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Nurses' Perceived Needs and Barriers Regarding Pediatric Palliative Care: A Mixed-Methods Study

  • Kang, Kyung-Ah;Yu, SuJeong;Kim, Cho Hee;Lee, Myung-Nam;Kim, Sujeong;Kwon, So-Hi;Kim, Sanghee;Kim, Hyun Sook;Park, Myung-Hee;Choi, Sung Eun
    • Journal of Hospice and Palliative Care
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    • 제25권2호
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    • pp.85-97
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    • 2022
  • Purpose: This study aimed to describe nurses' perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through open-ended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: "children and adolescents," "families," "PPC management system," and "community-based PPC." Meanwhile, PPC barriers were divided into 3 categories: "healthcare delivery system," "healthcare provider," and "client." The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion: In this study, by using mixed-methods, items of nurses' perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

소설의 발생과 성적 계약 -국민국가 담론을 넘어 (The Rise of the Novel and the Sexual Contract: Beyond correspondence between novel and nation-state)

  • 김봉률
    • 영어영문학
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    • 제55권5호
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    • pp.793-820
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    • 2009
  • The studies of correspondence between novel and nation-state, among which The Rise of the Novel by Ian Watt is supposed to be the first book, have flourished for more than twenty years, encouraged by Benedict Anderson's and Cathy Davidson's works. According to them, the novel should come simultaneously with, or after the foundation of the nation-state, and testify to its production or the emergence of its subject/citizen. This paper questions about these prepositions, trying to introduce a new paradigmatical approach, "between global and transnational historical approach," to first novels in transatlantic areas including England and atlantic coastal areas. In its complex relation to a variety of colonial, post-colonial, and transnational geopolitics, various cultural practices such as history, traveler's tales and epistolary novels can be included in the genre of the novel. The idea of the sexual contract by Carole Pateman is very useful because it helps more clearly understand the nature of relation between men and women in the capitalist reproduction, while the social contract tells about the relation between men as citizens. Unlike Freud in Totem and Taboo, Zilboorg argues that there were primordial and violent scenes such as rape before the first sexual contract. This paper will illuminate that "the rise of the novel" corresponded with the emergence of the sexual contract. In the so-called first novel Pamela, the heroine Pamela was threatened to be violated by Mr. B., and was really even confined in his cottage. Mary Rowlandson's The Captive Narrative shows that her body was confined as an English female captive, and troubled with imaginary rape by Indians which resulted in the unequal sexual contract between her and her puritan community in America. However, Leonora Sansay's Secret History in an alternative communality, which was not a nation-state, was different from both novels mentioned above, in that it shows the possibility of emancipation from their unequal marriage, the sexual contract. Therefore, it can be argued that "between global and transnational historical approach" has a possibility to provide a new vision of global sisterhood and solidarity to recognize globalized women's violence, and free themselves from the unequal sexual contract.

Incorporation of amoxicillin-loaded microspheres in mineral trioxide aggregate cement: an in vitro study

  • Fabio Rocha Bohns;Vicente Castelo Branco Leitune;Isadora Martini Garcia;Bruna Genari;Nelio Bairros Dornelles Junior;Silvia Staniscuaski Guterres;Fabricio Aulo Ogliari;Mary Anne Sampaio de Melo;Fabricio Mezzomo Collares
    • Restorative Dentistry and Endodontics
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    • 제45권4호
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    • pp.50.1-50.11
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    • 2020
  • Objectives: In this study, we investigated the potential of amoxicillin-loaded polymeric microspheres to be delivered to tooth root infection sites via a bioactive reparative cement. Materials and Methods: Amoxicillin-loaded microspheres were synthesized by a spray-dray method and incorporated at 2.5% and 5% into a mineral trioxide aggregate cement clinically used to induce a mineralized barrier at the root tip of young permanent teeth with incomplete root development and necrotic pulp. The formulations were modified in liquid:powder ratios and in composition by the microspheres. The optimized formulations were evaluated in vitro for physical and mechanical eligibility. The morphology of microspheres was observed under scanning electron microscopy. Results: The optimized cement formulation containing microspheres at 5% exhibited a delayed-release response and maintained its fundamental functional properties. When mixed with amoxicillin-loaded microspheres, the setting times of both test materials significantly increased. The diametral tensile strength of cement containing microspheres at 5% was similar to control. However, phytic acid had no effect on this outcome (p > 0.05). When mixed with modified liquid:powder ratio, the setting time was significantly longer than that original liquid:powder ratio (p < 0.05). Conclusions: Lack of optimal concentrations of antibiotics at anatomical sites of the dental tissues is a hallmark of recurrent endodontic infections. Therefore, targeting the controlled release of broad-spectrum antibiotics may improve the therapeutic outcomes of current treatments. Overall, these results indicate that the carry of amoxicillin by microspheres could provide an alternative strategy for the local delivery of antibiotics for the management of tooth infections.

