• Title/Summary/Keyword: Care efficacy

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Effects of Maternity Nursing Simulation using High-fidelity Patient Simulator for Undergraduate Nursing Students (고충실도 시뮬레이터를 활용한 모성간호 시뮬레이션 교육의 효과)

  • Kim, Ahrin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.3
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    • pp.177-189
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    • 2016
  • This study examined the effectiveness of maternity nursing simulations using a high-fidelity simulator for undergraduate nursing students. One-group pretest-posttest design was used. The simulation-based education program consisted of three sessions, including the clinical scenarios about prenatal, childbearing and postpartum care. The program provided for 3 weeks in November 2014. Data was collected before and after the simulation education using self-reported questionnaires, which included simulation effectiveness, problem solving ability, communication skills and self-confidence in maternity nursing. The data of 83 participants were analyzed using the IBM SPSS 20.0 program. After simulation education, the overall score of the simulation effectiveness was 17.4 out of 26.0. Communication skill (t=4.58, p=<.001) and self-confidence in maternity nursing (t=9.70, p=<.001) increased significantly in the posttest. On the other hand, there was no significant change in the problem solving ability. The simulation effectiveness correlated significantly with the problem solving ability (r=.494, p<.001), communication skill (r=.361, p<.001), and self-confidence in maternity nursing (r=.497, p<.001) after simulation-based education. These findings suggest that the high-fidelity simulation in maternity nursing education could be used not only to enhance the nursing competency, but also to deal with the limitations of the clinical practicum in the current situation.

Anti-inflammatory and antimicrobial effects of Jeju rosemary essential oil against skin flora (제주산 로즈마리 에센셜 오일의 항염 및 피부 상재균에 대한 항균 활성)

  • Kim, So-Hee;Yi, Mi-Ran;Kim, Chang-Soo;Kim, Jung-Mi;Bu, Hee-Jung
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.3
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    • pp.744-756
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    • 2018
  • The purpose of this study was to investigate the anti-inflammatory effect and the antimicrobial activity to skin flora of essential oil from rosemary that naturally grown in Jeju. rosemary essential oil was extracted by water distillation essential oil extraction method. In order to confirm the anti-inflammatory activity of rosemary essential oil, it was confirmed that the production of NO and $PGE_2$ induced by LPS in RAW 264.7 cells was inhibited in a concentration-dependent manner. Western blot analysis showed that the expression of iNOS and COX-2, which are biosynthetic enzymes, decreased in a concentration-dependent manner. In addition, production of $TNF-{\alpha}$ and IL-6 the pro-inflammatory cytokines were inhibited. Antimicrobial activities of three S. epidermidis and three P. acnes strains including two antibiotic resistant strains were observed in paper disc method and MIC and MBC tests showed inhibition of bacterial growth and death. From the results of the experiment, we confirmed that rosemary essential oil has the anti-inflammatory and antimicrobial efficacy and it could be used as a cosmetic and skin care material in the future.

Success of a Cervical Cancer Screening Program: Trends in Incidence in Songkhla, Southern Thailand, 1989-2010, and Prediction of Future Incidences to 2030

  • Sriplung, Hutcha;Singkham, Phathai;Iamsirithaworn, Sopon;Jiraphongsa, Chuleeporn;Bilheem, Surichai
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.10003-10008
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    • 2014
  • Background: Cervical cancer has been a leading female cancer in Thailand for decades, and has been second to breast cancer after 2007. The Ministry of Public Health (MoPH) has provided opportunistic screening with Pap smears for more than 30 years. In 2002, the MoPH and the National Health Security Office provided countrywide systematic screening of cervical cancer to all Thai women aged 35-60 years under universal health care coverage insurance scheme at 5-year intervals. Objectives: This study characterized the cervical cancer incidence trends in Songkhla in southern Thailand using joinpoint and age period cohort (APC) analysis to observe the effect of cervical cancer screening activities in the past decades, and to project cervical cancer rates in the province, to 2030. Materials and Methods: Invasive and in situ cervical cancer cases were extracted from the Songkhla Cancer Registry from 1990 through 2010. Age standardized incidence rates were estimated. Trends in incidences were evaluated by joinpoint and APC regression models. The Norpred package was modified for R and was used to project the future trends to 2030 using the power of 5 function and cut trend method. Results: Cervical cancer incidence in Songkhla peaked around 1998-2000 and then dropped by -4.7% per year. APC analysis demonstrated that in situ tumors caused an increase in incidence in early ages, younger cohorts, and in later years of diagnosis. Conclusions: Both joinpoint and APC analysis give the same conclusion in continuation of a declining trend of cervical cancer to 2030 but with different rates and the predicted goal of ASR below 10 or even 5 per 100,000 women by 2030 would be achieved. Thus, maintenance and improvement of the screening program should be continued. Other population based cancer registries in Thailand should analyze their data to confirm the success of cervical cancer screening policy of Thailand.

