• Title/Summary/Keyword: Population-based intervention

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Practical Communication Strategies to Improve the Surgical Outcomes in a Pediatric Cardiac Intensive Care Unit (소아심장외과 중환자실에서의 실무의사소통 프로토콜이 수술 후 성과에 미치는 영향)

  • Uhm, Ju-Yeon;Lee, Worlsook
    • Journal of Korean Academy of Nursing Administration
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    • v.21 no.3
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    • pp.243-253
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    • 2015
  • Purpose: The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). Methods: Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS. Results: The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (${\chi}^2=7.23$, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (${\chi}^2=6.66$, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (${\chi}^2=20.31$, p<.001). Conclusion: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.

Development of Health Assessment Tools and Tailored Home Visiting Nursing Service Model for Children in Poverty (신생아-학령전기 대상자의 맞춤형 방문건강관리 기록지 및 모형 개발)

  • Kim, Hee-Ja;Yoo, Jae-Soon;Kim, Hyun-Sook;Tak, Yang-Ju;Bang, Kyung-Sook;Huh, Bo-Yun
    • Korean Parent-Child Health Journal
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    • v.13 no.2
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    • pp.63-77
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    • 2010
  • Purpose: The purpose of this study was to develop child's health assessment tools and tailored home visiting nursing service model in a community. Methods: Based on the literature review and several types of workshops participated with the child health nursing professors and visiting nurses in public health centers from May to December 2009, the standards of child health assessment tools, service model and education materials for visiting nurses were developed. Results: Some record forms were newly developed, including neonatal assessment, breast feeding, mother-infant interaction, oral care, vaccination and safety, and appropriate developmental screening tests in the community were selected. For systematic health care management in the community, problem list, problem criteria, health care plan, outcome criteria were also developed. Conclusion: On the demand of growing need for health promotion and early intervention for children and their association with parenting and socioeconomic status, assessment and control measures are indispensable to the promotion of child health for vulnerable population. Children's health and developmental problems, and safe circumstances can be assessed using this assessment tools, and can be used for tailored home visiting nursing care for children.

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Firefighters and Posttraumatic Stress Disorder (소방공무원과 외상 후 스트레스 장애)

  • Ryu, Jia;Ha, Eunhee;Jeong-Choi, Kyunghee;Kim, Jieun E.;Park, Shinwon;Kim, Hyunjoo
    • Korean Journal of Biological Psychiatry
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    • v.24 no.1
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    • pp.10-18
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    • 2017
  • Occupational hazards of firefighting and rescue works include frequent exposure to emergencies and life-threatening situations. These stressful work conditions of being constantly under pressure and exposed to potentially traumatic events put them at higher risk of developing posttraumatic stress disorder (PTSD), compared to the general population. PTSD is a potentially debilitating mental disorder, due to persistent intrusive thoughts, negative alterations of mood and cognition, hypervigilance, avoidance of similar situations and reminders, and re-experiences of the traumatic event. Previous studies have shown a relatively high prevalence of PTSD among firefighters, indicating the need for a systematic approach of early detection and prevention. Therefore, a critical review of the current literature on PTSD in firefighters would provide valuable insights into developing effective prevention and intervention programs. Literature indicated that there are risk factors of PTSD in firefighters, such as pre-existing depression, anxiety, sleep disorders, occupational stress, physical symptoms, and binge drinking, whereas social support and adequate rewards are protective factors. Although there are differences in the prevalence of PTSD across studies, partly due to various assessment tools utilized, different sample sizes, and sample characteristics, over one tenth of the firefighters were estimated to have PTSD. The current review warrants further investigations to precisely assess PTSD and co-morbid mental disorders, functional outcomes, and associated factors, and to develop evidence-based preventive and interventional programs to help firefighters with PTSD.

The Role of Social Support and the Neighborhood Environment on Physical Activity in Low-income, Mexican-American Women in South Texas

  • Salinas, Jennifer J.;McDaniel, Marisol;Parra-Medina, Deborah
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.234-241
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    • 2018
  • Objectives: To determine the relationships between physical activity (PA), the neighborhood environment support for PA, and social support for PA among Mexican-American women living in South Texas. The Enlace study was a randomized controlled trial that tested the effectiveness of a promotora-led PA intervention among low-income Mexican origin women (n=614) living in colonias. Methods: The dependent measures included accelerometer-measured average moderate to vigorous physical activity (MVPA) and sedentary breaks and the Community Health Activities Model Program for Seniors PA 41-item questionnaire. The independent measures included the Physical Activity and Neighborhood Environment Scale (PANES) and the 13-item Physical Activity Social Support (PASS) scale. Results: Enlace participants were on average 40.4 (standard deviation, 10.3) years old, born in Mexico (86.1%), and uninsured (83.1%). Adjusted linear regression results indicated that each 1-point increment in the PANES overall score was associated with 0.050 (p<0.001) unit increase in sedentary break and a -0.043 (p=0.001) unit decrease in sedentary break duration. Both PANES (${\beta}=0.296$; p=0.002) and PASS scores (${\beta}=0.076$; p<0.001) were associated with weekly average self-reported MVPA. Interaction effects were observed between PASS scores and accelerometer-measured frequency of sedentary breaks and sedentary time duration. Conclusions: The findings of this study indicate that the relationships between PA and built environment and social support are measure-dependent and suggest that reducing sedentary time in this population may require a closer assessment of social support for PA.