Assessment of the radiant emittance of damaged/contaminated dental light-curing tips by spectrophotometric methods

  • Abdulrahman A. Balhaddad;Isadora Garcia;Fabricio Collares;Cristopher M. Felix;Nisha Ganesh;Qoot Alkabashi;Ward Massei;Howard Strassler;Mary Anne Melo
    • Restorative Dentistry and Endodontics
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    • 제45권4호
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    • pp.55.1-55.12
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    • 2020
  • Objectives: This study investigated the effects of physically damaged and resin-contaminated tips on radiant emittance, comparing them with new undamaged, non-contaminated tips using 3 pieces of spectrophotometric laboratory equipment. Materials and Methods: Nine tips with damage and/or resin contaminants from actual clinical situations were compared with a new tip without damage or contamination (control group). The radiant emittance was recorded using 3 spectrophotometric methods: a laboratory-grade thermopile, a laboratory-grade integrating sphere, and a portable light collector (checkMARC). Results: A significant difference between the laboratory-grade thermopile and the laboratory-grade integrating sphere was found when the radiant emittance values of the control or damaged/contaminated tips were investigated (p < 0.05), but both methods were comparable to checkMARC (p > 0.05). Regardless of the method used to quantify the light output, the mean radiant emittance values of the damaged/contaminated tips were significantly lower than those of the control (p < 0.05). The beam profile of the damaged/contaminated tips was less homogeneous than that of the control. Conclusions: Damaged/contaminated tips can reduce the radiant emittance output and the homogeneity of the beam, which may affect the energy delivered to composite restorations. The checkMARC spectrophotometer device can be used in dental offices, as it provided values close to those produced by a laboratory-grade integrated sphere spectrophotometer. Dentists should assess the radiant emittance of their light-curing units to ensure optimal curing in photoactivated, resin-based materials.

Resin infiltrant protects deproteinized dentin against erosive and abrasive wear

  • Ana Theresa Queiroz de Albuquerque;Bruna Oliveira Bezerra;Isabelly de Carvalho Leal;Maria Denise Rodrigues de Moraes;Mary Anne S. Melo;Vanara Florencio Passos
    • Restorative Dentistry and Endodontics
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    • 제47권3호
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    • pp.29.1-29.10
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    • 2022
  • Objectives: This study aimed to investigate the anti-erosive/abrasive effect of resin infiltration of previous deproteinized dentin. Materials and Methods: Dentin slabs were randomly assigned to 3 groups (n = 15): Control (no deproteinization; no resin infiltrant applied), RI (no deproteinization; resin infiltrant applied), and DRI (deproteinization; resin infiltrant applied). After undergoing the assigned treatment, all slabs were subjected to an in vitro cycling model for 5 days. The specimens were immersed in citric acid (0.05 M, pH = 3.75; 60 seconds; 3 times/day) and brushed (150 strokes). Between the challenges, the specimens were exposed to a remineralizing solution (60 minutes). The morphological alterations were analyzed by mechanical profilometry (㎛) and scanning electron microscopy (SEM). Data were submitted to one-way analysis of variance (ANOVA) and Tukey tests (p < 0.05). Results: Control and RI groups presented mineral wear and did not significantly differ from each other (p = 0.063). DRI maintained a protective layer preserving the dentin (p < 0.001). After erosive/abrasive cycles, it was observed that in group RI, only 25% of the slabs partially evidenced the presence of the infiltrating, while, in the DRI group, 80% of the slabs presented the treated surface entirely covered by a resin-component layer protecting the dentin surface as observed in SEM images. Conclusions: The removal of the organic content allows the resin infiltrant to efficiently protect the dentin surface against erosive/abrasive lesions.

