Record Sheet Research Articles

Evaluation of clinical sites used for training undergraduate physiotherapy students: Factors that may impact on learning

Background. Clinical education forms an integral part of the training of undergraduate healthcare students. Clinical learning and education can be influenced by a number of factors. Objectives. To evaluate clinical service sites used to train undergraduate physiotherapy students at Stellenbosch University, in terms of: ( i ) the suit­ability of the site as a training facility; and ( ii ) the range of clinical problems students encounter at these clinical service sites. Methods. A descriptive study was conducted. Data were gathered through structured clinical site visits, staff interviews and student record sheets documenting the number and type of patients students encountered at the clinical service sites. Results. Seven of the nine clinical sites used for training were evaluated. Close proximity to the Faculty was an identified strength of three of the sites. There were opportunities for the expansion of multidisciplinary services and group treatment classes. There were safety concerns at most of the sites visited. The number of qualified physiotherapists was low and there was also a lack of basic equipment needed for patient management at more than half of the clinical sites. Students’ exposure to the various fields of physiotherapy varied greatly at the tertiary service settings versus primary healthcare settings. On average students saw only two patients per day during a 5-hour clinical day. Conclusion. The suitability of healthcare service sites for training undergraduate students should be carefully evaluated prior to commencing training at these sites. The development of good clinical training sites for undergraduate healthcare students requires the availability of adequate resources such as equipment, an adequate complement of clinical staff and effective measures to ensure student and patient safety.

Learning experiences of physiotherapy students during primary healthcare clinical placements

Background. Primary healthcare (PHC) is necessary to address the health needs of communities. It creates the opportunity for the attainment of curricular outcomes through community-based education. Appropriate learning opportunities are needed to enable students to develop the necessary skills to attain these outcomes. Objectives. To describe the learning opportunities occurring during physiotherapy PHC placements and to explore the role the learning environment and learning opportunities played in attaining the outcomes for the placements. Methods. A descriptive case study was conducted using different strategies for data collection and analysis. Participants completed a record sheet to indicate time spent on different activities. Observational site evaluations, individual interviews with site representatives and focus-group discussions with students were conducted to explore their perceptions about PHC clinical placements. Results. The results indicated that the participants valued PHC placements as powerful learning environments. However, students did not have the opportunity to engage satisfactorily in activities that foster the principles of PHC. Participants acknowledged that several resource constraints existed in this context; however, they identified several potential valuable learning opportunities. Students suggested curriculum-specific strategies needed to prepare them for PHC, and recognised the need for healthcare services in the communities they served. Conclusion. While the PHC learning environment was rich and authentic, learning opportunities need to be optimised to enable students to fully reach the outcomes for the placements. Learning opportunities need to be crafted to foster collaborative learning, interdisciplinary learning, community engagement and empowerment.

English

BACKGROUND: AIMS: To review the clinical features and management of patients with injuries related to the cobra bite. DESIGN: Retrospective study. METHODS AND MATERIAL: Patients who attended the hospital for cobra–bite related injuries from 1 April 2008 to 31 March 2009 were included. The data were obtained from the admission register, and snakebite case record sheets were then retrieved from the medical record section of hospital. Demographic data, time of occurrence, location of wound site, local and systemic complications, anti-venom therapy (number of vials), clinical outcome, any surgical intervention, and length of hospital stay were retrieved from the clinical records. RESULTS: Eighteen patients were recruited during the 1-year study period. Of the 18 patients with cobra bites, 14 (78 %) presented with local swelling. No patient developed severe neurotoxic symptoms. Two patients had laboratory features of haemolysis. Fourteen patients received antivenom therapy and five of them subsequently underwent surgical interventions for extensive local tissue damage and necrosis. There was no fatality. CONCLUSION: Bites from cobras result in serious local complications with extensive tissue necrosis and minimal neurotoxic symptoms. There is an apparent trend of favorable outcomes following the early administration of antivenom to patients without early signs of irreversible tissue damage. Ciprofloxacin should be used in infected wounds of cobra bite, if facilities for culture and sensitivity are not available.

