• Title/Summary/Keyword: quality of care

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The Effect of Glasthma Syrup in Asthma: a study protocol for a triple-blind randomized controlled trial

  • Derakhshan, Ali Reza;Saeidinejat, Shahin;Khadem-Rezaiyan, Majid;Asnaashari, Amir-Mohammad-Hashem;Mirsadraee, Majid;Salari, Roshanak;Jabbari-Azad, Farahzad;Jalali, Shima;Jalali, Shabnam
    • Journal of Pharmacopuncture
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    • v.25 no.3
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    • pp.233-241
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    • 2022
  • Objectives: Asthma is a chronic disease, and the demand for herbal medicines in this field has increased in recent years. The new findings highlight the role of the gut-lung axis in the pathophysiology of asthma. Hence, this study will evaluate the safety and efficacy of Glasthma syrup, an herbal formula based on Persian medicine, in improving asthma and regulating intestinal permeability. The formula consists of five herbal ingredients that have anti-inflammatory effects on the respiratory tract, also known as gut tonics. Methods: The study will be conducted as a placebo-controlled, triple-blind, randomized trial. It will consist of a 4-week intervention followed by a 4-week follow-up period. The target sample size is 20 patients with moderate asthma aged 18 to 60 years. Eligible participants will be randomly assigned to either the experimental group or the control group in equal numbers. Patients in the experimental group will take Glasthma syrup (7.5 mL, twice a day), while patients in the control group will take a matching placebo. Both groups will receive a 4-week combination of a long-acting beta2 agonist and a leukotriene modulator as standard of care. Inhaled corticosteroids can be used as rescue medication as needed. Results: The primary outcomes are asthma symptom scale, lung function, and intestinal permeability. Secondary outcomes include quality of life, symptom recurrence rates, and blood tests. A safety assessment will also be conducted during the trial. Conclusion: In this trial, the effects of Glasthma syrup in patients with moderate asthma will be examined. The study will also assess the effects of the formulation on the gut-lung axis by simultaneously monitoring the gut permeability index, asthma symptoms, and lung function.

Prognostic Implication of Volumetric Quantitative CT Analysis in Patients with COVID-19: A Multicenter Study in Daegu, Korea

  • Byunggeon Park;Jongmin Park;Jae-Kwang Lim;Kyung Min Shin;Jaehee Lee;Hyewon Seo;Yong Hoon Lee;Jun Heo;Won Kee, Lee;Jin Young Kim;Ki Beom Kim;Sungjun Moon;Sooyoung, Choi
    • Korean Journal of Radiology
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    • v.21 no.11
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    • pp.1256-1264
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    • 2020
  • Objective: Lung segmentation using volumetric quantitative computed tomography (CT) analysis may help predict outcomes of patients with coronavirus disease (COVID-19). The aim of this study was to investigate the relationship between CT volumetric quantitative analysis and prognosis in patients with COVID-19. Materials and Methods: CT images from patients diagnosed with COVID-19 from February 18 to April 15, 2020 were retrospectively analyzed. CT with a negative finding, failure of quantitative analysis, or poor image quality was excluded. CT volumetric quantitative analysis was performed by automated volumetric methods. Patients were stratified into two risk groups according to CURB-65: mild (score of 0-1) and severe (2-5) pneumonia. Outcomes were evaluated according to the critical event-free survival (CEFS). The critical events were defined as mechanical ventilator care, ICU admission, or death. Multivariable Cox proportional hazards analyses were used to evaluate the relationship between the variables and prognosis. Results: Eighty-two patients (mean age, 63.1 ± 14.5 years; 42 females) were included. In the total cohort, male sex (hazard ratio [HR], 9.264; 95% confidence interval [CI], 2.021-42.457; p = 0.004), C-reactive protein (CRP) (HR, 1.080 per mg/dL; 95% CI, 1.010-1.156; p = 0.025), and COVID-affected lung proportion (CALP) (HR, 1.067 per percentage; 95% CI, 1.033-1.101; p < 0.001) were significantly associated with CEFS. CRP (HR, 1.164 per mg/dL; 95% CI, 1.006-1.347; p = 0.041) was independently associated with CEFS in the mild pneumonia group (n = 54). Normally aerated lung proportion (NALP) (HR, 0.872 per percentage; 95% CI, 0.794-0.957; p = 0.004) and NALP volume (NALPV) (HR, 1.002 per mL; 95% CI, 1.000-1.004; p = 0.019) were associated with a lower risk of critical events in the severe pneumonia group (n = 28). Conclusion: CRP in the mild pneumonia group; NALP and NALPV in the severe pneumonia group; and sex, CRP, and CALP in the total cohort were independently associated with CEFS in patients with COVID-19.