양극성 장애 환자에서 퇴원 이후 외래 치료 유지에 영향을 미치는 예측인자 : 일 대학병원 후향적 의무기록 조사연구 (Predictors of Continuity of Care after Inpatient Discharge of Patients with Bipolar Disorder : A Retrospective Chart Review Study in a University Hospital)

  • 왕희령;정영은;송후림;전태연;김광수;박원명
    • 우울조울병
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    • 제9권2호
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    • pp.126-132
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    • 2011
  • Background and Objectives : This study aims to identify sociodemographic and disease-related variables which predicts continuity of outpatient treatment after discharge among bipolar patients. Materials and Method : The medical records of patients who discharged with the diagnosis of bipolar disorder from Department of Psychiatry, St. Mary's hospital from 2005 to 2009 were reviewed. Data on sociodemographic and disease-related variables were analyzed. Results : It showed older age, higher rate of male and higher rate of being married in 1-year follow-up group than in non-follow-up group. And it showed longer duration of index hospitalization, higher rate of previous psychiatric outpatient treatment within 3 months before index hospitalization, higher rate of involuntary admission in 1-year follow-up group than in non-follow-up group. The univariate logistic regression analysis revealed that older age, being male, previous psychiatric treatment and longer duration of index hospitalization were significantly related to an increased likelihood of 1-year follow-up visits. Conclusion : Age, sex, history of previous psychiatric treatment, and duration of hospitalization seems to have influence on continuity of outpatient treatment after discharge.

사내기업가정신이 의료기관의 조직유효성에 미치는 영향 : 사내 혁신·창업 공모전 참여동기의 매개효과와 전담조직 지원의 조절효과 (The Effect of Corporate Entrepreneurship on Organizational Effectiveness of Medical Institutions : Mediating Effect of Motivation to Participate in The In-house Innovation & Start-up Contest and Moderating Effect of Support from a Dedicated Organization)

  • 한재훈;박병진
    • 한국병원경영학회지
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    • 제28권3호
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    • pp.68-86
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    • 2023
  • Purpose: The purpose of this study is to explore the relationship between corporate entrepreneurship and organizational effectiveness among employees of medical institutions. In addition, we aim to investigate the mediating effect of motivation to participate in the In-house Innovation & Start-up Contest and the moderating effect of support from a dedicated organization. Methodology/Approach: A survey was conducted on participants in the 3rd in-house contest held in 2023 at Granum Sinapis Center of Seoul St. Mary's Hospital. A total of 122 people responded to the survey. The collected data were analyzed PLS-SEM(Partial Least Squares-Structural Equation Model) using SmartPLS 4.0 program. Findings: First, 'Corporate entrepreneurship' had an effect on 'Participation motivation in in-house contest'. Second, 'Corporate entrepreneurship' had an effect on 'Organizational Effectiveness'. Third, 'Participation motivation in in-house contest' mediated the relationship between 'Corporate entrepreneurship' and 'Organizational Effectiveness'. And last, 'Support from a dedicated organization' had no moderating effect on the relationship between 'Corporate entrepreneurship' and 'Organizational Effectiveness'. Practical Implications: Since the dedicated organization is in the early stages of operation, there may be no moderating effect on organizational effectiveness. If follow-up research is conducted after the dedicated organization's system has been supplemented, the moderating effect may appear differently.

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Occupational Characteristics and Health Status of Vietnamese Male Migrant Workers in the Republic of Korea

