• Title/Summary/Keyword: Time Use Intervention

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Factors Influencing Ventilator-Associated Pneumonia in Cancer Patients

  • Park, Sun-A;Cho, Sung Sook;Kwak, Gyu Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5787-5791
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    • 2014
  • Background: With increasing survival periods and diversification of treatment methods, treatment of critically ill cancer patients has become an important factor influencing patient prognosis. Patients with cancer are at high risk of infections and subsequent complications. This study investigated the incidence and factors contributing to the development of ventilator-associated pneumonia (VAP). Materials and Methods: This retrospective study investigated the incidence of VAP and factors leading to infection in patients admitted to the intensive care unit (ICU) of a cancer center from January 1, 2012 to December 31, 2013. Results: The incidence of VAP was 2.13 cases per 1,000 days of intubation, and 13 of 288 patients (4.5%) developed VAP. Lung cancer was the most common cancer associated with VAP (N=7, 53.9%), and longer hospital stays and intubation were associated with increased VAP incidence. In the group using a "ventilator bundle," the incidence was 1.14 cases per 1,000 days compared to 2.89 cases per 1,000 days without its use; however, this difference was not statistically significant (p=0.158). Age (${\geq}65$, OR=5.56, 95% confidence interval [CI]=1.29-23.95), surgery (OR=3.78, 95%CI=1.05-13.78), and tracheotomy (OR=4.46, 95%CI=1.00-19.85) were significant VAP risk factors. The most common causative organisms were methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (N=4, 30.8% each), followed by Acinetobacter baumannii and Candida albicans (N=2, 15.4% each). Conclusions: The incidence of pneumonia among critically ill cancer patients is highest in those with lung cancer, but lower than among non-cancer patients. The length of hospital stay and time on mechanical ventilation are important risk factors for development of VAP. Although not statistically significant, "ventilator bundle" care is an effective intervention that delays or reduces incidence of VAP. Major risk factors for VAP include age (${\geq}65$ years), surgery, and tracheostomy, while fungi, gram-negative bacteria, and multidrug-resistant organisms were identified as the major causative pathogens of VAP in this study.

Effects of Doctor-patient Communication on Quality of Life among Breast Cancer Patients in Southern China

  • Zhou, Qin;Shen, Ji-Chuan;Liu, Ying-Zhi;Lin, Guo-Zhen;Dong, Hang;Li, Ke
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5639-5644
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    • 2014
  • Objective: This study aimed to determine effects of doctor-patient communication on the quality of life among breast cancer survivors in 16 communities in southern China. Methods: Multistage random sampling was to use to recruit 260 females from the Guangzhou Cancer Registry Database who were diagnosed with breast cancer. A questionnaire provided data on the doctor-patient communication (including the doctor's attitude, the patient's participation with the medical decision and information about the disease) and QOL (quality of life), as measured using FACT-B. Univariate analysis, non-conditional logistic regression was used to evaluate the associations between the doctor-patient communication and QOL. Results: Females who received good attitudes from doctors demonstrated higher FACT-B (OR=4.65, 95% CI: 1.68-12.86), social well-being (OR=5.88, 95% CI: 2.16-16.05), emotional well-being (OR=4.77, 95% CI: 1.92-11.88), and functional well-being ((OR=5.26, 95% CI: 1.90-14.52) compared to the females who encountered worse attitudes from their doctor, adjusting for age, education, marriage, employment, family income, years since diagnosis, TNM stage, radiation therapy, chemotherapy and side effects, particularly when the TNM stage was 0-II and the patients exhibited no side effects. Regardless of the length of time after diagnosis, doctors' good attitudes resulted in higher QOL scores. Conclusions: This study demonstrated that the doctor-patient communication has a significant association with the QOL of breast cancer survivors, mainly dependent on the doctors' attitude. Effective intervention is required to develop optimal doctor-patient communication.

