• Title/Summary/Keyword: Quality of primary care

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Assessing Neurobehavioral Alterations Among E-waste Recycling Workers in Hong Kong

  • Gengze Liao;Feng Wang;Shaoyou Lu;Yanny Hoi Kuen Yu;Victoria H. Arrandale;Alan Hoi-shou Chan;Lap Ah Tse
    • Safety and Health at Work
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    • v.15 no.1
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    • pp.9-16
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    • 2024
  • Background: E-waste workers in Hong Kong are handling an unprecedented amount of e-waste, which contains various neurotoxic chemicals. However, no study has been conducted to evaluate the neurological health status of e-waste workers in Hong Kong. This study aimed to evaluate the prevalence of neurobehavioral alterations and to identify the vulnerable groups among Hong Kong e-waste workers. Methods: We recruited 109 Hong Kong e-waste workers from June 2021 to September 2022. Participants completed standard questionnaires and wore a GENEActiv accelerometer for seven days. Pittsburgh Sleep Quality Index and Questionnaire 16/18 (Q16/18) were used to assess subjective neurobehavioral alterations. The GENEActiv data generated objective sleep and circadian rhythm variables. Workers were grouped based on job designation and entity type according to the presumed hazardous level. Unconditional logistic regression models measured the associations of occupational characteristics with neurobehavioral alterations after adjusting for confounders. Results: While dismantlers/repairers and the workers in entities not funded by the government were more likely to suffer from neurotoxic symptoms in Q18 (adjusted odds ratio: 3.18 [1.18-9.39] and 2.77 [1.10-7.46], respectively), the workers from self-sustained recycling facilities also have poor performances in circadian rhythm. Results also showed that the dismantlers/repairers working in entities not funded by the government had the highest risk of neurotoxic symptoms compared to the lowest-risk group (i.e., workers in government-funded companies with other job designations). Conclusion: This timely and valuable study emphasizes the importance of improving the working conditions for high-risk e-waste workers, especially the dismantlers or repairers working in facilities not funded by the government.

A Case Study on Nosocomial Infection Control Activities in A General Hospital in Pusan (일 병원에서의 병원감염관리활동 사례연구)

  • Bae, Young-Soon
    • Quality Improvement in Health Care
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    • v.2 no.2
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    • pp.156-171
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    • 1996
  • Background: Nosocomial infection control is one of important means to assure the quality of medical care in the hospital, however, it has been neglected by most of the hospital personnels. Of nosocomial infections, urinary tract infection is the highest incidence, which is related to the indwelling catheter. It is, therefore, necessary to pay primary attention to the patients with the indwelling catheter in intensive care unit in order to control nosocomial Infection and to improve the quality of medical care in the hospital. Methods : The subjects of this study were patients with indwelling catheter who were admitted to the ICU of Pusan Paik Hospital from March 1994 to May 1995. The author calculated UTI rate among the subjects through the cultivation of the urine, identified the related factors of the UTI through brain storming of study team and head nurses working at ICU, and analized the effectiveness of the proposed approaches through comparing the infection rates of before and after activities. Results : The major activities carried out by the study team were to conduct in-service education programs for the staffs working at ICU about the importance of the nosocomial infection control in QA, and nursing intervention to reduce the UTI rate among the patients with indwelling catether. 1. The major nursing interventions that the study team had implemented were as follows ; 1) Drainage system was changed from partial open system to completely closed system. 2) Bladder irrigation which was routinely practised in all patients stopped among the noninfected patients. 3) Bladder irrigation set was changed to the disposable one. 4) Catheter was inserted under the anesthesia for patients to be operated. 5) Male patient receiving wrapped with gauze after perineal care was not wrapped. 6) Clamp which had not been before was newly attached to drainage tube. 7) Urine bag which had been packed into a lot of pieces was done into each piece. 8) The interval of change of indwelling catheter had regularly been four weeks, however it was used continously until it worked well. 9) Catheter was attached well at the defined site. 10) Paper towel was used instead of cotton towel. 11) Mats at the entrance were removed and cleansing of wards was enhanced. 2. The UTI rate by month was 34.4% in maximum and 9.8% in minimum during the period of this study, however it had gradually decreased. After 6 months from initiating infection control activities, the trend of rates was relatively stable. It was identified that UTI rate was different by season 12.5% in winter and 27.2% in summer. 3. Utilization rate of indwelling catheter was maintained at under 50%, but it was increased above 57% from April 1995. 4. The number of bladder irrigation sets used per day was 33.3 sets in maximum and 2.8 sets in minimum. The number used per day were also remarkably deceased. Conclusion : It was found that a program to control UTI could contribute to nosocomial infection control, and it was, in turn, a mean to assure the quality of medical care in the hospital. The nursing interventions which this study team had implemented were effective in the reduce of UTI rates.

