Improved Hand Hygiene Compliance is Associated with the Change of Perception toward Hand Hygiene among Medical Personnel / 감염과화학요법

BACKGROUND: Hand hygiene compliance has improved significantly through hand hygiene promotion programs that have included poster campaign, monitoring and performance feedback, and education with special attentions to perceived subjective norms. We investigated factors associated with improved hand hygiene compliance, focusing on whether the improvement of hand hygiene compliance is associated with changed perception toward hand hygiene among medical personnel. MATERIALS AND METHODS: Hand hygiene compliance and perceptions toward hand hygiene among medical personnel were compared between the second quarter of 2009 (before the start of a hand hygiene promotion program) and the second quarter of 2012. We assessed adherence to hand hygiene among medical personnel quarterly according to the WHO recommended method for direct observation. Also, we used a modified self-report questionnaire to collect perception data. RESULTS: Hand hygiene compliance among physicians and nurses improved significantly from 19.0% in 2009 to 74.5% in 2012 (P < 0001), and from 52.3% to 91.2% (P < 0.001), respectively. These improvements were observed in all professional status or all medical specialties that were compared between two periods, regardless of the level of the risk for cross-transmission. Hand hygiene compliance among the medical personnel continued to improve, with a slight decline in 2013. Perceptions toward hand hygiene improved significantly between 2009 and 2012. Specifically, improvements were evident in intention to adhere to hand hygiene, knowledge about hand hygiene methods, knowledge about hand hygiene indications including care of a dirty and a clean body site on the same patient, perceived behavioral and subjective norms, positive attitude toward hand hygiene promotion campaign, perception of difficulty in adhering to hand hygiene, and motivation to improve adherence to hand hygiene. CONCLUSIONS: The examined hand hygiene promotion program resulted in improved hand hygiene compliance and perception toward hand hygiene among medical personnel. The improved perception increased hand hygiene compliance. Especially, the perception of being a role model for other colleagues is very important to improve hand hygiene compliance among clinicians.

Histomorphometric study of machined titanium implants and calcium phosphate coated titanium implants / 대한치과보철학회지

PURPOSE: The objective of this study was to investigate the effects of calcium phosphate coated titanium implant surface on bone response and implant stability at early stage of healing period of 3 weeks and later healing period of 6 weeks. MATERIAL AND METHODS: A total of 24 machined, screw-shaped implants (Dentium Co., Ltd., Seoul, Korea) which dimensions were 3.3 mm in diameter and 5.0 mm in length, were used in this research. All implants (n = 24), made of commercially pure (grade IV) titanium, were divided into 2 groups. Twelve implants (n = 12) were machined without any surface modification (control). The test implants (n = 12) were anodized and coated with thin film (150 nm) of calcium phosphate by electron-beam deposition. The implants were placed on the proximal surface of the rabbit tibiae. The bone to implant contact (BIC) ratios was evaluated after 3 and 6 weeks of implant insertion. RESULTS: The BIC percentage of calcium phosphate coated implants (70.8 +/- 18.9%) was significantly higher than that of machined implants (44.1 +/- 16.5%) 3 weeks after implant insertion (P = 0.0264). However, there was no significant difference between the groups after 6 weeks of healing (P > .05). CONCLUSION: The histomorphometric evaluation of implant surface revealed that: 1. After 3 weeks early healing period, bone to implant contact (BIC) percentage of calcium phosphate coated implants (70.8%) was much greater than that of surface untreated machined implants (44.1%) with P = 0.0264. 2. After 6 weeks healing period, however, BIC percentage of calcium phosphate coated implants group (79.0%) was similar to the machined only implant group (78.6%). There was no statistical difference between two groups (P = 0.8074). 3. We found the significant deference between the control group and experimental group during the early healing period of 3 weeks. But no statistical difference was found between two groups during the later of 6 weeks.

A Retrospective Analysis to Determine Criteria for Termination of Resuscitation (TOR) for a Patient with an Out-of-Hospital Cardiac Arrest (OHCA) who Presents at the Emergency Department (ED)

PURPOSE: As public awareness of medical futility increases, more studies on pronouncement of death and related protocols in the field have been conducted overseas. However, it appears to be hard to declare death in the field in Korea due to a lack of proper treatment procedures for patients with out-of-hospital cardiac arrest (OHCA) under the current emergency medical service (EMS) system. As such, the objective of this study was to establish criteria to determine whether to perform cardiopulmonary resuscitation (CPR) for a patient who visits the ED with OHCA. METHODS: CPR results over an 8-year period, from January 2001 to December 2008, from patients with OHCA at Ewha Womans University, Mokdong Hospital were analyzed. The main factors affecting patients that survived for 24 hours after return of spontaneous circulation (ROSC) were identified retrospectively. RESULTS: A total of 782 patients visited the hospital due to OHCA during the study period. Of these, 752 met the inclusion criteria for our study. Of the 752, 162 (21.5%) survived over 24 hours after ROSC. Of the 752, 38 (5.1%) survived to hospital discharge and 18 (2.4%) survived to hospital discharge with good neurologic function. Among patients who survived over 24 hours after ROSC, factors that predicted survival included the presence of a witness (p<0.001), the implementation of CPR by a bystander (p=0.012), a short time from being found to time of arrival at the hospital (p<0.001) and younger age (p=0.042). Factors that predicted non-survival included no witness at the time of cardiac arrest, a prehospital time longer than 20 minutes, bystander CPR but the initial rhythm was asystole. The positive predict value was 95.6%. CONCLUSION: When an individual has an out-of-hospital cardiac arrest, termination of resuscitation should be considered when there are no witnesses, when there was no bystander to administer CPR, when the initial rhythm was asystole, and when prehospital time was longer than 20 minutes.