Surgical Ligation on Significant Patent Ductus Arteriosus in Very Low Birth Weight Infants: Comparison between Early and Late Ligations

  • Lee, Jun Ho;Ro, Sun Kyun;Lee, Hyun Ju;Park, Hyun Kyung;Chung, Won-Sang;Kim, Young Hak;Kang, Jeong Ho;Kim, Hyuck
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.444-450
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    • 2014
  • Background: We aimed to evaluate the efficacy and safety of early surgical ligation (within 15 days of age) over late surgical ligation (after 15 days of age) by a comparative analysis of very low birth weight (VLBW) infants undergoing surgical correction for symptomatic patent ductus arteriosus (PDA) over the course of 6 years in our hospital. Methods: We retrospectively reviewed all the medical records in the neonatal intensive care unit at Hanyang University Seoul Hospital, from March 2007 to May 2013, to identify VLBW infants (<1,500 g) who underwent surgical PDA ligation. Results: The gestational age (GA) in the late ligation (LL) group was significantly younger than in the early ligation (EL) group (p=0.010). The other baseline characteristics and preoperative conditions did not differ significantly between the two groups. The intubation period before surgery (p<0.001) and the age at surgery (p<0.001) were significantly different. The postoperative clinical outcomes of the study patients, including major morbidity and mortality, are summarized. There were no significant differences in bronchopulmonary dysplasia, sepsis, or mortality between the EL and the LL groups. However, the LL group was significantly associated with an increased risk of necrotizing enterocolitis (p=0.037) and with a prolonged duration of the total parenteral nutrition (p=0.046) after adjusting for GA. Conclusion: Early surgical ligation for the treatment of PDA that failed to close after medical treatment or in cases contraindicated for medical treatment might be desirable to reduce the incidence of necrotizing enterocolitis and to alleviate feeding intolerance in preterm infants.

Outcomes of Pulmonary Resection and Mediastinal Node Dissection by Video-Assisted Thoracoscopic Surgery Following Neoadjuvant Chemoradiation Therapy for Stage IIIA N2 Non-Small Cell Lung Cancer

  • Jeon, Yeong Jeong;Choi, Yong Soo;Lee, Kyung Jong;Lee, Se Hoon;Pyo, Hongryull;Choi, Joon Young
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.29-34
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    • 2018
  • Background: We evaluated the feasibility and outcomes of pulmonary resection and mediastinal node dissection (MND) by video-assisted thoracoscopic surgery (VATS) following neoadjuvant therapy for stage IIIA N2 non-small cell lung cancer (NSCLC). Methods: From November 2009 to December 2013, a total of 35 consecutive patients with pathologically or radiologically confirmed stage IIIA N2 lung cancer underwent pulmonary resection and MND, performed by a single surgeon, following neoadjuvant chemoradiation. Preoperative patient characteristics, surgical outcomes, postoperative drainage, postoperative complications, and mortality were retrospectively analyzed. Results: VATS was completed in 17 patients. Thoracotomy was performed in 18 patients, with 13 planned thoracotomies and 5 conversions from the VATS approach. The median age was $62.7{\pm}7.9years$ in the VATS group and $60{\pm}8.7years$ in the thoracotomy group. The patients in the VATS group tended to have a lower diffusing capacity for carbon monoxide (p=0.077). There were no differences between the 2 groups in the method of diagnosing the N stage, tumor response and size after induction, tumor location, or histologic type. Complete resection was achieved in all patients. More total and mediastinal nodes were dissected in the VATS group than in the thoracotomy group (p<0.05). The median chest tube duration was 5.3 days (range, 1 to 33 days) for the VATS group and 7.2 days (range, 2 to 28 days) for the thoracotomy group. The median follow-up duration was 36.3 months. The 5-year survival rates were 76% in the VATS group and 57.8% in the thoracotomy group (p=0.39). The 5-year disease-free survival rates were 40.3% and 38.9% in the VATS and thoracotomy groups, respectively (p=0.8). Conclusion: The VATS approach following neoadjuvant treatment was safe and feasible in selected patients for the treatment of stage IIIA N2 NSCLC, with no compromise of oncologic efficacy.