Application of preoperative assessment of record sheet in neurosurgical procedures

Objective To study the application of preoperative assessment of record sheet on surgical patients in neurosurgery department .Methods Totals of 80 surgical patients were randomly divided into observation group and control group .Patients in observation group were given preoperative assessment record sheet, and patients in control group were given routine preoperative visit .The curative effect and postoperative nursing effects were compared .Results The intraoperative blood loss , operative time , length of hospital stay and patients increasing blood pressure in observation group were （268.88 ±38.38） ml, （142.1 ±10.10） min, （12.88 ±0.56） days,2, respectively, which were significantly lower than （407.50 ±54.05）ml, （178.40 ± 11.83）min, （25.63 ±1.02） days, 8 in control group.The differences were statistically significant （t=2.176, 2.288,10.960, respectively; χ2 =4.114;P 〈0.05）.HAMA and HAMD scores of patients in observation group after operation were （10.42 ±2.64）,（9.44 ±2.65）,respectively, which were lower than （13.53 ±4.63）, （12.32 ±2.44） before operation, and lower than （13.12 ±3.34）,（11.82 ±2.54） in control group after operation too, the differences were statistically significant （t=3.043,3.856,3.544,2.643, respectively;P〈0.05）.Patient satisfaction scores was （7.64 ±1.65） and the number of satisfied patients was 23 in observation group, which were significantly higher than （6.55 ±1.63） and 14 in the control group.The differences were statistically significant difference （t=3.643,Z=4.073;P〈0.05）.Conclusions Neurosurgery patients with preoperative assessment can better improve the patient ’ s emotional impact , the curative effect of surgical treatment and reduce the risk of intraoperative complications . Key words: Neurosurgical procedures; Preoperative assessment record sheet; Postoperative nursing

The Evaluation of Time Performance in the Emergency Response Center to Provide Pre-Hospital Emergency Services in Kermanshah

This study evaluated the time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah. This study was a descriptive retrospective cross-sectional study. In this study 500 cases of patients from Shahrivar (September) 2012 to the end of Shahrivar (September) 2013 were selected and studied by the non-probability quota method. The measuring tool included a preset cases record sheet and sampling method was completing the cases record sheet by referring to the patients’ cases. Data were analyzed using SPSS version 18 and the concepts of descriptive and inferential statistics (Kruskal-Wallis test, benchmark Eta (Eta), Games-Howell post hoc test). The results showed that the interval mean between receiving the mission to reaching the scene, between reaching the scene to moving from the scene, and between moving from the scene to a health center was 7.28, 16.73 and 7.28 minutes. The overall mean of time performance from the scene to the health center was 11.34 minutes. Any intervention in order to speed up service delivery, reduce response times, ambulance equipment and facilities required for accuracy, validity and reliability of the data recorded in the emergency dispatch department, Continuing Education of ambulance staffs, the use of manpower with higher specialize levels such as nurses, supply the job satisfaction, and increase the coordination with other departments that are somehow involved in this process can provide the ground for reducing the loss and disability resulting from traffic accidents.

CEFOTAXIME ADMINISTRATION TO NEONATES ON POSTNATAL WARDS: AUDIT OF NEW SERVICE

AimThe primary aim was to audit the impact on omitted doses following the implementation of a new procedure which allow midwives to administer intravenous (IV) cefotaxime to neonates on postnatal...

The Impact of Third Party Presence on the Motivational Concerns Underlying Linguistic Politeness Behavior in English-speaking Intercultural Contexts

This paper reports the impact of third party presence on the Vietnamese motivational concerns underlying their politeness behavior in English-speaking intercultural workplace. Data are collected by means of diary-type record sheet. Twenty-four Vietnamese speakers of English working in non-government-organization offices in Vietnam reported noticeable incidents of their interaction with Westerners (Anglo-culturals). Data have shown that the presence of a third party influences Vietnamese motivational concerns, especially the concern for face and for association rights. Based on the findings, implications for intercultural communication are provided.

The impact of a change in prescribing policy on antipsychotic prescribing in a general adult psychiatric hospital.

