3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.
This study was a qualitative investigation into hemodialysis patients' dietary practices. The purpose of this study was to explore the obstacles and requirements to maintain a recommended diet therapy in hemodialysis patients. Five patients undergoing hemodialysis in the renal chamber of the general hospital were interviewed individually. The interviews were based on an interview guide and analyzed by Giorgi's method of analysis. As a result of this study, five elemental factors and 12 subelemental factors were derived. Derived elements were "difficulty in dietary guidelines", "recognizing necessity of diet therapy", "awareness of importance of diet", "difficulty practicing diet therapy", and "looking for ways to practice diet therapy". Patients not only felt difficulties in practicing dietary guidelines but also recognized the need and importance of diet therapy. Patients seemed to have difficulty practicing meal therapy and eating with their families or others. They were also stressed by the limited selection of dietary components and rapid dietary changes before and after dialysis. However, patients showed a willingness to implement dietary management to improve their quality of life and to practice dietary therapy. In order to improve the practice of dietary management in hemodialysis patients, nutritional education should be focused on long-term dietary habits through continuous education and monitoring, not just one-off education. Moreover, patients should be educated that adherence to dietary control may be less burdensome on their families.
Background: The rising incidence of dialysis-dependent end-stage renal disease (ESRD) has underscored the need for collaboration between plastic surgeons and nephrologists, particularly concerning preoperative and postoperative management for facial reconstruction. This collaboration is essential due to a scarcity of comprehensive information in this domain. Methods: A study initiated in January 2015 involved 10 ESRD cases on dialysis undergoing Mohs micrographic surgery for facial skin cancer, followed by reconstructive surgery under general anesthesia. To ensure surgical safety, rigorous measures were enacted, encompassing laboratory testing, nephrology consultations, and preoperative dialysis admission. Throughout surgery, meticulous control was exercised over vital signs, electrolytes, bleeding risk, and pain management (excluding nonsteroidal anti-inflammatory drugs). Postoperative assessments included monitoring flap integrity, hematoma formation, infection, and cardiovascular risk through plasma creatinine levels. Results: Adherence to the proposed guidelines yielded a notable absence of postoperative wound complications. Postoperative plasma creatinine levels exhibited an average decrease of 1.10 mg/dL compared to preoperative levels, indicating improved renal function. Importantly, no cardiopulmonary complications or 30-day mortality were observed. In ESRD patients, creatinine levels decreased significantly postoperatively compared to the preoperative levels (p< 0.05), indicating favorable outcomes. Conclusion: The consistent application of guidelines for admission, anesthesia, and surgery yielded robust and stable outcomes across all patients. In particular, the findings support the importance of adjusting dialysis schedules. Despite the limited sample size in this study, these findings underscore the effectiveness of a collaborative and meticulous approach for plastic surgeons performing surgery on dialysis-dependent patients, ensuring successful outcomes.
Objectives: The purpose of this study is to evaluate the quality of case reports published in the Journal of Korean Obstetrics and Gynecology from April 2019 to February 2024, compared with January 2015 to March 2019. Methods: Case reports were selected by searching from archive on the website of society of the Journal of Korean Obstetrics and Gynecology. The quality of the case reports were assessed based on CAse REport (CARE) guideline. Results: A total of 30 case reports was finally included for the assessment. Overall quality of reporting for case reports published from April 2019 to February 2024 was improved compared to one of previous study. However, the 4 items of CARE guidelines with an unreported rate of 50% or more - patient's perspective on interventions (96.67%), diagnostic challenges (93.33%), intervention adherence and tolerability (93.33%), adverse events (56.67%) - are items that require active description in future case reports. In addition, Keyword and timeline have more than 50% reported to be 'Not-sufficient' in both previous and present studies. So active efforts by researchers are needed to include 'Case report (or Case study)' in keywords, and to include intervention by period, symptom changes in a timeline. Conclusions: Despite the overall improvement in the quality of reporting in the Journal of Korean Obstetrics and Gynecology, efforts to improve the quality of case reports should be continued.
Nutritional support in critically ill patients is an essential aspect of treatment. In particular, the benefits of enteral nutrition (EN) are well recognized, and various guidelines recommend early EN within 48 hours in critically ill patients. However, there is still controversy regarding EN in critically ill patients with septic shock requiring vasopressors. Therefore, this case report aims to provide basic data for the safe and effective nutritional support in septic shock patients who require vasopressors. A 62-year-old male patient was admitted to the intensive care unit with a deep neck infection and mediastinitis that progressed to a septic condition. Mechanical ventilation was initiated after intubation due to progression of respiratory acidosis and deterioration of mental status, and severe hypotension required the initiation of norepinephrine. Due to hemodynamic instability, the patient was kept nil per os. Subsequently, trophic feeding was initiated at the time of norepinephrine dose tapering and was gradually increased to achieve 75% of the energy requirement through EN by the 7th day of enteral feeding initiation. Although there were signs of feeding intolerance during the increasing phase of EN, adjusting the rate of EN resolved the issue. This case report demonstrates the gradual progression and adherence to EN in septic shock patient requiring vasopressors, and the progression observed was relatively consistent with existing studies and guidelines. In the future, further case reports and continuous research will be deemed necessary for safe and effective nutritional support in critically ill patients with septic shock requiring vasopressors.