Predictors of Depression and Quality of Life among Older Adults with Osteoarthritis (퇴행성관절염 노인환자의 우울과 삶의 질 예측요인)

  • Chun, Jung-Ho;Lee, Hae-Jung;Kim, Myung-Hee;Shin, Jae-Shin
    • Korean Journal of Adult Nursing
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    • v.15 no.4
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    • pp.650-659
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    • 2003
  • Purpose: The purpose of this study was to identify predictors of depression and quality of life among older adults with osteoarthritis. The predictors included in the model were the client's characteristics(age, pain, disease duration, ADLs), personal resources(hardiness, self-care agency and family support), and depression. Method: 150 subjects who were older than 65 years and had diagnosis of osteoarthritis participated in the study. To answer the research questions, descriptive analysis, Pearson correlation, and hierarchical multiple regression were utilized using SPSS WIN program. Result: Older adults who were younger and had lower levels of pain and dependency on ADLs, and higher levels of self care agency and hardiness reported lower levels of depression($R^2=0.517$). Older adults who had lower levels of depression, pain, and dependency on ADLs, higher levels of family support and hardiness, and who are younger reported higher levels of quality of life($R^2=0.084$). Conclusion: Based on the findings of this study, development of nursing intervention program including pain reduction, enhancing ADL abilities and personal resources (hardiness, family support) can be suggested. Further study is needed to increase the ability of generalization of the study findings to the broader population.

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Predictors of Participation in Prostate Cancer Screening among Older Men in Jordan

  • Abuadas, Mohammad H;Petro-Nustas, Wasileh;Albikawi, Zainab F.
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5377-5383
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    • 2015
  • Background: Participation is one of the major factors affecting the long-term success of population-based prostate cancer screening programs. The aim of this study was to explore strong factors linked to participation in prostate cancer screening among older Jordanian adults using the Health Belief Model (HBM). Materials and Methods: Data were obtained from Jordanian older adults, aged 40 years and over, who visited a comprehensive health care center within the Ministry of Health. A pilot test was conducted to investigate the internal consistency of the the Champion Health Belief Model Scale for prostate cancer screening and the clarity of survey questions. Sample characteristics and rates of participation in prostate cancer screening were examined using means and frequencies. Important factors associated with participation in prostate cancer screening were examined using bivariate correlation and multivariate logistic regression analysis. Results: About 13% of the respondents had adhered to prostate cancer screening guidelines over the previous decade. Four out of the seven HBM-driven factors (perceived susceptibility, benefits and barriers to PSA test, and health motivation) were statistically significant. Those with greater levels of susceptibility, benefits of PSA test and health motivation and lower levels of barriers to PSA testing were more likely to participate in prostate cancer screening. Family history, presence of urinary symptoms, age, and knowledge about prostate cancer significantly predicted the participation in prostate cancer screening. Conclusions: Health professionals should focus more on the four modifiable HBMrelated factors to encourage older adults to participate in prostate cancer screening. Intervention programs, which lower perceived barriers to PSA testing and increase susceptibility, benefits of PSA testing and health motivation, should be developed and implemented.

Effect of the Virtual Reality Cognitive Rehabilitation Program on Cognition Ability and Activities of Daily Living in Patients with Mild Cognitive Impairment (가상현실 인지재활 프로그램이 경도인지장애 환자의 인지능력과 일상생활동작에 미치는 영향)

  • Kang, Hyeok-Jun;Kim, Sang-Ryul;Kim, Jeong-Heon;Song, Dae-Heon;Yang, Ji-Eun;Chu, Mi-Ran;Lee, Hyun-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.4
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    • pp.155-161
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    • 2020
  • PURPOSE: This study investigated the effect of a head-mounted display (HMD) based virtual reality (VR) cognitive rehabilitation program on the cognitive ability and activities of daily living in patients with mild cognitive impairment. METHODS: This study enrolled 5 mild cognitive impairment patients at the G welfare center in Gwangju metropolitan city. Patients were examined using the MMSEDS (Mini mental state examination-dementia screening). The VR cognitive rehabilitation program was applied twice a week for four weeks. The functional independence measure (FIM) and Loewenstein occupational therapy cognitive assessment-geriatric population (LOTCA-G) were compared before and after applying the VR cognitive rehabilitation program. RESULTS: Subsequent of application of the VR cognitive rehabilitation program, significant increase was observed in the LOTCA-G score. The FIM score was also perceived to increase, after the intervention, but was not statistically significant. CONCLUSION: Application of the VR cognitive rehabilitation program as a therapy is effective in improving the visual perception, and upper extremity executive ability, especially orientation, thinking organization, attention, and concentration.