Development and Effects of Smartphone App-Based Walking Exercise Program for Taxi Drivers: Based on Bandura's Self Efficacy Theory (택시 운전자들을 위한 스마트폰 앱 기반 걷기운동 프로그램 개발 및 효과: Bandura의 자기효능이론을 중심으로)

  • Choi, Yun Ha;Chae, Min-Jeong
    • Journal of Korean Academy of Nursing
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    • v.50 no.2
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    • pp.242-254
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    • 2020
  • Purpose: The purpose of this study was to examine the effects of smart-phone app-based walking exercise programs for taxi drivers on self-efficacy and outcome expectations for exercise, health-related quality of life, walking as an exercise, and physiological indexes. Methods: A nonequivalent control group with a pre-post-test design was used. The subjects were recruited in G metropolitan city. Subjects were assigned to the experimental (n=31) or control groups (n=30). The smart phone app-based walking exercise program consisted of educations via the app, twelve short message services, and one individual telephone counseling session, which was spread over 12 weeks. Results: Self-efficacy, outcome expectations, and health-related quality of life had significantly higher pre-post test differences in scores in the experimental group. Additionally, blood pressure, body mass index, and waist circumference had significantly decreased prepost-test difference levels in the experimental group. Walking as an exercise (which consisted of days walked, number of steps walked, and amount of time walked) had significantly increased in the experimental group after 7~12 weeks in the period following the intervention program rather than 1~6 weeks after the program. Conclusion: The smart phone app-based walking exercise program based on the self-efficacy theory demonstrates a significant effect on improving self-efficacy, outcome expectations physical activities, and health-related quality of life for taxi drivers. Therefore, it is recommended to actively use the program as a tool to promote self-efficacy, physical activities, and health behaviors in taxi drivers.

The Effectiveness of Na Education Program in Elementary School - Six Month Follow-up Study - (초등학생 Na 교육 효과에 관한 연구 - 사전, 사후, 추후 검증을 통한 교육효과 비교 -)

  • Lee, Young-Mee;Park, Hyun-Nae
    • Korean Journal of Community Nutrition
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    • v.15 no.5
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    • pp.603-613
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    • 2010
  • Nutrition education in elementary school is confronted with the present problem, as a legal basis about obligation of nutrition education in school was clarified. Moreover, it's also important for providing evidence based scientific resources to make a study of evaluating the education effectiveness. Most studies of the nutrition education effectiveness have evaluated the changing dietary attitude and nutritional knowledge score before and after the nutrition education, and suggested the effectiveness of intervention as changing between pre- and post-treatment. Nutrition education, however, purposing long-term changes, follow-up evaluation process about the learned attitude and knowledge of nutrition education were requested. For these reasons, this study attempted to fulfilled standardized nutrition education program which use "Na Story and Food World" and "Na Story for Me", a textbook for the 1st-3rd grade and 4th-6th grade designed by KFDA, and analyzed the changes about the effectiveness of nutrition education happened over a period of time. In this study, each student was assessed their dietary attitude and nutritional knowledge by four periods, before the education, right after the education, after 3 months, and after 6 months. As a result, an average score of nutritional knowledge before the education, $70.08{\pm}17.91$, were changed significantly higher right after the education to $85.69{\pm}15.05$ (p < 0.001), but it lowered to $84{\pm}15.56$ after 3 month. After the nutrition education, students in all grades had positive dietary attitude to Na reduction (p < 0.001). However, the healthy eating attitude about Na reduction had been unable to maintain after 3 and 6 months. Therefore, the systematic reeducated program in elementary school was positively necessary to reinforce children's learning and cognitive skills to maintain healthy eating knowledge and attitude toward Na reduction.

Modulatory Effect of Linoleic Acid During Brucella abortus 544 Infection in Murine Macrophage RAW264.7 Cells and Murine Model BALB/c Mice