To examine the impact of a change in local prescribing policy on the adherence to evidence-based prescribing guidelines for antipsychotic medication in a general adult psychiatric hospital. All adult in-patients had their clinical record and medication sheet reviewed. Antipsychotic prescribed, dose prescribed and documented indications for prescribing were recorded. This was done before and after the implementation of the change in hospital antipsychotic prescribing policy. There were no significant differences in age, sex, Mental Health Act status, psychiatric diagnosis or documented indications for prescribing multiple or high dose antipsychotics between the two groups. There was an increase in the preferential prescribing of multiple second-generation antipsychotics (p=0.01) in the context of a significant reduction in the prescribing of multiple antipsychotics overall (p=0.02). There were no significant reductions in prescribing of mixed generations of antipsychotics (p=0.12), high dose antipsychotics (p=1.00) or as required (PRN) antipsychotics (p=0.74). Changes in local prescribing policy can improve adherence to quality prescribing guidelines and cause clinically significant improvements in patterns of prescribing in a general adult psychiatric hospital.

A Study on Outcome of VVF Repair at Kumudini Women's Medical College Hospital

This cross sectional study was carried out on 101 cases of vesico-vaginal fistula who were admitted and operated in Kumudini Women's Medical College Hospital. The aim of the study was to find out the outcome of vesicovaginal fistula repair. A detailed interview was taken from the patients and attendants by using a questionnaire. Necessary information were collected from the patient's record sheets . Small, medium and large sized fistulae were 59.41%, 26.73% and 11.88% respectively. The result of the study showed that success of fistula repair was 73.27%, though seven cases developed stress incontinence. Totally 27 patients were unsuccessfully repaired. Of which 19 (70.37%) were dropped out, 5(18.52%) were referred and 3(11.11%) had operative failure. Post-operative recovery was mostly (87.13%) uneventful. Urethral leakage (6.93%), blocked catheter ( 2.97%) and UTI (2.97%) were the leading complications. To improve the outcome, more training and skill of surgeons, improvised per-operative and post-operative care is necessary. Approaches should be designed to make the incidence of drop out to zero. DOI: http://dx.doi.org/10.3329/bmj.v40i3.18652 Bangladesh Medical Journal 2011 Vol.40(3):18-20

Drug utilization study in Pregnancy induced hypertension in a tertiary care teaching hospital

Introduction: Pregnancy induced hypertension(PIH) is one of the most common complications of pregnancy worldwide.It is associated with both maternal mortality and morbidity as well as perinatal mortality. Though a number of drugs are available to treat PIH, differences in benefit-risk ratio of these drugs stresses the need for surveying the use of these drugs. Methods: The present study is a retrospective observational study performed on the basis of case record sheets of patients admitted with PIH. Results: Out of the total prescriptions studied the most commonly prescribed antihypertensive was Methyldopa, followed by Labetalol. Nifedipine, Amlodipine, and Magnesium sulphate were the other drugs prescribed. Majority drugs prescribed were from category B and C. Single drug therapy was prescribed in 79.87 % patients. Conclusion: Methyldopa was the commonly prescribed antihypertensive. None of the prescribed drugs were from teratogenic category D and X. Keywords: Pregnancy induced hypertension, Drug utilization study, Antihypertensive

Cognitive and sexual functions in patients with traumatic brain injury.

Background:Traumatic brain injury (TBI) has an immense psychosocial impact on an individual as well as on the close relatives. Sexuality is one among the functions which are usually found compromised post injury. The aim of present study was to examine cognitive and sexual functions post TBI. The objective of the study was to explore these domains and their relationship with each other.Tools:The tools used were sociodemographics record sheet, Edinburg handedness inventory, brief sexual function inventory, depression anxiety stress scales-21 and NIMHANS head injury battery. The sample consisted of 30 patients with mild-to-moderate TBI. All the subjects were tested individually in their regional language.Results:On cognitive domain, patients performed inadequately on all the tests; however, the percentage was higher in mental speed (43.3%), sustained attention (26.7%), verbal working memory (30%), response inhibition (36.7%), verbal memory (immediate and delayed) (43%) and visual (immediate, 23.3% and delayed, 26.7%). On the domain of sexual functions, all the four domains (sexual drive, erection, ejaculation and problem assessment) were affected however overall satisfaction (93.3%) was adequate. Among the four domains higher percentage of involvement was noted on problem assessment (70%), ejaculation (56.7%), and erection (46.7%). Significant correlation was found between mental speed, verbal working memory, planning, and visual memory with sexual drive, erection, ejaculation and overall satisfaction domains of sexual functioning. Negative correlation was found between motor speed and sustained attention with sexual drive, erection and ejaculation.Conclusion:Both cognitive and sexual functioning were found effected post TBI. However less emphasis is given to sexual functioning by the professionals. Educational intervention is needed to sensitize professional about this area and to include this area for better management.