Design and Evaluation of the Program on the Internet for Sexuality Education of Adolescences (사춘기 청소년의 성교육 활성화를 위한 인터넷기반 교수-학습 프로그램의 내용설계 및 평가도구 개발)

  • Kang, Nam-Mi;Kim, Young-Ran;Park, Young-Sook;Sohn, In-Sook;Lee, Sung-Ho
    • Women's Health Nursing
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    • v.8 no.4
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    • pp.595-607
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    • 2002
  • Sexuality education in the period of adolescents need much care and attention. The programs of sexual education through the Internet are excellent resources for adolescents to gain the information related to their sexual health. And systematic program which is necessary for adolescents to manage their sexual health has been rarely found in Korea. The purpose of this study was to offer valuable database for program design and evaluation on sexual education of middle school students through the Internet. Needs assessment for the information of sexual education on the internet among middle school students were carried out. A questionnaire survey was conducted with respondents of 602 middle school students from January to March in 2002. In the sexual counseling center for middle school students, counseling cases through internet were analyzed and evaluated from October, 2001 to September, 2002, We have selected 16 Sexual educational websites in Seoul confirmed Korean Educational Human Resource. Contents which was illustrated in 16 sexual educational websites were analyzed and evaluated by 12 sexual counselors. Design and evaluation of the program on the internet for sexuality education of adolescences was conducted on the basis of this study results by middle school expert teachers, sexual counselors, sexuality education professionals. Data was statistically analyzed using dBSTAT 4.0 for Windows. The extent and phase of the teaching-learning program of the sexuality education on the internet was seen as follows : 1. We evaluated to need for sexuality education on the internet by middle school student. 2. We assessed the properness of sexuality education curriculum on the internet frequently used by middle school students. 3. We designed teaching strategy and learning program for sexuality education of the middle school students. 4. We developed the assessment method for the teaching-learning program of the sexuality education in adolescences on the internet. Middle school students responded that sexual education through Internet is needed in the order of programs related to acquaintances with opposite sex, Sexual culture and ethics, Sexual health, Reproductive health structure and development, Marriage and family, Psychology of Sexuality, Pregnancy and birth. In the internet counseling, cases on the 'reproductive health structure and development' was ranked as the top. In short we have found the most needs as follows; Meaning of the marriage life and having family, Sexes and Love, Human relation, Sexual Culture.We recommend as follows on the basis of this study results: 1. It is necessary for sexuality education program on the internet to specify according to age and target the specific individual needs. 2. Sexual educators have to employ various educational materials such as flash, cartoon, multimedia in order to provide effective sexuality education. 3. Internet based sex education need to be evaluated regularly through reassessment of the effectiveness of sexuality education for content quality and richness.