  • Reyes, Alisha Wehdnesday Bernardo;Vu, Son Hai;Huy, Tran Xuan Ngoc;Min, Wongi;Lee, Hu Jang;Chang, Hong Hee;Lee, John Hwa;Kim, Suk
    • Journal of Microbiology and Biotechnology
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    • v.30 no.5
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    • pp.642-648
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    • 2020
  • In this study, we investigated the effects of linoleic acid (LA) treatment on Brucella abortus infection in professional phagocyte RAW264.7 cells, particularly during the pathogen's invasion and intracellular growth in these cells, as well as in murine model BALB/c mice focusing on bacterial splenic proliferation and immunoregulatory activities. LA inhibited the growth of Brucella in a dose- and time-dependent manner. The ability of the pathogen to enter the phagocytes was inhibited as was its survival within these cells. This was accompanied by increased nitrite accumulation in these cells at 24 h post-infection. The concentration of LA used in the present study did not affect the total body weight or liver function of the mice. During Brucella infection, the total splenic weight of these animals was not changed; rather, resistance to bacterial proliferation was enhanced in the spleen. Furthermore, mice treated with LA displayed elevated levels of IL-12 and IFN-γ but reduced levels of IL-10 during infection. The findings in this study showed the regulatory role of LA against B. abortus infection suggesting its potential use in designing intervention strategy for brucellosis.

Development of Self-Consumption Smart Home System (에너지 자립형 스마트 홈 시스템 개발)

  • Lee, Sanghak
    • Journal of Satellite, Information and Communications
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    • v.11 no.2
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    • pp.42-47
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    • 2016
  • Due to advances such as photovoltaic power generation and energy storage system, energy self-consumption smart home system in which energy management system is built and energy is generated in house has been actively researched. In particular, due to the instability of the grid after the Fukushima nuclear accident, home system in which generating electricity from photovoltaic, storing and using it in energy storage system was commercialized in Japan. While subsidizing renewable energy projects through a combination of solar and energy storage systems in North America and Europe has expanded home installation. In this paper, we describe development of self-consumption smart home system which is connecting photovoltaic system and energy storage system in home area network and operating it based on real-time price. We implemented automated self-consumption home in which optimizing the use of energy from the power grid with minimal user's intervention.

Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal Flaps

  • Yim, Ji Hong;Yun, Jiyoung;Lee, Taik Jong;Kim, Eun Key;Cho, Jonghan;Eom, Jin Sup
    • Archives of Plastic Surgery
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    • v.42 no.6
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    • pp.741-745
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    • 2015
  • Background Microvascular complications after free-flap breast reconstructions are potentially devastating problems that can increase patient morbidity and lead to flap loss. To date, no comprehensive study has examined the rates of salvage and the methods of microvascular revision in breast reconstruction. We reviewed the treatment of microvascular complications of free-flap breast reconstruction procedures over a seven-year period. Methods A retrospective review of all patients who underwent microvascular breast reconstruction at our institution between April 2006 and December 2013 was conducted. Based on their surgical records, all patients who required emergency re-exploration were identified, the rate of flap salvage was determined, the factors associated with flap salvage were evaluated, and the causes and methods of revision were reviewed. Results During the review period, 605 breast reconstruction procedures with a free lower abdominal flap were performed. Seventeen of these flaps were compromised by microvascular complications, and three flaps were lost. The overall salvage rate was 82.35%. No significant differences between the salvaged group and the failed group were observed with regard to age, BMI, axillary dissection, number of anastomotic arteries and veins, recipient vessel types, or use of the superficial inferior epigastric vein in the revision operation. Successful salvage of the flap was associated with a shorter time period between recognizing the signs of flap compromise and the take-back operation. Conclusions The salvage rate of compromised lower abdominal flaps was high enough to warrant attempting re-exploration. Immediate intervention after the onset of flap compromise signs is as important as vigilant postoperative monitoring.

Effects of Sling and Resistance Rotation Exercises on Pelvic Rotation and Pain in Patients with Chronic Low Back Pain