  • Ohwi Kwon;Ji-Hun Song;Jeong-Ok Kong;Seong-Won Ma;Young Shin Lee;Joonho Ahn
    • Safety and Health at Work
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    • 제14권3호
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    • pp.267-271
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    • 2023
  • Background: The objective of this study is to identify the working conditions and health status of Vietnamese male migrant workers in Republic of Korea, in comparison to the Korean general population. Methods: We conducted our survey through the Migrant People Center, and we received completed questionnaires from 87 male Vietnamese migrant workers. The questionnaire employed was identical to those used in the Korean Working Conditions Survey and the 2020 Korea National Health and Nutrition Examination Survey. The collected data from the Vietnamese migrant workers was then compared with the Korean reference population using indirect age-standardization. Results: Vietnamese male workers demonstrated a higher prevalence of health problems including hearing problems (age-standardized prevalence ratio (aSPR) 13.22, 95% confidence interval [CI]: 8.07-20.4), skin problems (aSPR 13.49, 95% CI: 8.07-20.4), and low back pain (aSPR 8.40, 95% CI: 6.50-10.69). Elevated exposure to workplace hazards such as chemicals (aSPR 2.36, 95% CI: 1.51-3.51), organic solvents (aSPR 2.22, 95% CI: 1.44-3.28), handling of heavy objects (aSPR 1.67, 95% CI: 1.24-2.21), and high temperatures (aSPR 1.96, 95% CI: 1.46-2.57) was observed among them. Additionally, they faced a higher risk of no personal protective equipment (aSPR 2.53, 95% CI: 1.26-4.52) and a greater prevalence of unmet medical needs (aSPR 7.14, 95% CI: 4.74-10.32). Conclusion: Our findings highlight the elevated workplace hazards, health problems, and unmet medical needs among Vietnamese male workers compared to the Korean reference population. These findings underscores the urgency for enhanced scrutiny over working conditions and protective equipment provision, coupled with efforts to improve healthcare accessibility and worker education.

관심 영역 설정에 따른 Gates법 토리여과율의 유효성 평가 (Evaluation of Validity Glomerular Filtration Rate Measured by Gates Method according Region of Interest)

  • 박수영;안성민
    • 대한방사선기술학회지:방사선기술과학
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    • 제46권5호
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    • pp.417-425
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    • 2023
  • The glomerular filtration rate (GFR) has been the subject of much research as a key indicator for diagnosing, treating, and monitoring kidney function. The gamma camera method (Gates method) is simple and allows simultaneous acquisition of GFR and renal scintigraphy for each kidney, however its accuracy is inferior. This study aimed to investigate changes in GFR depending on how region of interest (ROI) are set up, which is one of many factors influencing accuracy. GFR was calculated by setting the ROI for each phase of the image acquisition time (Gates-1: 0~1 minutes, Gates-2: 1~3 minutes, Gates-3: 3~27 minutes), and statistical significance was verified based on probability value 0.05 through ANOVA analysis. While there was no statistically significant difference among results from Gates-1, 2, 3 (p=0.481>0.05), overall results from the Gates method tended to overestimate compared to those from the multiple blood sampling-dual exponential (MBSDE) method. When comparing averages between phases, results from Gates-2 were most similar to those from the MBSDE method. Moreover, paired t-test p-values between MBSDE method and phases were as follows Gates-1: 0.021 (p<0.05), Gates-2: 0.280 (p>0.05), and Gates-3: 0.164 (p>0.05) indicating that only Gates-1 had statistically significant differences compared with MBSDE method. Thus, setting ROI around 2~3 minutes is calculated can aid in accurately determining GFR when Gates Method.

관상동맥중재술 후 개별화된 교육-상담 프로그램이 심혈관위험도 및 건강행위에 미치는 효과 (Effect of Individualized Education-counseling Program on Cardiovascular Risk and Health Behavior in Patients with Percutaneous Coronary Intervention)

  • 조화영;우수희
    • 근관절건강학회지
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    • 제30권3호
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    • pp.254-262
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    • 2023
  • Purpose: This study was to determine the effect of Individualized education-counseling program on the performance of Health behavior and Cardiovascular risk after discharge inpatients with percutaneous coronary intervention. Methods: This study is a quasi-experimental study of the non-equivalence control group and the subjects of this study were patients who underwent percutaneous coronary intervention for coronary artery disease and had no complications due to severe arrhythmia or heart failure. The purpose of the study was explained to the subjects who met the selection conditions, and written consent was obtained, and 50 randomized experimental groups and 50 control groups were selected and assigned. Results: Compared to the control group, health behaviors were significantly higher after 1 week (F=33.63, p<.001) and 12 weeks (F=23.63, p<.001). The cardiovascular risk score based on Framingham risk score differed significantly depending on the measurement period (F=26.18, p<.001), there was no significant difference in the interaction between the two groups and the measurement period (F=0.72, p=.469). Conclusion: It was confirmed that the Individualized education counseling program provided to patients with Percutaneous coronary intervention was effective in increasing the subject's health behavior, but not in lowering the cardiovascular risk.