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Relations Between the Types of Communication and, Job Satisfaction and Nursing Performance in Staff Nurses (일반간호사의 조직 내 의사소통 유형과 직무만족 및 간호업무성과의 관계)

  • Seo Eee ah;Park Kyung Min;Lee Byung Sook
    • Journal of Korean Public Health Nursing
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    • v.17 no.2
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    • pp.317-332
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    • 2003
  • This study attempts to investigate the relations between the types of communication, the job satisfaction. and the nursing performance of the staff nurses. The subjects of this study were the 114 nurses working in general wards, intensive care units, and the emergency rooms of the general hospital in Kyongbuk province. They were asked to answer the questionnaires as regards the types of communication and job satisfaction, and their performance of nursing, and these were evaluated by the head nurses, and their direct seniors. The data were collected for 10 days from the September 17 to 26, 2002. According to the purpose of the study, descriptive analysis, ANOVA. Pearson correlation coefficient, and stepwise multiple regression were applied for the data analysis using SPSS 10.0. The results are as follows : 1. The types of communication of staff nurses showed that the upward communication was $3.12\pm0.56$. the downward communication was $3.56\pm0.42$. the horizontal communication was $2.98\pm0.44$. and the informal communication was $2.59\pm0.49$. It showed that the most frequent communication was the downward communication. 2. In terms of the job satisfaction, there was significant difference according to the length of the period working for one ward (F=5.95, p=0.003), 3. The performance of nursing was significantly different according to the age (F=23.52, p=0.000), the working duration as a nurses (F=21.9, p=0.000), the types of nursing unit (F=5.33, p=0.002), and the working duration in present nursing unit (F=15.87, p=0.000). 4. In terms of communication type, the job satisfaction was associated with quality of the upward communication (F=6.23, p=0.003), the downward communication (F=5.78, p=0.004), and the horizontal communication (F=11.73, p=0.000) There were no association between the types of communication and the performance of nursing. 5. There was a positive correlation between the communication and the job satisfaction. And the downward communication (r=0.398) showed the greatest correlation with the job satisfaction. There was no statistically significant correlation between the communication and the performance of nursing. And the upward communication (r=-0.058) showed a negative, though not significant correlation with performance of nursing. 5. There was a positive correlation between the communication and the job satisfaction. And the downward communication (r=0.398) showed the greatest correlation with the job satisfaction. There was no statistically significant correlation between the communication and the performance of nursing. And the upward communication (r=-0.058) showed a negative. though not significant correlation with performance of nursing. 6. The stepwise multiple regression result showed that the downward communication accounts for $15.8\%$ (p=0,000) of the job satisfaction.

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Adolescent Health Promotion and Development of School Health Education (청소년기의 건강증진과 학교보건교육의 발전방향)

  • Yoo, Jae-Soon
    • Journal of the Korean Society of School Health
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    • v.11 no.1
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    • pp.27-50
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    • 1998
  • Adolescent health is considered to contribute to health promotion in the home and community in the near future as well as individual health. However, adolescent health has been neglected from education field because of competitive school education focused on the university entrance examination That's why I suggest in this study that we should pay much more attention to adolescent health condition and try to make It better, in terms of man-power development and life-health promotion for nation development The purposes of this study are as follows First, to look into a variety of adolescent health problems Second, to find out the situation and problems of current adolescent health promotion and school health education Third, to make an effort to find, based on the current situation, various developments of adolescent health promotion and school health education in terms of practical, political and environmental change There are used study methods as adolescent-related, school heath-related literature review and anlysis of statistical data The results and suggestions are as follows Teenagers have a great variey of health problems including most Important physical, mental and social developments Recently, chronic diseases, emotional problems, health-risk behaviors linked With adolescents are on increase The complicated disorders of physical, mental, social health rather than paricular aspects of health or health-behavior problems influence adolescent health problems adolescence is regarded as the period when most health-related behaviors are formed. Therefore, adolescent health promotion would he assured by developing the ability of controlling multi-dimensional health determinants in the early stage. Health promotion is a positive concept that each individual, family and community makes real efforts to improve their health To achive this, we need health educational, organizational, political and environmental supports. Adolescent health promotion in Korea has been systematically treated in the category of school health Current school health services have had lots of systemic, constitutional, administrative and educational flaws Accordingly, I'm concerned that we can afford to accept a variety of adolescent health needs However, I would say that if were not to make those flaws better, it's certain that Korean national competitive power and the quality of the lives of most Koreans Will he threatened someday We have to develop Comprehensive School Health Crriculum(CSHC) and set up its standards to Improve adolescent health. CSHC is an organizational and costant process. CSHC means an Important part of overall curriculums. In addition, I could say that it's an Important school health education acivity including current school health services-health care service and school health environment. In conclusion, in order to develop CSHC, we require school nurse's role changes, establishment and management of intergrated subject of health education, striking revision of school health law(or legislation of school health promotion law), reorganization of administration system, big changes in curriculum for school health educators.