Clinical Outcome for High-dose Pralidoxime in Treating Organophosphate Intoxication (유기인계 농약 중독 환자에서 고용량 Pralidoxime이 치료 결과에 미치는 효과)

  • Lee, Kyung-Min;Choi, Yoon-Hee;Cheon, Young-Jin;Lee, Duk-Hee
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.2
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    • pp.56-60
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    • 2011
  • Purpose: The optimal dose of oximes for use in the treatment of organophosphorus pesticide poisoning has not been conclusively established. In this retrospective study, we assessed the effectiveness of the use of high-dose pralidoxime infusion in treating organophosphorus pesticide poisoning. Methods: From January 1998 to December 2009, 71 patients visited the hospital Emergency Department (ED) as a result of organophosphate pesticide intoxication. All of these patients received an initial bolus of 2 g of pralidoxime as the first step of treatment. Patients who then received continuous infusion of pralidoxime at a dose of 500 mg/hr were entered into study group 1 (low dose), and those treated by continuous infusion of pralidoxime at a dose of 1000 mg/hr were entered into study group 2 (high-dose). Plasma cholinesterase activities for each patient were evaluated at ED arrival and re-evaluated 24 hours after pralidoxime infusion. The effectiveness of the two treatment modalities was gauged by comparing the required duration of mechanical ventilation, time spent in the intensive care unit (ICU) and total time spent in the hospital. Results: The mean duration of mechanical ventilation was $9.98{\pm}6.47$ days for group 1 and $4.39{\pm}6.44$ days for group 2. The respective mean duration of time spent in ICU and the total number of days in the hospital were $16.38{\pm}18.84$ days and $21.87{\pm}20.16$ days for group 1, and $7.83{\pm}9.99$ days and $11.71{\pm}13.53$ days for group 2. Highdose pralidoxime treatment was associated with shorter required durations for mechanical ventilation, ICU and hospital stay. In addition, plasma cholinesterase reactivation rates were higher for those patients receiving high-dose pralidoxime treatment. Conclusion: The results suggest that high-dose pralidoxime treatment has greater efficacy for patients suffering from organophosphorus pesticide poisoning.

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Angled implant brush for hygienic maintenance of full-arch fixed-implant rehabilitations: a pilot study

  • Setti, Paolo;Pesce, Paolo;Dellepiane, Elena;Bagnasco, Francesco;Zunino, Paola;Menini, Maria
    • Journal of Periodontal and Implant Science
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    • v.50 no.5
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    • pp.340-354
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    • 2020
  • Purpose: This pilot study was conducted to evaluate the cleaning efficacy of an angled implant brush for home oral hygiene of full-arch fixed-implant prostheses. Methods: Forty-one patients treated with a full-arch implant rehabilitation in the maxilla or mandible (164 implants) for at least 4 months were enrolled. The screw-retained fixed prostheses were removed and baseline (T0) parameters were recorded, including plaque index (PI), probing depth (PD), and bleeding on probing (BOP). All patients completed a 5-item questionnaire on hygiene maintenance and received an implant brush for home hygiene. After 1 month (T1) PI, PD, and BOP were recorded again and patients completed a 7-item questionnaire to evaluate their satisfaction with the implant brush. One-way repeated-measures analysis of variance was conducted to evaluate the significance of changes in PI, PD, and BOP. A P value <0.05 was considered to indicate statistical significance. Results: A statistically significant reduction of BOP (0.62±0.6 at T0 vs. 0.5±0.5 at T1; P=0.032) was found, while no statistically significant changes in PD (1.74±0.5 mm at T0 vs. 1.77±0.5 mm at T1; P=0.050) or PI (1.9±0.7 at T0 vs. 1.7±0.7 at T1; P=0.280) occurred. According to the 7-item questionnaire, patients reported no difficulty in using the angled brush (63.4%) and deemed it highly (46.3%) or very highly (4.8%) effective in improving their home oral hygiene. Conclusions: Within the limits of the present pilot study, the patients experienced a reduction of BOP 1 month after being instructed to use the angled implant brush. The angled implant brush appeared to be a well-accepted device for home-care hygiene of full-arch fixed-implant rehabilitations.