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Dyadic Interventions for Heart Failure Patients and Their Family Caregivers: A Systematic Review (심부전 환자와 가족 돌봄제공자를 위한 다이애딕 중재에 관한 체계적 고찰)

  • Kim, Da-Young;Kim, Sun-Hee;Park, Eun Ju;Son, Youn-Jung
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.113-127
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    • 2021
  • Purpose : This systematic review was conducted to identify which dyadic intervention could be implemented for heart failure patient-family caregiver dyads to improve patient and/or their family caregivers outcomes. Method : Eleven databases were searched from their inception to July, 2021. This review considered any randomized controlled trials that evaluated the effectiveness of intervention including heart failure patient-family caregiver dyads. Two reviewers independently evaluated the methodological quality using the Cochrane Collaboration's tool for assessing risk of bias and extracted details of the included studies. The studies included in this review were not suitable for meta-analysis and therefore the results were presented as a narrative summary. Results : Six studies including 900 dyads were included and mainly primary family caregiver of patients was spouse. Majority of dyadic intervention were focused on psychoeducational intervention excepting one study on mobile health intervention. All studies included in this review focused on patients' outcomes compared to family caregivers' outcomes and dyadic outcomes. Individual interventions improved quality of life among heart failure patients and their family caregivers in two articles. The overall quality of selected articles was low. Conclusions : This study provides moderate support for the use of a dyadic intervention to improve quality of life among heart failure patients and their family caregivers. More rigorous high-quality studies investigating interventions to meet the needs of patient and family caregivers in heart failure care are needed.

Completeness of Patient Care Report (PCR) by Paramedics

  • Lee, HyoJu;Kim, JongHo;Yun, Seong Woo
    • Journal of information and communication convergence engineering
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    • v.20 no.3
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    • pp.204-211
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    • 2022
  • This study evaluated the completeness of patient care report (PCR). A retrospective quality analysis was conducted using raw data of 122,140 EMS activity reports prepared by paramedics in Gyeonggi-do from April 1 to May 31, 2021. In all, 67,830 cases of normal transfers were statistically analyzed using IBM SPSS Statistics version 22, and statistical significance was set at p<0.5. The 119EMT_2 certificate was omitted in 50,037 (73.8%) cases, followed by time-related items in 1,227 (1.8%) cases. In the primary assessment of vital signs, systolic blood pressure was omitted and erroneous in 1,218 (1.9%) and 1,129 (1.8%) cases, respectively. In the secondary assessment, the completeness of all vital sign items was approximately 70%. Advanced emergency care and online medical control (OLMC) reporting showed discrepancies in all items. As the severity of the patient's condition increased, the errors in the Patient care report (PCR) also increased, at a significant level (p= .00). Paramedics must be aware of the importance of completing the activity report.