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Comparison of Treatment Outcome Assessment for Class I Malocclusion Patients: Peer Assessment Rating versus American Board of Orthodontics-Objective Grading System

  • Hong, Mihee;Kook, Yoon-Ah;Baek, Seung-Hak;Kim, Myeng-Ki
    • Journal of Korean Dental Science
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    • v.7 no.1
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    • pp.6-15
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    • 2014
  • Purpose: The purpose of this retrospective study is to investigate the degree of coincidence between the peer assessment rating (PAR) index and American Board of Orthodontics objective grading system (ABO-OGS) in the assessment of orthodontic treatment outcomes of Class I malocclusion cases. Materials and Methods: The sample consisted of 26 Class I patients. The PAR index was used for evaluation of pre-(T0) and posttreatment (T1) casts, and the ABO-OGS for assessment of T1 casts. If there was a reduction in PAR scores from T0 to T1 of more than 30%, the label 'PAR+' was given to the case, and if not, it was labeled 'PAR-'. If the ABO-OGS was less than 27, the label 'OGS+' was given to the case and if not, it was labeled 'OGS-'. 'A PAR-only qualified group' (PAR+), 'ABO-OGS-only qualified group' (OGS+), 'both indices qualified group' (PAR+/OGS+), and 'both indices disqualified group' (PAR-/OGS-) were compared with a Wilcoxon rank-sum test, sensitivity/specifi city test and Spearman's correlation test. Result: PAR scores for T0, T1, and percentage reduction were 21.1, 6.4, and 65.9%, respectively, and 35.4 for ABOOGS. The distribution of the 'PAR+/OGS+', 'PAR+', and 'PAR-/OGS-' group was 19.3%, 76.9%, and 3.8%, respectively. The T0-PAR, T1-PAR and PAR point reductions for the 'PAR+' group were significantly higher than those of 'PAR+/OGS+' groups (23.1 vs. 15.6; 6.7 vs. 4.6; and 16.5 vs. 11.0; all P<0.05). However, the PAR-percentage reduction and treatment duration between the two groups were not statistically different (70.0% vs. 67.0%, P=0.4325; 24.1 months vs. 25.0 months, P=0.4057). The T1-ABO-OGS score for 'PAR+' group was significantly higher than that of the 'PAR+/OGS+' groups (38.2 vs. 24.0, P<0.001). Conclusion: Since the fraction of the 'PAR+/OGS+' group was less than 20% and there was no significant correlation between PAR-percentage reduction and T1-ABO-OGS, development of a new index system for the accurate evaluation of treatment outcome is needed.