This study examined the prevalence of adherence factors, toxin genes, antimicrobial resistance phenotypes, and resistance genes in Escherichia coli (E. coli) isolated from piglets with diarrhea before and after the ban on antibiotic growth promoters (AGPs) in Korea from 2007 to 2018. In this period, pathogenic 474 E. coli isolates were obtained from diarrheic piglets. The virulence factors and antimicrobial resistance genes were assayed using a polymerase chain reaction, and the susceptibility to antibiotics was tested according to the Clinical and Laboratory Standards Institute guidelines. After the ban on AGPs, the frequency of F4 (12.5% to 32.7%) increased significantly, and LT (31.9% to 20.3%) and EAST-I (46.5% to 35.2%) decreased significantly. In addition, the resistance to streptomycin (45.8% to 67.9%), cephalothin (34.0% to 59.4%), and cefazlin (10.4% to 28.8%) increased significantly. Colistin resistance plasmid-mediated genes, mcr-1 and mcr-3, were detected after the ban on AGPs. The results of this study can provide useful data for analyzing the impact of the ban on AGPs on the virulence profiles and antimicrobial resistance of E. coli isolated from piglets with diarrhea in Korea.
Purpose: Given the importance and impact of trust between nurse and pediatric patient on treatment adherence and nursing outcomes, this study was aimed to investigate how nurses perceive the trust between nurses themselves and children in a hospital setting using a qualitative research methodology. Methods: In depth interviews with 10 nurses working at pediatric units were conducted using semi-structured questionnaires, and data were analyzed using a thematic analysis. Results: Main themes were categorized as attributes of nurse-child trust and influencing factors. Attributes of trust can be divided into definition and characteristics of nurse-child trust. Nurses perceived nurse-child trust were not coercive, and changeable mutual relationship needing time and effort, and helpful for child's hospital adaptation and child's participation for care. There existed facilitating factors and interfering factors in developing nurse-child trust. Conclusion: The findings of this study would help nurses who are caring children in a hospital setting re-shape their points of views on 'trust between nurses and children' in day to day practice. It is also hoped that these results contribute to develop nursing guidelines on trust building with children in hospital in future.
Purpose: Safe sleep practices (SSP) are among the main strategies to reduce sleep-related sudden unexplained infant death (SUID). Daycare personnel must be knowledgeable and trained in SSP related to SUID. This study explored the experience, knowledge, and confidence regarding SSP associated with SUID of daycare personnel. Methods: A cross-sectional survey was conducted with 395 staff members at 61 daycare centers to measure their experience related to SSP (10 items), related to sleep position and location, bedding materials, and other topics; knowledge of SSP (18 items); and confidence in SSP (1 item) related to SUID. Results: A substantial proportion (23.6%) of respondents used the lateral or prone positions for infant sleep. On average, 4.5 bedding materials were used for infant sleep. Participants showed a lack of knowledge about SSP as indicated by a 56.6% knowledge of SSP related to SUID correct answer rate. Personnel who received SUID education were more knowledgeable and had more confidence regarding SSP than those who did not. More knowledge and confidence related to SSP were associated with better adherence to SSP. Conclusion: Standard SSP guidelines should be developed based on South Korea's culture of childcare for educating both childcare professionals and parents at home.
Purpose: Based on the health belief model and theory of planned behavior, this study investigated how age group (adolescence and emerging adulthood) moderated the relative effects of perceived susceptibility, perceived severity, and subjective norms on preventive behavior against coronavirus disease 2019 (COVID-19). Methods: This secondary data analysis utilized data from adolescents (n=272) and emerging adults (n=239). Hierarchical multiple regression analysis was performed to test the moderating effect of age group on the relationships among variables. Results: Higher perceived susceptibility (β=.21, p<.001), perceived severity (β=.14, p=.002), subjective norms (friends) (β=.26, p<.001), subjective norms (parents) (β=.44, p<.001), and subjective norms (schools) (β=.28, p<.001) enhanced COVID-19 preventive behaviors. Moderated regression analysis showed that subjective norms (friends and school) impacted preventive behavior in adolescents more than in emerging adults. Conclusion: Given the need to increase perceived susceptibility and severity among adolescents and emerging adults, these findings provide baseline data for designing effective COVID-19 prevention interventions that consider the developmental characteristics of different age groups. Interventions by health centers at universities can strengthen COVID-19 preventive behavior among emerging adults. As adolescents are influenced by friends, their peer roles must be strengthened to enhance adherence to COVID-19 preventive guidelines.
Seon Ahr Cho;Hong Chul Chae;Jun Sik Min;Seong Jae Lee
International Journal of Advanced Culture Technology
/
v.11
no.3
/
pp.18-25
/
2023
The COVID-19 pandemic has had a significant impact on the educational landscape for students across the globe, leading to a shift towards long-term online learning. This study aims to examine the changes in the health status of college and university students before and after the transition to online classes. We conducted a survey questionnaire among 200 students enrolled at K University in Gangwon-do, including participants from both the Department of Visual Optics and the Department of Physical Therapy. The survey employed a 5-point Likert scale to evaluate a range of health-related factors, including physical and mental well-being, alterations in lifestyle, and academic performance. Both male and female students experienced a decline in physical strength and exercise during the online class period, while mental health and overall happiness showed improvement, particularly among female students. Notable shifts in lifestyle emerged, including an increased usage of electronic devices and enhanced familial connections. The study also shed light on intriguing trends related to academic accomplishments and adherence to official quarantine guidelines. In sum, the findings of this study offer valuable foundational information for the maintenance of students' well-being during online learning, as well as the development of effective strategies for online education in future academic settings.
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