Quality of Life of Family Members Living with Cancer Patients

  • Lee, Hyo Jung;Park, Eun-Cheol;Kim, Seung Ju;Lee, Sang Gyu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6913-6917
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    • 2015
  • Background: Due to the rapid progress of industrialization, the expansion of the nuclear family, and an increase in women's social activities, the burden of care of cancer patients has increased, so that all family members are now involved in care. We compared the health-related quality of life (HRQOL) between members of families of cancer patients (hereafter, cancer families) and members of cancer-free families (non-cancer families). Materials and Methods: The data were from the Community Health Survey (2012). The study population included respondents at least 30 years of age. Data were adjusted for the following covariates: sex, age, education, marital status, household income, economic activity, household type, chronic disease, and perceived health status. Frequency analysis, analyses of variance, and multiple linear regression analysis were performed. Results: Among 163,495 respondents, 3,406 (2.1%) were part of a cancer family and 160,089 (97.9%) were part of a non-cancer family. Cancer families had lower EQ-5D scores than non-cancer families. However, by subgroup, the scores had significant association between cancer and non-cancer families only for females and for those who worked. Conclusions: There was a significant relationship between HRQOL scores and being a family member of a cancer patient. This indicates that the responsibility for care has been extended to the entire family, not only the primary caregiver.

AAALAC International Standards and Accreditation Process

  • Gettayacamin, Montip;Retnam, Leslie
    • Toxicological Research
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    • v.33 no.3
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    • pp.183-189
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    • 2017
  • AAALAC International is a private, nonprofit organization that promotes humane treatment of animals in science through a voluntary international accreditation program. AAALAC International accreditation is recognized around the world as a symbol of high quality animal care and use for research, teaching and testing, as well as promoting animal welfare. Animals owned by the institution that are used for research, teaching and testing are included as part of an accredited program. More than 990 animal care and use institutions in 42 countries around the world (more than 170 programs in 13 countries in the Pacific Rim region) have earned AAALAC International accreditation. The AAALAC International Council on Accreditation evaluates overall performance and all aspects of an animal care and use program, involving an in-depth, multilayered, confidential peer-review process. The evaluators (site visitors) consider compliance with applicable local animal legislation of the host country, institutional policies, and employ a customized approach for evaluating overall program performance using a series of primary standards that include the Guide for the Care and Use of Laboratory Animals, the Guide for the Care and Use of Agricultural Animals in Research and Teaching, or the European Convention for the Protection of Vertebrate Animals Used for Experimental and Other Purposes, Council of Europe (ETS 123), and supplemental Reference Resources, as applicable.

Effects of Distant Reiki On Pain, Anxiety and Fatigue in Oncology Patients in Turkey: A Pilot Study

  • Demir, Melike;Can, Gulbeyaz;Kelam, Ayhan;Aydiner, Aydin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4859-4862
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    • 2015
  • Background: Fatigue, stress and pain are common symptoms among cancer patients, affecting the quality of life. The purpose of the present study was to determine the effect of distant Reiki on pain, anxiety and fatigue in oncology patients. Materials and Methods: Participants in the control group received usual medical and nursing care during their stay. The intervention group received usual care plus five distant Reiki sessions, one each night for 30 min. A face to face interview was performed and patient personal and illness related characteristics were evaluated using the Patient Characteristics form. Pain, stress and fatigue were evaluated according to a numeric rating scale. Results: The experimental group was predominantly composed of women (71.4%), married individuals (40%), and primary school graduates (40%). The control group was predominantly male (72.7%), married (60%), and primary school graduates (60%). The control group demonstrated greater levels of pain (p=0.002), stress (p=0.001) and fatigue (p=0.001). The Reiki group pain score (p <0.0001), stress score (p <0.001) and fatigue score were also significantly lower. Conclusions: The results of this study indicate that Reiki may d ecreasepain, anxiety and fatigue in oncology patients.

The Characteristics of the Families with Pneumoconiosis Patients (진폐환자 가족의 특성)