Lumbar Interbody Fusion Outcomes in Degenerative Lumbar Disease : Comparison of Results between Patients Over and Under 65 Years of Age

  • Jo, Dae-Jean;Jun, Jae-Kyun;Kim, Ki-Tack;Kim, Sung-Min
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.412-418
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    • 2010
  • Objective : To evaluate the clinical and radiological outcomes of lumbar interbody fusion and its correlation with various factors (e.g., age, comorbidities, fusion level, bone quality) in patients over and under 65 years of age who underwent lumbar fusion surgery for degenerative lumbar disease. Methods : One-hundred-thirty-three patients with lumbar degenerative disease underwent lumbar fusion surgery between June 2006 and June 2007 and were followed for more than one year. Forty-eight (361%) were older than 65 years of age (group A) and 85 (63.9%) were under 65 years of age (group B). Diagnosis, comorbidities, length of hospital stay, and perioperative complications were recorded. The analysis of clinical outcomes was based on the visual analogue scale (VAS). Radiological results were evaluated using plain radiographs. Clinical outcomes, radiological outcomes, length of hospital stay, and complication rates were analyzed in relation to lumbar fusion level, the number of comorbidities, bone mineral density (BMD), and age. Results : The mean age of the patients was 61.2 years (range, 33-86 years) and the mean BMD was -2.2 (range, -4.8 to -2.8). The mean length of hospital stay was 15.0 days (range, 5-60 days) and the mean follow-up was 23.0 months (range, 18-30 months). Eighty-five (64.0%) patients had more than one preoperative comorbidities. Perioperative complications occurred in 27 of 133 patients (20.3%). The incidence of overall complication was 22.9% in group A, and 18.8% in group B but there was no statistical difference between the two groups. The mean VAS scores for the back and leg were significantly decreased in both groups (p < 0.05), and bony fusion was achieved in 125 of 133 patients (94.0%). There was no significant difference in bony union rates between groups A and B (91.7% in group A vs. 95.3% in group B, p = 0.398). In group A. perioperative complications were more common with the increase in fusion level (p = 0.027). Perioperative complications in both groups A (p = 0.035) and B (p = 0.044) increased with an increasing number of comorbidities. Conclusion : Elderly patients with comorbidities are at a high risk for complications and adverse outcomes after lumbar spine surgery. In our study, clinical outcomes, fusion rates, and perioperative complication rates in older patients were comparable with those in younger populations. The number of comorbidities and the extent of fusion level were significant factors in predicting the occurrence of postoperative complications. However, proper perioperative general supportive care with a thorough fusion strategy during the operation could improve the overall postoperative outcomes in lumbar fusion surgery for elderly patients.

Adaptation of Intravenous Infusion Nursing Practice Guideline (정맥주입요법 간호실무지침 수용개작)

  • Gu, Mee Ock;Cho, YoungAe;Cho, Myung Sook;Eun, Young;Jeong, Jae Sim;Jung, Ihn Sook;Lee, Young Geun;Kim, Mi Kyung;Kim, Eun Hyun;Kim, Ji Haei;Lee, Sun Hee;Kim, Hyun Lim;Yun, Hee Sook
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.1
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    • pp.128-142
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    • 2013
  • Purpose: This study was conducted to adapt the previously developed intravenous infusion guidelines with good quality for development of the evidence-based intravenous infusion nursing practice guideline in Korea. Methods: Guideline adaptation process was conducted according to guideline adaptation manual version 2.0 developed by NECA (Kim, Kim et al., 2011) which consisted of three main phases, 9 modules including a total of 24 steps. Results: Adapted intravenous infusion nursing practice guideline was consisted of 19 domains and 180 recommendations. The domains and number of recommendations in each domain were: general guide, 4; assessment, 1; vascular access device selection, 4;site selection, 14;site preparation, 5;site care, 29; maintaining patency, 11; blood sampling via vascular access, 4; vascular access device exchange and removal, 9; add-on device selection, 27; infusion related complications, 63; education, 7; and documentation and report, 2. There were 11.9% of A, 28.4% of B, 58.7% of C in grade of recommendations. Conclusion: Adapted intravenous infusion nursing practice guideline is expected to contribute providing an evidence based practice guides for intravenous infusion. The guideline is recommended to be disseminated to nurses nationwide to improve the efficiency of intravenous infusion practice.