Clinical Comparison of Low-dose and High-dose Steroid in Pediatric Cardiac Surgery with Cardiopulmonary Bypass

  • Choi Seok-Cheol;Kim Song-Myung;Kim Yang-Weon
    • Biomedical Science Letters
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    • v.12 no.3
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    • pp.289-301
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    • 2006
  • Cardiopulmonary bypass (CPB) for cardiac surgery triggers the production and release of numerous chemotactic substances and cytokines, ensuing systemic inflammatory response that leads to postoperative major organ dysfunction. Traditionally, corticosteroids (steroid) have been administered to patients undergoing cardiac surgery to ward off these detrimental physiologic alterations. However, the majority of the studies have been performed on adult patients with high-dose steroid. We carried out a randomized, prospective, double-blind study to compare the efficacy of low-dose steroid with that of high-dose steroid and to determine the adequate dose of pretreated-steroid for prophylactic effects in pediatric cardiac surgery. Thirty pediatric patients scheduled for elective cardiac surgery were randomly assigned to two groups; fifteen patients received low-dose methylprednisolone (10mg/kg intravenously, n=15, low-dose group) and the others received high-dose methylprednisolone (30mg/kg intravenously, n=15, high-dose group) 1 hour prior to CPB. Arterial blood samples were taken before CPB (Pre-CPB), 10 minutes after start of CPB (CPB-10), and immediately after CPB-end (CPB-OFF) for measuring total leukocyte counts (T-WBC) and diff-counts, platelet counts, interleukin-6 (IL-6), myeloperoxidase (MPO), total antioxidant (TAO), neuron-specific enolase (NSE), troponin I (TNI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and blood urea nitrogen (BUN) levels. Other parameters such as volumes of urine output, pulmonary index $(PI,\;PaO_2/FiO_2)$, mechanical ventilating period, intensive care unit (ICU)-staying period, postoperative complications (fever, wound problem), postoperative 24 hrs and total volumes in blood loss, and hospitalized days were also assessed. All parameters were compared between two groups. There were no significant differences in T-WBC counts, monocyte fraction, platelet counts, TA levels, NSE levels, creatinine levels, BUN levels, the volumes of total urine output, PI, the incidences of fever and wound problem, postoperative 24hrs- and total-blood loss volumes and ICU-staying period between two groups (P>0.05). At CPB-OFF, neutrophil fraction, MPO level, TNI level, and AST level were higher in the high-dose group than in the low-dose group (P<0.05). IL-6 level at CPB-10 was higher in the high dose-group than in the low-dose group (P<0.05). Furthermore, mechanical ventilating periods and hospitalized days of the high-dose group were significantly longer than those of low-dose group (P<0.05). The high-dose group had significantly low lymphocyte fi-action at CPB-OFF compared with the low-dose group (P<0.001). These findings suggest that pretreatment of high-dose steroid is not superior to that of low-dose steroid regrading its potential benefits in pediatric cardiac surgery. Therefore, the conventional strategy of steroid treatment, high-dose pretreatment, should be modified in the cardiac surgery with CPB. However, further studies must be performed on the larger number of patients in as much as small number of patients in this study.

