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Новая работа Бэнкси появилась в среду в университетской больнице на юге Англии. Эта картина — благодарность художника сотрудникам Национальной системы здравоохранения, которые отважно борются с пандемией коронавируса.
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AMIA 2021: Understanding how technology impacts patients and providers
New technology can have a significant impact on the day-to-day experience of providers and patients.
The American Medical Informatics Association is hosting its 2021 Annual Symposium, and, during its virtual day last week, researchers presented multiple studies on how technology is impacting both groups.
Here’s a look at some of the findings:
Using VR to understand the challenges of home care
To study and better understand behaviors that affect health outcomes, the National Institute of Nursing Research (NINR) developed an immersive virtual reality tool to track participants as they engage in a common daily activity like food shopping. The tool simulates a typical grocery store and tests participants’ ability to follow low-sodium diets in the context of chronic illnesses like heart failure.
The benefit of using this technology, Denise Goldsmith, a nursing informatics consultant at NINR, explained during her panel, is the level of factors in the environment researchers could control. In fact, it would be difficult—if not impossible—to replicate in real life, she said.
Another appealing element is the fact that the study could be done remotely without being in the patient’s presence.
Participants were trained for a brief period beforehand on how to use the technology. Then, in the simulation, they were free to move about the grocery store, select food items, read nutrition labels and then check out at the cash register. At the end, each user received feedback on their food choices based on the total sodium tally.
“Using IVR in this way, we can observe real-time decision-making and activities of our users without needing to be present in their natural setting,” Goldsmith, who develops the clinical scenarios chosen for these studies at NINR, said.
The technology captures behaviors including frequency of label referencing and product comparisons and also tracks and plots movement activity throughout the virtual store. This helps researchers study cognitive patterns in home-care patients and potential challenges impacting the performance of such tasks.
The various self-care management scenarios NINR develops are identified by home-care nurses, according to its website.
Medical conditions dictate patients’ tech savviness
To explore whether certain medical conditions lend themselves to better telemedicine preparedness among seniors, Jorge Rodriguez-Fernandez, a clinical informatics fellow at the University of Illinois at Chicago, analyzed data from the National Health and Aging Trends Study on nearly 4,000 seniors 65 years and older.
He and his team defined telemedicine readiness as being able to contact a provider, handle medical insurance or get medical information all online.
There were two other categories, one for telemedicine physical unreadiness, and another for telemedicine technical unreadiness. The former was defined by a physical barrier preventing a patient from using telemedicine; the latter was defined by a patient not owning a proper device, not knowing how to use it or not having recent email, text or internet access.
Cancer patients by far exhibited the most telemedicine readiness, followed by those with hypertension and arthritis.
“For cancer, which was the most striking result, there is the theory of the cancer continuum,” Rodriguez-Fernandez explained during the panel. An oncologist treats not only their remission but also focuses on follow-up care and their long-term well-being. Drug manufacturers also increasingly support and engage with patients across the oncology spectrum through their entire care and recovery journey, he noted.
In terms of technical unreadiness, conditions that were most impacted included depression, anxiety, stroke and diabetes. In contrast to cancer patients, people living with depression or anxiety may lack good support, Rodriguez-Fernandez said, may be isolated and may have difficulty trusting providers online.
It’s critical for providers to keep in mind that patients with certain conditions are harder to follow, harder to treat and harder to engage with, he said, and therefore may be less responsive to telemedicine than others, he said.
In terms of physical unreadiness, nearly every condition studied except for cancer was found to be significantly impacted. One helpful solution is making technology more accessible to patients with physical barriers, Rodriguez-Fernandez said, like improving touch features on devices for patients with diabetic neuropathy.
“We have to engage into a new design of telemedicine,” he explained, “that follows the senior technology acceptance model. The idea is that we have to design our apps better.”
Transcribing visit notes may save physicians energy
In a presentation on how patient visit notes can be automatically generated using technology, Kevin Lybarger, a postdoctoral fellow and engineer at the Department of Biomedical and Health Informatics at the University of Washington, explained the benefits and drawbacks of the developing approach.
“Creating clinical notes is known to be time-consuming, and in fact, this documentation burden negatively impacts the job satisfaction of clinicians,” he said. Notes may also at times omit critical information, he added.
With the aid of what’s known as a digital scribe, a visit dialogue can be recorded, transcribed using speech recognition and then produced in a note that can be edited and finalized by the clinician before being put into the electronic health record.