Biblioteca escolar e mediação de leitura: uma proposta de fichas pedagógicas de registro dos livros

Introduction: This article handles the social and academic education of the School Library educator and her contribution to the development of reading mediation practices for reader’s education. Objective: Check how the school library, its pedagogical organization and the storytelling contribute to the formation of readers. Methodology: The bibliographic research of documentary method based on personal papers written and on official papers, aiming to verify the education of the individual, the school library and the pedagogical organization of storytelling contribute to the reader’s education. This research is guided by: Silva, Lajolo, Zilberman, whom conceptualize reading and UNESCO and Barbosa et al. papers regarding School Library organization. Results: As a result of this research obtained a bibliographic record sheet as assistance in the continuing education of library educator for all school educators can use the books in the classroom at the time of storytelling and therefore expand their practice in a reading mediation Conclusions : It is concluded what the teacher of the school library has a function to intermediate the student’s learning process, stimulating him/her to be a diligent reader and presenting literature that contributes to his/her growth as reader, it is important to highlight that the library environment must be suitable to accommodate this reader, providing approximation the reader with book.

A Study of Adverse Drug Reactions in Paediatric Age Group with Assessment of Causality, Severity and Preventabilty in a Tertiary Care Hospital

Objective-To study the adverse drug reactions in paediatric age group in a tertiary care hospital. Methods-A retrospective study was undertaken to analyse adverse drug events in paediatric department of a tertiary care hospital.Medical record sheets were analysed and adverse event marked as ADR by the paediatrician was included in the study. Causality, preventability and severity were analysed by 2 Pharmacologists. Other parameters like male to female ratio, most common class of drug causing ADR, common types of ADRs, commonly involved systems, polypharmacy were studied. Results64 cases of ADRs were identified in study duration(overall incidence 4.4%) of which 56% were females and infants the commonest age group. Antinfectives were the commonest drug class(68%) causing ADRs,with skin the commonest involved organ. 81% of ADRs were of moderate degree as compared to 1% of severe degree.76% cases fell in probable category of preventability where as 3% were definitely preventable.76.5% cases scored into probable category according to Naranjo’s scale of causality assessment. 86% cases were prescribed polypharmacy. ConclusionIncidence of Iatrogenic harm is rising and due to suboptimal ADR reporting practices only the tip of iceberg is seen. Though more vulnerable, paediatric age group is neglected in various aspects. To ensure safety we need to judiciously use drugs, strengthen ADR reporting and conduct more studies & awareness programmes.

Interactions between Siblings in Institutional Sheltering: A Case Study

Interactions between Siblings in Institutional Sheltering: A Case Study Lígia Negrão Costa, Celina Maria Colino Magalhães, Janari da Silva Pedroso Abstract The aim of the research was to analyze the interaction between siblings and their peers in institutional sheltering, debating the contextual conditions of the institution. A group of siblings took part in the research, in total there were four children housed in a big institution the city of Belém, Pará. The data was collected through the record sheets and the observation of the children's interaction, making use of the socio-focal observation technique. The interactive episodes among the children were categorized into interactions that involved sharing, conflict, cooperation, competition, behavior similarity, affection and search for closeness. The results showed that the siblings spent more time and increased frequency of interacting with themselves, among the most common categories were the search for closeness, affection and cooperation. The data raise the debate about sheltering institutions, especially in regards to establishing the relationship between siblings in this kind of institution and the strategies used by them to keep their bonds. Full Text: PDF DOI: 10.15640/jehd.v3n4a14

Incidence and Predicted Risk Factors of Pressure Ulcers in Surgical Patients: Experience at a Medical Center in Taipei, Taiwan