The Effects of Cognition-Exercise Program Using Step on Cognitive Function, Gait, and Depression in Elderly with Mild Cognitive Impairment (스텝을 활용한 인지-운동프로그램이 경도인지장애 노인의 인지기능, 보행, 우울에 미치는 효과)

  • Ju, Eunsol;Bang, Yosoon;Oh, Eunju
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.3
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    • pp.21-31
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    • 2020
  • Purpose : The purpose of this study was to determine the effects of a cognitive-exercise program using step on the cognitive function, gait, and depression of elderly with mild cognitive impairment. Methods : The subjects comprised 30 elderly people with mild cognitive impairment who used elderly welfare centers in the provinces A, B, and C between March 21 and June 7, 2019. They were divided into an experimental group (n=15) and a control group (n=15) before undergoing an experiment based on a pretest-posttest control group design. The lowenstein occupational therapy cognitive assessment-geriatric population was used to assess the subjects' cognitive function, while the 4-stage balance test, 30-second chair-stand test, timed up & go test, and functional reach test were employed to evaluate their gait. In addition, the beck depression inventory was used to measure their levels of depression. Results : The cognitive-exercise program using step enhanced the subjects' cognitive function and gait and reduced their levels of depression. Furthermore, statistically significant differences were found between the experimental group and the control group. Conclusion : The cognitive-exercise program using step promoted the process of sensorimotor and cognition through the learning process of various steps taking left and right steps and cognitive activities. It improves gait by activating the coordination of the musculoskeletal and nervous systems of the body and positively affecting posture control, balance, flexibility, and lower extremity muscles. It also relieved depression by performing successful step learning and cognitive activities with forward-looking (doing) that leads to pleasure and achievement. The present study confirmed the value of a cognitive-exercise program using step to treat multiple domains of functional decline in elderly patients with mild cognitive impairment. This is therefore proposed as an intervention program for this patient group.

Many-to-Many Warship Combat Tactics Generation Methodology Using the Evolutionary Simulation (진화론적 시뮬레이션을 이용한 다대다 함정교전 전술 생성 방법론)

  • Jung, Chan-Ho;Ryu, Han-Eul;You, Yong-Jun;Chi, Sung-Do;Kim, Jae-Ick
    • Journal of the Korea Society for Simulation
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    • v.20 no.3
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    • pp.79-88
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    • 2011
  • In most existing warships combat simulation system, the tactics of a warship is manipulated by human operators. For this reason, the simulation results are restricted due to the stereotype of human operators. To deal with this, we have employed the genetic algorithm for supporting the evolutionary simulation environment. In which, the tactical decision by human operators is replaced by the human model with a rule-based chromosome for representing tactics so that the population of simulations are created and hundreds of simulation runs are continued on the basis of the genetic algorithm without any human intervention until to find emergent tactics which shows the best performance throughout the simulation. This paper proposes an evolutionary tactics generation methodology for the emergent tactics in many-to-many warship combat simulation. To do this, 3:3 warship combat simulation tests are performed.

Effect of QMix irrigant in removal of smear layer in root canal system: a systematic review of in vitro studies

  • Chia, Margaret Soo Yee;Parolia, Abhishek;Lim, Benjamin Syek Hur;Jayaraman, Jayakumar;de Moraes Porto, Isabel Cristina Celerino
    • Restorative Dentistry and Endodontics
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    • v.45 no.3
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    • pp.28.1-28.13
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    • 2020
  • Objectives: To evaluate the outcome of in vitro studies comparing the effectiveness of QMix irrigant in removing the smear layer in the root canal system compared with other irrigants. Materials and Methods: The research question was developed by using Population, Intervention, Comparison, Outcome and Study design framework. Literature search was performed using 3 electronic databases PubMed, Scopus, and EBSCOhost until October 2019. Two reviewers were independently involved in the selection of the articles and data extraction process. Risk of bias of the studies was independently appraised using revised Cochrane Risk of Bias tool (RoB 2.0) based on 5 domains. Results: Thirteen studies fulfilled the selection criteria. The overall risk of bias was moderate. QMix was found to have better smear layer removal ability than mixture of tetracycline isonomer, an acid and a detergent (MTAD), sodium hypochlorite (NaOCl), and phytic acid. The efficacy was less effective than 7% maleic acid and 10% citric acid. No conclusive results could be drawn between QMix and 17% ethylenediaminetetraacetic acid due to conflicting results. QMix was more effective when used for 3 minutes than 1 minute. Conclusions: QMix has better smear layer removal ability compared to MTAD, NaOCl, Tubulicid Plus, and Phytic acid. In order to remove the smear layer more effectively with QMix, it is recommended to use it for a longer duration.