Gustavsenziegler2023

This study aimed to evaluate child health needs in South Korea and the country's healthcare system capacities to meet them. A comprehensive needs assessment was performed by reviewing child health programs in Korea, followed by focus group discussions and individual interviews with multiple health experts and practitioners. Analysis of the meeting and interview transcripts were identified seven major domains of child health needs and healthcare system capacities. Comparison of child health needs and healthcare system capacities revealed that a much-needed linkage system between child health resources and preventive healthcare services is lacking. A new government policy to integrate current child health programs with high-quality preventive care is required.Purpose To examine the effect of Transcultural Nursing education on nursing students' Professional Values, Empathic Skills, Cultural Sensitivity and Intelligence.Design A posttest quasi-experimental study with a control group.Methods The participants were second year nursing students (n = 125). The experiment group was composed of students who had enrolled in the Transcultural Nursing course (n = 65). The control group consisted of students who did not enroll in this course (n = 60).Findings The posttest scores of the experiment group in the scales were significantly higher than those in the control group (p less then  .01).Conclusion Transcultural nursing course is an effective method to increase the professional values, empathic skills, cultural sensitivity and intelligence of students.Background The community college student is not currently armed with the resources or prevention information regarding influenza. Less than twenty percent of the college population receives influenza immunization annually.Purpose The purpose of the project was to evaluate if an evidenced-based influenza and vaccine education intervention will affect nursing students' intent to vaccinate for influenza by increasing knowledge of the influenza vaccine using Zingg and Siegrist's Knowledge Scale.Methods Participants were recruited voluntarily from their attendance at orientation for incoming nursing students on a specific date and time. Utilizing a computer survey, all seventy-seven participants completed an online pretest before an educational intervention, and then, the results were compared following the educational intervention with a posttest. Parametric tests such as a paired t-test, Pearson's correlation coefficient, one-way analysis of variance (ANOVA), and percent change were utilized to determine whether an educational intervention was effective in improving influenza knowledge and whether there was a change in vaccination intention.Outcomes and Results The educational intervention in this project resulted in enhancement of influenza knowledge. check details The implications of this project demonstrated the value of providing an educational intervention to improve knowledge, intent, and willingness to vaccinate for influenza for nursing students at a community college.Background Work productivity loss (WPL) is a major contributor to the indirect costs of psoriasis. Newer biologic therapies are effective at reducing disease symptoms and improving quality of life, but their impact on WPL and associated indirect cost savings compared to previously approved biologic therapies is largely unknown.Objectives To compare the effects of guselkumab and adalimumab on WPL and associated indirect cost savings in patients with moderate-to-severe psoriasis.Methods Using data from the VOYAGE 1 (NCT02207231) trial, improvements from baseline in Dermatology Life Quality Index (DLQI) work/study domain scores were compared for patients receiving guselkumab or adalimumab at 24 and 48 weeks of treatment. Improvements in WPL and associated cost savings were calculated using a previously established DLQI-WPL algorithm.Results Among patients who could not work/study at baseline (DLQI work/study domain score = 3), a significantly greater proportion of guselkumab-treated patients could work/study without problems (DLQI work/study domain score = 0) than adalimumab-treated patients at Weeks 24 and 48. Improvements from baseline in WPL and associated cost savings were greater with guselkumab than with adalimumab at Week 48.Conclusions Guselkumab was superior to adalimumab for improvement in WPL and associated indirect cost savings, and its use may reduce the economic burden of psoriasis.OBJECTIVE Our study aimed to compare regional node coverage and doses to the organ at risk (OAR) using conventional technique (CT) vs "AMAROS" (AT) vs intensity-modulated radiation therapy (IMRT) techniques in patients receiving regional nodal irradiation (RNI) for breast cancer (BC). METHODS We included 30 consecutive patients with BC who received RNI including axillary nodes. Two independent and blinded dosimetric RNI plans were generated for all patients. For target volume coverage, we analyzed the V95%, the D95%, the mean and the minimal dose within the nodal station. For hotspots within nodal target volume, we used the V105%, the V108% and the maximal doses. For OAR, lung V20, mean lung and heart doses, the maximal dose to the brachial plexus and the axillary-lateral thoracic vessel junction region were compared between the three techniques. RESULTS Target volume coverage and hotspots Mean V95% in stations I, II, III and IV were 35.8% and 75% respectively with CV, 22.59 and 59.9% respectively with AT tecsection since it decreases hotspots in the target volume and lowers the radiation exposure of the OAR. For more advanced tumors or patients who did not respond to primary systemic therapy, CT or IMRT should be considered because of their better coverage of the potentially residual nodal disease. link2 IMRT combines several advantages of offering high conformal plans, limited hotspots and protection of main OAR. The clinical impact of these dosimetric differences need to be addressed. ADVANCES IN KNOWLEDGE This study is to our knowledge the first to compare conventional three-dimensional and IMRT techniques for regional nodal irradiation for each