  • Park, Young Mi;Lee, Sung Eun
    • Korean Journal of Occupational Health Nursing
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    • v.8 no.1
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    • pp.84-91
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    • 1999
  • Pneumoconiosis is a pathological change which is caused by coal dusts. It is a chronic disease that is not cured thoroughly but need treatment and nursing care through all lifetime of the patient. The family of the patient will be suffered from the physical and mental difficulties in the consequence of pneumoconiosis. The study is to find out the characteristics of the families with pneumoconiosis patients. The subjects of the study were 300 families with pneumoconiosis patients who were under medical treatment in Taeback, Donghae, Jeongsun Occupational Medical Center. The period of the study was from the 8th to the 31st of August, 1998. The data were collected by the structured questionnaires included the family intensity measurement which was translated by "Oh". The general properties of the subjects were calculated by frequency and percentage with SAS program. The followings are the summaries of the study. 1) The mean age of the pneumoconiosis patients was 62.3 years. The mean duration of diseases was 11 years and 7 months and the mean duration of hospital stay was 6 years and 4 months. 2) The mean age of the primary care giver was 55.7 years. The proportion of highschool education was 9.6% and it was quite low level compared to other primary care giver groups. 3) The average number of family members were 1.76 person(2.76 persons included patient). The economic status was somewhat high compared to other families with chronic patients. 4) The mean score of family intensity was 41.2(item mean=3.4). With the result, it is recommended to develop a program to improve the quality of family life. For example, there will be social support program for pneumoconiosis patients family sponsored by Social Insurance for Occupational Diseases.

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Succeeding Factors and Barriers to Implementing Quality Improvement Programs (의료 질 향상 사업의 성공요인과 실패요인)

  • Choi, Kui Son;Lee, Sun Hee;Cho, Woo-Hyun;Kang, Hye-Young;Chae, Yoo Mi
    • Quality Improvement in Health Care
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    • v.8 no.2
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    • pp.146-159
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    • 2001
  • Background : To propose effective strategies for successful implementation of QI in health care institutions, by identifying facilitating factors and barriers to conducting QI programs. Methods : In order to examine empirical evidence on the success factors or barriers to QI implementation in hospitals, a literature study was performed on the basis of MEDLINE search. Among the identified literature. 13 provided reliable findings and basis comprehensive discussion on this issue and thus were selected for in-depth analysis. A mailed questionnaire survey was conducted for hospital CEOs and QI directors of hospitals with 400 beds or greater to investigate what attributes of their organizations they perceived as success factors or obstacles to QI implementation. Result : The analysis of selected literature and survey results presented that the primary factors considered to be most important as successful implementation of QI were: strong support from hospital CEOs, setting higher priority for QI activities, continuous and persistent efforts in QI activities, and active participation of clinical staffs. The barriers identified in this study were : the lack of orientation and understanding of QI concepts, low level of interest and participation of physician in QI programs, the lack of evaluation and rewarding system for QI activities. Conclusion : By identifying factors that affect facilitation of QI, the study results will be of great use for either institutions being in the early stage of evolving QI or those looking for better strategies to achieve more active and persistent QI implementation in their institutions.

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Nursing Education in North Korea: Past 50 Years and Future (북한의 간호교육 -반세기동안의 변화와 전망-)

  • Yi, Ggod-Me
    • Research in Community and Public Health Nursing
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    • v.12 no.2
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    • pp.437-449
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    • 2001
  • Purpose: To understand the development of nursing education of North Korea after 1945. Method: First, collecting primary sources published in NK. Second, collecting secondary sources published in South Korea. Third, interview with South Korean medical personnels who visited NK. Forth, interview with medical personnels who escaped NK. Result: After 1945 NK increased health care facilities in short time and had the policy of training medical personnel in short time. Nursing education was focused on the basic practice. NK could begin free medical treatment for the laborer in 1947. Post Korean War restoration and free medical treatment system of national level in 1950s and 1960s served to the health promotion of NK population. The medical personnel training policy continued and the number of R.N. in NK had increased 13 times in 15 years. NK has tried to increase the quality of health care service and medical personnel since 1970s. Nursing education in medical colleges is three-year course but 6 month training courses in general hospitals continue. They focus on primary prevention and oriental medicine in nursing curriculum reflecting the characteristics of NK medial care. But English and high technology is very poor, and there is no computer related curriculum. Conclusion: nursing education in NK has developed reflecting the changes of NK society and health care since 1945. After 1980s NK is in deep economic depression and it is hard to recover from the state with their hands. In this state, we cannot expect the development of nursing education in NK.

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