  • Kim, Dae Hyun;Kim, Tea Ho
    • The Journal of Korean Physical Therapy
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    • v.30 no.5
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    • pp.166-172
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    • 2018
  • Purpose: This study compared the different sling and resistance exercises on pelvic rotation during active straight leg raises (ASLR) and on pain in patients with chronic low back pain (CLBP). Methods: Twenty subjects were divided randomly into a sling group (SG) and a resistance exercise group (REG). Internal oblique (IO), external oblique (EO), rectus abdominis (RA), and rectus femoris (RF) muscle activity; pelvic rotation angle during ASLR; and visual analogue scale, pressure pain threshold were measured. Sling and resistance exercises were then performed for 30 minutes and the measurements taken again. Results: Both groups showed significantly lower RF muscle activity and significantly higher EO and IO muscle activity (p<0.05). The RA muscle activity decreased significantly in the SG, but increased significantly in the REG (p<0.05). The pelvic rotation angle was significantly lower in the SG (p<0.05). The pain press threshold increased significantly in both groups (p<0.05). The visual analogue scale decreased significantly in the SG (p<0.05). Conclusion: Both exercises appear to be beneficial for modifying the muscle activity and pain control in the intervention of CLBP. On the other hand, the sling was more effective in increasing the pressure threshold than resistance exercise, and the pelvic rotation angle was reduced. Therefore, both exercises can help patients with CLBP change their muscle activity and control pain. CLBP patients should use a sling for short periods of time to learn to reduce the pain and control pelvic rotation.

Removal of foreign body on cheek using endoscope and C-arm fluoroscopy (내시경과 C-arm을 이용한 얼굴 이물질 제거 치험례)

  • Cho, Yeong-Cheol;Jang, Soo-Mi;Park, Soo-Won;Choi, Byung-Hwan;Ha, Jin-Hee;Son, Jang-Ho;Sung, Iel-Yong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.3
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    • pp.234-236
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    • 2011
  • Traditional surgery to remove foreign bodies in the face carries a risk of postoperative morbidity with an injury to various anatomical structures, particularly the facial nerve and parotid duct and gland. Endoscopy can be a great aid in the removal of foreign bodies in the maxillofacial region. Surgical intervention using endoscope and/,or intraoperative images can be minimized, allowing the safe and precise removal of foreign bodies, and saving operating time. We report a case of the use of an endoscope and C-arm fluoroscopy guidance system to remove a very small foreign body.

Dietary Aloe Improves Insulin Sensitivity via the Suppression of Obesity-induced Inflammation in Obese Mice

  • Shin, Eun-Ju;Shim, Kyu-Suk;Kong, Hyun-Seok;Lee, Sung-Won;Shin, Seul-Mee;Kwon, Jeung-Hak;Jo, Tae-Hyung;Park, Young-In;Lee, Chong-Kil;Kim, Kyung-Jae
    • IMMUNE NETWORK
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    • v.11 no.1
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    • pp.59-67
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    • 2011
  • Background: Insulin resistance is an integral feature of metabolic syndromes, including obesity, hyperglycemia, and hyperlipidemia. In this study, we evaluated whether the aloe component could reduce obesity-induced inflammation and the occurrence of metabolic disorders such as blood glucose and insulin resistance. Methods: Male C57BL/6 obese mice fed a high-fat diet for 54 days received a supplement of aloe formula (PAG, ALS, Aloe QDM, and Aloe QDM complex) or pioglitazone (PGZ) and were compared with unsupplemented controls (high-fat diet; HFD) or mice fed a regular diet (RD). RT-PCR and western blot analysis were used to quantify the expression of obesity-induced inflammation. Results: Aloe QDM lowered fasting blood glucose and plasma insulin compared with HFD. Obesity-induced inflammatory cytokine (IL-$1{\beta}$, -6, -12, TNF-${\alpha}$) and chemokine (CX3CL1, CCL5) mRNA and protein were decreased markedly, as was macrophage infiltration and hepatic triglycerides by Aloe QDM. At the same time, Aloe QDM decreased the mRNA and protein of $PPAR{\gamma}/LXR{\alpha}$ and $11{\beta}$-HSD1 both in the liver and WAT. Conclusion: Dietary aloe formula reduces obesity-induced glucose tolerance not only by suppressing inflammatory responses but also by inducing anti-inflammatory cytokines in the WAT and liver, both of which are important peripheral tissues affecting insulin resistance. The effect of Aloe QDM complex in the WAT and liver are related to its dual action on $PPAR{\gamma}$ and $11{\beta}$-HSD1 ression and its use as a nutritional intervention against T2D and obesity-related inflammation is suggested.