In his past work, Lybarger and his team had set up information extraction modules to draw out information on social determinants of health and symptom data from clinical texts. They then applied those extractors to the dialogue transcripts and evaluated their performance in a conversational environment.
What they found is that the visit transcripts were “rich” with symptom data, with roughly a dozen symptoms per note. However, the extractors still outperformed on clinical notes, for which they were originally designed.
One problem is that extractors have difficulty recognizing colloquial language used by patients during visits. Ultimately, while digital scribes have the potential to ease the documentation burden for clinicians and may benefit from these types of information extraction modules, “new extraction architectures are likely needed to extract medical concepts from the dialogues with high performance,” Lybarger said.
Dental nurse almost blinded by botched lip fillers — as beautician injected into artery
A dental nurse claims she was almost left blind after a bungling beautician she 'trusted' injected into her artery during a botched lip filler treatment — that blocked blood flowing into her face.
Amy Wiseman, from Durham, paid £70 to go under the needle last month but knew something wasn't right when she was left in 'agony' with a bruised lip.
Despite being in 'agony', the 21-year-old says the beautician told her it was 'nothing to worry about'.
However after sharing photos her dramatically-swollen lip, a quick-thinking dental colleague had them checked by plastic surgeons and a GP, who warned her that the filler could have blocked the blood supply in her face.
Horrified Amy was told by medics that she could have lost her eyesight and movement in the left side of her face if her lip filler wasn't dissolved within 24 hours.
The dental nurse claims that the filler was injected into an artery, causing a vascular occlusion, where blood can't pass through a blood vessel.
Amy claims her lip had been starved of oxygen and she had 24 hours to save her face before the tissue completely died, which would have left her needing a skin graft to save her dying face.
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The filler was dissolved by a medical practitioner the next day who told her that she'd been at risk of losing her eyesight — while a GP said she was lucky to still have a lip at all.
Amy said: "I was in utter shock when they said I could lose my sight.
"I didn't know what was going on. I didn't know if my lips could be saved or if they would be permanently damaged.
"I had reduced blood flow because the filler was blocking the artery so the bruising was blood that had nowhere to go.
"The dentist said if I didn't get it dissolved in 24 hours then I would go blind.
"If I didn't work in a dentist, I would have lost my eyesight and the left side of my face and I would have needed a tissue graft in my face.
"What if I'd ended up losing my eyesight and face? I wouldn't want to be here."
Amy had 0.5ml injected but immediately noticed something wasn't right as she's been having the treatment since she was 17.
After frantically messaging the beautician who'd carried out the treatment, she was assured that the bruising was normal and Amy thanks her career as a dental nurse for saving her sight.
Amy said: "After the first injection, I felt severe pain but I didn't think anything of it because I know getting your lips done hurts but it was worse than I've experienced before.
"I told the lady and she said it will look swollen because she'd hit a vein but it's nothing to worry about unless its a vascular occlusion.
Как сделать макияж скелета на Хэллоуин: пошаговая инструкция для мужчин
Для создания этого образа вам понадобятся:
Приближенные к профессиональным изображения докторов
Неудивительно, что перед тем как нарисовать доктора, многие задумываются о том, как же воплотить эту идею в реальность. Ведь многие из произведений искусства могут легко стать претендентами для попадания на школьную выставку. А ведь это гордость и почет для ученика.
Чтобы картина выглядела словно профессиональная, необязательно придерживаться пропорций миллиметр в миллиметр. Порой решающую роль играет то, какой краской разукрашено творение. Масляные, акриловые или гуашь. Все эти варианты помогут сделать рисунок идеальным, словно его начертал настоящий художник.
Dental nurse almost blinded by botched lip fillers — as beautician injected artery
A dental nurse claims she was almost left blind after a bungling beautician she 'trusted' injected into her artery during a botched lip filler treatment — that blocked blood flowing into her face.
Amy Wiseman, from Durham, paid £70 to go under the needle last month but knew something wasn't right when she was left in 'agony' with a bruised lip.
Despite being in 'agony', the 21-year-old says the beautician told her it was 'nothing to worry about'.
The 31-year-old had them checked by her GP, who said the filler could have blocked the blood supply in her face. (Image: Kennedy News and Media)
However after sharing photos her dramatically-swollen lip, a quick-thinking dental colleague had them checked by plastic surgeons and a GP, who warned her that the filler could have blocked the blood supply in her face.
Horrified Amy was told by medics that she could have lost her eyesight and movement in the left side of her face if her lip filler wasn't dissolved within 24 hours.
The dental nurse claims that the filler was injected into an artery, causing a vascular occlusion, where blood can't pass through a blood vessel.