Purpose. To explore the context of incidence of and associated risk factors for pressure ulcers amongst the population of surgical patients. Methods. The initial study cohort was conducted with a total of 297 patients admitted to a teaching hospital for a surgical operation from November 14th to 27th 2006 in Taipei, Taiwan. The Braden scale, pressure ulcers record sheet, and perioperative patient outcomes free from signs and symptoms of injury related to positioning and related nursing interventions and activities were collected. Results. The incidence of immediate and thirty-minute-later pressure ulcers is 9.8% (29/297) and 5.1% (15/297), respectively. Using logistic regression model, the statistically significantly associated risk factors related to immediate and thirty-minute-later pressure ulcers include operation age, type of anesthesia, type of operation position, type of surgery, admission Braden score, and number of nursing intervention after adjustment for confounding factors. Conclusion. Admission Braden score and number of nursing intervention are well-established protected factors for the development of pressure ulcers. Our study shows that older operation age, type of anesthesia, type of operation position, and type of surgery are also associated with the development of pressure ulcers.

A survey of characteristics of self-immolation in the northern iran.

Background:Suicide is an action deliberately initiated and performed by a person with complete awareness of its fatal outcome, prevalence of which is very rare in developed countries, but it is reported with more frequency in Middle East including Iran.Aim:This study was carried out to analyze the characteristics, mortality, and related factors of burned patients who attempted to suicide by self-immolation in Northern Iran.Materials and Methods:In this retrospective study, the archived files of 101 cases that referred to the main burn care center located in northern Iran (Included: Mazadaran, Golestan cities) - cause of suicide attempting by self-immolation during 2 years 2010-2011, analyzed. A record sheet designed to extract data such as: Age, education, occupation, gender, residence, marital status, drug abuse, and extent of the burn injuries as a percent of burned total body surface area (TBSA).Results:The incidence rate of suicide attempted cases were 1.98/100,000 person-years. The mean ages for cases were 31.8 (13.6). The mean age for males and females were 36.1 (14.8) and 30.1 (12.9) years, respectively. In, about 84% (84/101) of the patient's burned TBSA was more than 40% (41/101). Burn injuries were more frequent, larger, and included higher mortality in females than males. Kerosene was the most common used material to self-burning. The mortality rate was about 74% (74/101), which showed a high mortality rate in this study. Other social factors such as marital status, employment, and education level have a role as individually protective or risk factors for self-burning.Conclusion:Finding of the current study manifested high rate of suicide by self-immolation among young, married, and low educated women in Northern Iran. It implies a social problem, and need to an arrangement of a cultural program aimed to improving health, psychological habits and educational level.

Reproductive Efficiency of BLRI Cattle Breed-1 at Farm Condition

The BLRI Cattle Breed 1(BCB-1) is a native cattle breed developed by Bangladesh Livestock Research Institute (BLRI) through selective breeding among indigenous cattle of Bangladesh. Data asserted from record sheets of 529 animals maintained during 1992 to 2006 were analyzed to evaluate the reproductive efficiency of BCB-1 cattle in different generations, seasons and parities. The highest percent of animals showed heat during summer season (36.88%) followed by rainy (35.73%) and winter season (27.39%). The highest percent of calving was recorded in summer (43.1%) followed by rainy (31%) and winter (26%). Sex ratio of male: female calves born according to season was the highest in summer (106.31:100) intermediate in rainy (106.06: 100) and lowest in winter (105.00:100). Age at first heat (AFH), age at first calving (AFC), calving interval (CI), service per conception (SPC), gestation length (GL) and post partum heat period (PPHP) of BCB-1 cows were 843.65±17.77, 1225.24±258.92, 451.65±6.51, 1.50±0.83, 283.31±11.50, and 105.51±3.95 days, respectively. AFS and PPHP varied with generation (p<0.01) and that of SPC and PPHP with parity of dams (p<0.05). However, AFC, GL and CI of BCB-1 females did not vary with parity, generation or season of birth. It was concluded that the overall reproductive performances of BCB-1 cattle are within the range of other indigenous cattle of Bangladesh and the at such results of reproductive characteristics may be used for planning cattle breeding strategy of the country.DOI: http://dx.doi.org/10.3329/pa.v19i2.16948 Progress. Agric. 19(2): 85 - 92, 2008

Users of secondary school‐based counselling services and specialist CAMHS in Wales: A comparison study