Psychometric Validation of the Bahasa Malaysia Version of the EORTC QLQ-CR29

  • Magaji, Bello Arkilla;Moy, Foong Ming;Roslani, April Camilla;Law, Chee Wei;Raduan, Farhana;Sagap, Ismail
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8101-8105
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    • 2016
  • Background: This study examined the psychometric properties of the Bahasa Malaysia (BM) version of the European Organization for Research and Treatment of Cancer (EORTC) Colorectal Cancer-specific Quality Of Life Questionnaire (QLQ-CR29). Materials and Methods: We studied 93 patients recruited from University Malaya and Universiti Kebangsaan Medical Centers, Kuala Lumpur, Malaysia using a self-administered method. Tools included QLQ-C30, QLQ-CR29 and Karnofsky Performance Scales (KPS). Statistical analyses included Cronbach's alpha, test-retest correlations, multi-traits scaling and known-groups comparisons. A p vaue ${\leq}0.05$ was considered significant. Results: The internal consistency coefficients for body image, urinary frequency, blood and mucus and stool frequency scales were acceptable (Cronbach's alpha ${\alpha}{\geq}0.65$). However, the coefficients were low for the blood and mucus and stool frequency scales in patients with a stoma bag (${\alpha}=0.46$). Test-retest correlation coefficients were moderate to high (range: r = 0.51 to 1.00) for most of the scales except anxiety, urinary frequency, buttock pain, hair loss, stoma care related problems, and dyspareunia (r ${\leq}0.49$). Convergent and discriminant validities were achieved in all scales. Patients with a stoma reported significantly higher symptoms of blood and mucus in the stool, flatulence, faecal incontinence, sore skin, and embarrassment due to the frequent need to change the stoma bag (p < 0.05) compared to patients without stoma. None of the scales distinguished between patients based on the KPS scores. There were no overlaps between scales in the QLQ-C30 and QLQ-CR29 (r < 0.40). Conclusions: the BM version of the QLQ-CR29 indicated acceptable psychometric properties in most of the scales similar to original validation study. This questionnaire could be used to complement the QLQ-C30 in assessing HRQOL among BM speaking population with colorectal cancer.

Selection of Tasks for Assessment of Pharmacy Clinical Performance in Korean Pharmacist Licensure Examination: Results of an Expert Survey (약사국가고시 실기시험 영역 선별을 위한 전문가 조사)

  • Han, Nayoung;Lee, Ju-Yeun;Gwak, Hye Sun;Lee, Byung Koo;Lee, Young Sook;Lee, Sukhyang;Yong, Chul-Soon;Kim, Joo Hee;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.3
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    • pp.119-126
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    • 2017
  • Background: As the demands of pharmacist's role and quality performance have increased, the verification of pharmacist's ability has been required. In this study, we aimed to select appropriate items for assessment of pharmacist's knowledge, attitude and performance. Methods: Based on the pharmacist job analysis, we selected duties and tasks in consideration of applying pharmacy practical examination through brainstorming of internal researchers and group discussion with experts. Survey was conducted to evaluate the tasks according to the criteria detailed below: Realistic, Understandable, Measurable, Behavioral and Achievable (RUMBA). The subjects included professors at colleges of pharmacy and instructors of institutional or community pharmacy settings. Results: Nine duties including 41 tasks were drawn for the survey through primary internal researchers. Of the 90 respondents, 95.6% were professors or preceptors who was engaged in practical training, and 62.2% had more than five years of practical experience. As a result of survey and discussion with expert panel, selected seven duties were selected as followings: 'Patient (customer) reception', 'Drug preparation and distribution', 'Patient care', 'Administration', 'Patient counseling', 'Non-prescription medication counseling', and 'Provision of drug information'. The final 20 tasks from seven duties were chosen to assess skills that a pharmacist should be able to perform. Conclusion: This is the first study to select the items that can be included in pharmacist practical examination in the future, based on the RUMBA criteria. As a next step, it is necessary to study how to implement these items.