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Amy claims her lip had been starved of oxygen and she had 24 hours to save her face before the tissue completely died, which would have left her needing a skin graft to save her dying face.
The filler was dissolved by a medical practitioner the next day who told her that she'd been at risk of losing her eyesight — while a GP said she was lucky to still have a lip at all.
Amy said: "I was in utter shock when they said I could lose my sight.
"I didn't know what was going on. I didn't know if my lips could be saved or if they would be permanently damaged.
"I had reduced blood flow because the filler was blocking the artery so the bruising was blood that had nowhere to go.
"The dentist said if I didn't get it dissolved in 24 hours then I would go blind.
Amy believes that the lip fillers blocked off vital oxygen from her lip (Image: Kennedy News and Media)
"If I didn't work in a dentist, I would have lost my eyesight and the left side of my face and I would have needed a tissue graft in my face.
"What if I'd ended up losing my eyesight and face? I wouldn't want to be here."
Amy had 0.5ml injected but immediately noticed something wasn't right as she's been having the treatment since she was 17.
After frantically messaging the beautician who'd carried out the treatment, she was assured that the bruising was normal and Amy thanks her career as a dental nurse for saving her sight.
Amy said: "After the first injection, I felt severe pain but I didn't think anything of it because I know getting your lips done hurts but it was worse than I've experienced before.
"I told the lady and she said it will look swollen because she'd hit a vein but it's nothing to worry about unless its a vascular occlusion.
Read More
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"I asked how she knew it wasn't that and she said it was fine.
"I looked at my lips in the car and I was really upset. They were bruised straight away which they don't normally do and the left side of my lip didn't look right at all and the pain was awful. It was agony.
"I sent a photo to the lady, she said it was just bruising and I trusted her because she's done them before.
"Later on the pain got really bad and I was really worried so I sent a photo to a dentist at work and they said I needed to go to the hospital.
"I went but there was a six-hour wait so I thought I'd leave it until the morning.
"My colleague sent photos to GPs and plastic surgeons she knows who said I needed to get it dissolved as soon as possible.
"The dentist dissolved the filler and the GP they'd been in touch with said the fact I still had my lip was unbelievable.
Amy says she would have listened to her GP were she not a dentist herself (Image: Kennedy News and Media)
"If it wasn't for me working in a dentist, I would have taken the lady's advice.
"They used six cartridges over two days to dissolve 0.5ml of filler."
Amy says she the traumatic ordeal has knocked her confidence so much that it's put her off lip filler treatment for life.
Amy said: "One side of my lips is smaller than the other where I've had the filler dissolved because it was an emergency so I was so grateful we have to wear masks because it's made me feel so down.
"It's my face at the end of the day and I was so concerned I would have permanent damage.
"I started getting them at 17 and it became a habit.
The botched injection caused the dental nurse's lip to double in size (Image: Kennedy News and Media)
"It's one of those things. Some people like going out drinking. I like the way they look but this has made me realise that there's more to life than getting lip filler. I'm still very traumatised."
Amy is sharing her ordeal in a bid to raise awareness and urge people to only get lip filler treatment by medically trained professionals.
Amy said: "It has put me off and I wouldn't get them done again but if I was to get them done again I'd go to someone who is medically trained.
"People do a lip filler course in a day and they're qualified. A medic could have diagnosed the issue and resolved it straight away.
"People need to be made aware of how dangerous it can be. Someone else might find out an even harder way."
Concerns at Cobequid
One persisting concern for the nurses' union is the fact that Cobequid Community Health Centre in Lower Sackville, N.S., has not been able to shut down overnight on several occasions over the last few months.
The hospital is scheduled to close at 12 a.m. AT and transfer patients to nearby centres such as Dartmouth General Hospital or QEII Health Sciences Centre.
"There's no capacity to take them anywhere else, so those nurses have to work and those patients have to stay," said Hazelton. "The issue with that is because Cobequid is not equipped to look after patients for long periods of time."
The health authority says in June, it needed to stay open 20 per cent of the time. In May, Cobequid didn't stay open at all.
Hazelton said it's not ideal for patients because the hospital doesn't have a kitchen or in-patient beds, and it's exhausting for nurses because they have to stay hours beyond their scheduled shift.
She added it's only a matter of time before the problem gets even worse.
"If you work for 24 hours straight, it's going to take you days to get over that. And if you do it often, you're going to get sick," she said.
A labour management committee is being formed between the unions and Nova Scotia Health to discuss how best to fill nursing positions in the short term.