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A Survey on the Perception of Gruel as Medicated Juk for Menu Development - Focusing on the Elders in Daejon area - (약선죽(藥膳粥) 메뉴개발을 위한 인식조사 - 대전지역 노인을 중심으로 -)

  • Kim, Jung Eun;Chang, Woo Shim;Ji, Myoung Soon
    • Korean journal of food and cookery science
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    • v.30 no.2
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    • pp.219-227
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    • 2014
  • The objective of this study was to research the health status of the elderly population and their perception and compliance to cook medicated juk. The results from this research will be used as basic data for medicated juk development. In addition, the purpose of this study was to find a way to popularize the juk and improve their usage as medicated juk in communal feeding and convalescent hospital for elderly. The study surveyed 300 elderly residents of age over 65, in Daejeon. The following data were collected: general characteristic, health status, perception of medicated juk, and preferred kind of juk for cooking. Moreover, the study researched the constraints in cooking the juk. Data were analyzed by SPSS Windows V. 18.0 and t-test verified the differences among the questions, according to frequency analysis of each item and characteristics of the aged. You might want to specify this characteristic. Within the surveyed elderly population, 80.6% had various existing diseases with circulatory diseases being the most prevalent with 68.9%. This emphasizes on the significance of proper diet, but this recognition is not put into practice. The survey also showed that as the individuals age, they tend to care less about the necessity of proper diet. Despite of this lack of perception, 84.5% of the elderly population responded positively to the question, "Would you like to have medicated juk for curing diseases, if such juk is available?" In addition, the elderly population was in favor of developing the juk that helps to prevent and cure diseases, and many were willing to cook them. The reasons behind their will to cook are arranged in the following order: higher efficacy in curing disease than regular juk, excellence in nutrition, and unavailability of the medicated juk in the stores that requires them to cook. The sources constraining the elderly population in cooking are arranged in the following order: not knowing how to cook the juk, lack of physical strength, financial burden, and lack of information order. Please clarify this part. Suggested change: not knowing what medicated juk is. Furthermore, the main obstacle in cooking the juk is lack of cooking technique, followed by inaccessibility to the ingredients and the financial burden to purchase the ingredients.

Conventional Radiotherapy with Concurrent Weekly Cisplatin in Locally Advanced Head and Neck Cancers of Squamous Cell Origin - a Single Institution Experience

  • Dimri, Kislay;Pandey, Awadhesh Kumar;Trehan, Romeeta;Rai, Bhavana;Kumar, Anup
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6883-6888
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    • 2013
  • Background: Platinum based concurrent chemo-radiation is the de-facto standard of care in the non-surgical management of locally-advanced head and neck cancer of squamous origin. Three-weekly single agent cisplatin at 100 $mg/m^2$ concurrent with radical radiotherapy has demonstrated consistent improvement in loco-regional control and survival. This improvement is however at the cost of considerable hematologic toxicity and poor overall compliance. The routine use of this regime is improbable in developing countries with limited resources. We therefore aimed to determine the safety and efficacy of an alternative regime of weekly cisplatin and concurrent radiotherapy in such patients. Materials and Methods: January-05 and April-12, 188 patients of locally-advanced head and neck cancer of squamous origin were treated with concurrent weekly-cisplatin at $35mg/m^2$ and conventional radiotherapy 60-66Gy/30-33 fractions/5days per week. Results: Overall, 95% patients received planned doses of RT while 74% completed within the stipulated overall treatment time of <50 days. Eighty-two percent received at-least 5 weekly cycles. Grade-III/IV mucositis was seen in 58%/9% respectively, which resulted in mean weight loss of 9.2% from a pre-treatment mean of 54.5 kg. Grade-III hematologic toxicity-0.5%; grade II nephrotoxicity-2.5% and grade III emesis-3% were also seen. Grade-III/IV subcutaneous toxicity-10%/1% and grade-III/IV xerostomia-10%/0% were observed. Complete responses at the primary site, regional nodes and overall disease were seen in 86%, 89% and 83% patients respectively. The median and 5-years disease-free survival were 26 months and 39.4% respectively, while the median and overall survival were 27 months and 41.8% respectively. Conclusions: Weekly-cisplatin at 35 $mg/m^2$ when delivered concurrently with conventional radical RT (at-least 66y/33 fractions) in locally-advanced head and neck cancer is well tolerated with minimal hematologic and neprologic toxicity and can be routinely delivered on an out-patient basis. It is an effective alternative to the standard 3-weekly cisplatin especially in the context of developing countries.