de interferências no mundo, de desdobramentos, de vias de escape. Conclui-se, assim, que em toda sua complexidade, a sucata da história (história pessoal e social), pode proporcionar, por meio de sua característica maior – a falta de significado –, a possibilidade de ressignificação, tornando-se um modo, um método, às avessas, em negativo, do contemporâneo

The perioperative patient experience of hand and wrist surgical patients: An exploratory study using patient journey mapping

Patient-centred care is becoming more important in healthcare. The success of patient-centred care can be assessed by exploring the patient experience through a patient journey map. As the number of outpatient surgeries is increasing, it is important to reveal the specific characteristics of this type of surgery. The perioperative patient experience is considered very important for outpatient surgery, because all perioperative activities are condensed in one day. To investigate this experience, we performed a case study of hand and wrist surgery. Six teams of two industrial design engineering students interviewed 40 patients in total in two private and two public hospitals in the Netherlands. All teams created a patient journey map, describing the patient experience. These maps were analysed by the authors to identify common themes among the six journeys. Four time-independent themes and four time-dependent themes were identified. Insecurity, reassurance by staff, loneliness, and lack of information were associated with the whole patient experience. Before surgery, lack of control was the most prominent experience. During surgery, acceptance and curiosity were present. After surgery, relief was the dominant experience. No significant differences between the public and private hospitals were discovered. Several suggestions are given on how to facilitate positive experiences and how to resolve negative experiences in outpatient surgery. These include suggestions for hospital policy and design interventions

Bilateral, anterior stromal ring opacity of the cornea

AIMS/BACKGROUND: To describe a bilateral, mid peripheral, ring-shaped corneal opacity, not resembling any known corneal degeneration, dystrophy, or other disorder, and occurring without ocular or systemic disease. METHODS: Ophthalmic examination, haematological screening, and ultrasound biomicroscopy. RESULTS: A 25 year old man showed grey-white, granular opacities in both corneas, with an 8 mm diameter ring configuration, and a V-shaped distribution in the anterior stroma. The surrounding corneal stroma was clear, and the tear film, the epithelium and its basement membrane, Descemet's membrane, and the endothelium were normal. Evidence of systemic disease was not found. Family members did not show corneal abnormalities. CONCLUSION: A bilateral corneal ring opacity may occur in healthy, asymptomatic, young people. These corneal rings may result from depositions of unknown origin, or possibly a rare corneal dystrophy

The perioperative patient experience of hand and wrist surgical patients: An exploratory study using patient journey mapping

Patient-centred care is becoming more important in healthcare. The success of patient-centred care can be assessed by exploring the patient experience through a patient journey map. As the number of outpatient surgeries is increasing, it is important to reveal the specific characteristics of this type of surgery. The perioperative patient experience is considered very important for outpatient surgery, because all perioperative activities are condensed in one day. To investigate this experience, we performed a case study of hand and wrist surgery. Six teams of two industrial design engineering students interviewed 40 patients in total in two private and two public hospitals in the Netherlands. All teams created a patient journey map, describing the patient experience. These maps were analysed by the authors to identify common themes among the six journeys. Four time-independent themes and four time-dependent themes were identified. Insecurity, reassurance by staff, loneliness, and lack of information were associated with the whole patient experience. Before surgery, lack of control was the most prominent experience. During surgery, acceptance and curiosity were present. After surgery, relief was the dominant experience. No significant differences between the public and private hospitals were discovered. Several suggestions are given on how to facilitate positive experiences and how to resolve negative experiences in outpatient surgery. These include suggestions for hospital policy and design interventions

The Importance of Design: a comparative evaluation of problem solving in engineering education.

Engineering education has been criticised for focusing solely on the science of engineering, to the detriment of preparing students for the practice of engineering. Graduates are considered by many in industry to be ill-prepared for real world problem solving and to have limited experience in applying their engineering knowledge to product outcomes. Instruction in design is uncommon, and where existing, follows a linear and predictable process that does not afford students opportunity for experimentation and exploration. However new engineering education pedagogy seeks to address these issues through early integration of design and project based learning into the curricula. This paper describes the initial findings of a comparative evaluation exercise conducted to measure relative aptitude in problem solving by two disciplines of final year engineering students and thus validate the impact of new engineering curricula. The evaluated students were from a typical Mechanical Engineering course and from the less conventional Product Design Engineering program which integrates industrial design studies into mechanical engineering curricula. Students’ problem solving methods were observed, the design outcomes were evaluated and participants surveyed. These exercises challenged the student’s problem framing and solving abilities and required the application of engineering science and design acumen to achieve a creative solution for either an open-ended or constrained problem. The early findings of this ongoing investigation are examined here, and the benefits of developing a creative design focus within an engineering curriculum are clearly evident