nodal station in breast cancer in a context of increasing utilization of axillary irradiation.Matrix metalloproteinases (MMPs) are a family of proteolytic enzymes that degrade extracellular matrix (ECM) components such as collagen and have important roles in multiple biological processes, including development and tissue remodeling, both in health and disease. The activity of MMPs is influenced by the expression of MMPs and tissue inhibitors of metalloproteinase (TIMPs). In the eye, MMP-mediated ECM turnover in the juxtacanalicular region of the trabecular meshwork (TM) reduces outflow resistance in the conventional outflow pathway and helps maintain intraocular pressure (IOP) homeostasis. An imbalance in the MMP/TIMP ratio may be involved in the elevated IOP often associated with glaucoma. The prostaglandin analog/prostamide (PGA) class of topical ocular hypotensive medications used in glaucoma treatment reduces IOP by increasing outflow through both conventional and unconventional (uveoscleral) outflow pathways. Evidence from in vivo and in vitro studies using animal models and anterior segment explant and cell cultures indicates that the mechanism of IOP lowering by PGAs involves increased MMP expression in the TM and ciliary body, leading to tissue remodeling that enhances conventional and unconventional outflow. PGA effects on MMP expression are dependent on the identity and concentration of the PGA. An intracameral sustained-release PGA implant (Bimatoprost SR) in development for glaucoma treatment can reduce IOP for many months after expected intraocular drug bioavailability. We hypothesize that the higher concentrations of bimatoprost achieved in ocular outflow tissues with the implant produce greater MMP upregulation and more extensive, sustained MMP-mediated target tissue remodeling, providing an extended duration of effect.Importance Medium and large nasal defects are mostly addressed with paramedian forehead flap reconstruction. The superior extended nasal myocutaneous island (SENMI) flap offers an alternative that can be single stage and can avoid a gross deformity. Objective To describe a new flap for nasal reconstruction of medium and large nasal defects and to define the flap's limitations and indications. link3 Design, Setting, and Participants This original study was a retrospective case series of patients who underwent SENMI flap reconstruction from 2008 to 2018 at a private tertiary referral center-Skin Cancer and Reconstructive Surgery Center (SCARS Center). Participants included all consecutive patients of the senior author who had undergone SENMI flap from September 2012 to December 2018, consisting of 53 patients. Indications for surgery were mostly skin cancer defects, postreconstructive, and post-traumatic deformities. IRB approval was obtained from the St. Joseph Health Center for Clinical Research. Main Outcomes and n 18 patients (33%) after one stage. Partial flap ischemia occurred in two patients (4%). Conclusions and Relevance SENMI flap is an effective technique for nasal reconstruction. It offers a single- or two-stage alternative with less temporary deformity in comparison with forehead flap reconstruction.Background Recent and preprohibition studies show that patients with serious illness might benefit from psychedelic-assisted therapies for a range of symptoms, physical, psychosocial, and existential. Objective To explore the potential roles and research priorities of these therapies in patients with serious illness. Design, Setting, and Participants Qualitative study based on semistructured interviews with 17 experts in serious illness care and/or psychedelic research from the United States and Canada. Measurements The interview guide elicited participants' perspectives on (1) the potential roles of psychedelic-assisted therapies in this setting, (2) research priorities relevant to this population, and (3) the potential for integrating psychedelic-assisted therapies into existing delivery models of serious illness care. We used thematic analysis until thematic saturation. Results Domain I Participants had polar views on the therapeutic potential of psychedelic-assisted therapies, ranging from strong beliefs in their medical utility to reluctance about their use in this patient population. They shared concerns related to the risks of adverse effects, such as delirium or worsening of psychological distress. Domain II Research priorities primarily concerned patients with clinically diagnosed psychosocial distress, such as depression, anxiety, or demoralization. Participants also articulated potential roles extending beyond traditional medical diagnosis. Domain III Participants emphasized essential safety and efficacy guidelines relevant to the integration of these therapies into existing models of care. Conclusion This qualitative study highlights issues and priorities for research on psychedelic-assisted therapies in patients with serious illness and proposes a conceptual framework for integrating these therapies into existing delivery models of serious illness care.Although insulin delivery devices are widely used by the patients, there is a paucity of published guidelines to help professionals manage their patients in insulin therapies. To provide simple and easily implementable guidelines to healthcare physicians on the choice of insulin delivery devices in routine clinical practice, experts in diabetes gathered together and discussed the recommendations at the National insulin Summit 2018.An ideal insulin delivery device should accurately deliver the prescribed dose of insulin and be easy to use. Recommendations are 1. insulin should be Initiated using insulin device if the patient seems to discontinue insulin therapy. 2. Pen devices offer accurate dosing than syringe and vial and associated with cost savings in the long-term. 3. Switching over from syringes and vial to disposable pen devices improves adherence. 4. FlexPen® offers better accuracy, requires lower dose force and injection force than SoloStar® and KwikPen® * 5. Durable delivery pen like NovoPen® 4 maintain accuracy and low dose force compared to vials and syringes.