Background: The increasing prevalence of mental health issues in young people has contributed to a rise in the provision of school‐based counselling services in the UK. Between 2008/09 and 2010/11, data were collected from users of secondary school‐based counselling services in Wales. Aims: To identify the characteristics of users of school‐based counselling services in Wales – including demographics, referral pathways, presenting issues, and predominant issues – and how they compare to users of specialist CAMHS in Wales and Welsh secondary school pupils in general. Method: Data were collected on 10,687 episodes of counselling. School counsellors completed a client record sheet after each counselling episode and submitted these to their Local Authority. Collated results were then compared to matched data from Welsh specialist CAMHS and Welsh secondary schools data. Results/findings: A typical user of a secondary school‐based counselling service in Wales was female, of white ethnicity, and from the ‘middle’ school years. There was a marked under‐representation of users from BME backgrounds. Users were most often referred by school staff, and the most common presenting issues were family‐related, anger, and behaviour‐related. Conclusions: There was a higher proportion of females accessing school‐based counselling services than males. This was in direct contrast to data from specialist CAMHS and possible explanations for this are discussed. The under‐representation of BME populations suggested that there were some equality issues associated with accessing these services. Implications for practice: Future research should explore equality issues associated with young people from BME backgrounds accessing intervention services.

Recreational Benefits of Boccia Intervention Courses in People with Cerebral Palsy

This study aimed to investigate the recreational benefits of boccia intervention courses (including effects on physical, mental, social and sports abilities) in people with cerebral palsy. In this study, ten intervention courses were conducted (once a week; 3 hours per each courses). The experimental measures from eleven members were collected from the Taoyuan Boccia Club of the Cerebral Palsy Association of R.O.C. The measures for the interventional effects including: recreational benefit scale, recreational benefit check list, skill record sheet, weekly training observation record sheet, completive performance assessment form, course satisfaction survey and overall opinions of the Boccia course. The findings were as follows: (1) The Boccia intervention improved participants' subjective feelings of recreational benefits, especially the social benefits and self-presentational benefits. (2) Boccia intervention enhanced the motor functions of people with cerebral palsy. According to the skill records, the pitching direction was improved significantly. (3) After ten weeks Boccia courses, shooting accuracy was also significantly enhanced. In the game contest of the last week, comprehensibility of the referee's instruction and preparation for pitching were performed much better by the participants. (4) Parents were satisfied with the course content, teaching quality and its related benefits. This study concludes that Boccia, designed specifically for people with physical and mental disabilities and motion control problems, showed physical, psychological, social and sport ability benefits via multidimensional evaluation with the effects of ten-week intervention. Boccia intervention proved to be a suitable recreational sport for people with cerebral palsy to participate, and worthy for further promotion.

Protocol for diagnostic test accuracy study: the efficacy of screening for common dental diseases by Dental Care Professionals

BackgroundThe bulk of service delivery in dentistry is delivered by general dental practitioners, when a large proportion of patients who attend regularly are asymptomatic and do not require treatment. This represents a substantial and unnecessary cost, given that it is possible to delegate a range of tasks to dental care professionals, who are a less expensive resource. Screening for the common dental diseases by dental care professionals has the potential to release general dental practitioner’s time and increase the capacity to care for those who don't currently access services. The aim of this study is to compare the diagnostic test accuracy of dental care professionals when screening for dental caries and periodontal disease in asymptomatic adults aged eighteen years of age.Methods/designTen dental practices across the North-West of England will take part in a diagnostic test accuracy study with 200 consecutive patients in each practice. The dental care professionals will act as the index test and the general dental practitioner will act as the reference test. Consenting asymptomatic patients will enter the study and see either the dental care professionals or general dental practitioner first to remove order effects. Both sets of clinicians will make an assessment of dental caries and periodontal disease and enter their decisions on a record sheet for each participant. The primary outcome measure is the diagnostic test accuracy of the dental care professionals and sensitivity, specificity, positive predictive value and negative predictive values will be reported. A number of clinical factors will be assessed for confounding.DiscussionThe results of this study will determine whether dental care professionals can screen for the two most prevalent oral diseases. This will inform the literature and is apposite given the recent policy change in the United Kingdom towards direct access.