Effect of Two-year Course of Food and Nutrition on Improving Nutrition Knowledge, Dietary Attitudes and Food Habits of Junior College Female Students / 대한지역사회영양학회지

This study was conducted to investigate the effect of two-year course of food and nutrition on improving nutrition knowledge, dietary attitudes and food habits of junior college female students by questionnaires. The subjects were 108 college female students enrolled in the department of food and nutrition in Gyeonggi area. The results were as follows: There were no significant changes in the weights and BMI (Body Mass Index) after 2-yr course of food and nutrition. Nutrition knowledge (14.7 vs 16.3, p < 0.001) and dietary attitude (34.3 vs 35.8, p < 0.01) increased significantly after 2-yr course. However, no significant changes in food habit were observed. Among nutrition knowledge, the scores of functions (4.5 vs 5.2, p < 0.001) and understanding (6.7 vs 7.4, p < 0.01) of nutrients were significantly increased. The recognition of nutrition knowledge increased significantly (83.1 vs 95.7, p < 0.001). Among food habit, dietary habit (13.2 vs 12.5, p < 0.01) and health related habit (15.6 vs 14.6, p < 0.001) were significantly lowered after 2-yr course. The change in dietary attitudes showed significantly positive correlation with food habit changes (p < 0.05). These results showed that 2-yr course of Food and Nutrition had improved the nutrition knowledge and dietary attitudes. Therefore, providing the more systematic and appropriate nutrition education to students during their study period will be improved dietary attitudes and food habits.

Evaluation of Nutrition Education for Diabetes Mellitus Management of Older Adults / 대한지역사회영양학회지

Diabetes mellitus is the prevalent disease among older adults. The purpose of this study was to implement and evaluate the nutrition education program for diabetes mellitus patients aged 60 and over. The one group pretest and posttest design was employed to evaluate the program effectiveness. Nutrition education program for diabetes mellitus patients was carried out at the public healthy center in Guri city. The 38 out of 63 patients completed education program. They received four sessions of group education during four weeks. Nutrition education materials (booklet, leaflet) for older adults were provided to participants. Data about blood glucose, blood pressure, nutrition and diabetes mellitus knowledge, dietary behavior, dietary intake by 24-hour recalls were collected before and after nutrition education to evaluate the program effectiveness. All data were statistically analyzed using SAS package (ver.8.2) and significant difference was evaluated by chi-square-test, paired t-test and Wilcoxon signed rank test. Study results showed that blood pressure and blood glucose were slightly decreased after nutrition education but they did not reach statistical significance. There were positive changes in nutrition knowledge and dietary behavior. The total score of nutrition and diabetes knowledge increased significantly (p < 0.001), and the total score of dietary behavior was improved (p < 0.05) after nutrition education. Dietary intakes of most of nutrients examined were not significantly different between preand post-test. Based on study results, it appears that nutrition education program for the aged diabetes mellitus patients might effectively increase nutrition knowledge, dietary behavior and diet quality. This nutrition education program can be used at the public health centers or senior centers for the management of diabetes mellitus for older adults.

Physical Anthropologic Characteristics of the Auricle through the Metric and Non-metric Analysis in Korean Young Adults / 체질인류학회지

The auricle, which has a subtle structure, is an element that conveys signs of age or sex and decides the facial characteristic. The anatomy of the auricle differs in each individual as well as in each race. Therefore, the anatomy of the auricle can be useful for physical anthropologist to classify the race of a person or for a forensic anthropologist to identify the body of dead person. Also, a standard measurement of a normal ear is required for plastic surgeons to reconstruct an ear or artists to express the ear. Studies on the auricle of Caucasians and Koreans have been reported. However, further study on the classification of the location and shape of the auricle is necessary. The authors investigated the metric and non-metric characteristics to obtain basic data that display physical anthropologic features. Seven hundreds and thirty three Koreans under 39 years old and over 18 years old were examined. Metric items investigated were the length of the auricle, width of the auricle, morphological width of the ear, physiognomic ear length, physiognomic ear breadth, morphologic ear breadth, length of the ear cartilage, length of the ear lobule, and the height of the tragus. Non-metric items investigated were the location of the ear, shape of the helix and antihelix, and the attaching shape of the lobule. According to the metric results, all measured values were significantly greater in males than females, and there was a sexual difference except the width of the auricle, length of the ear lobule, and the height of the tragus. In non-metric results of the auricle, cases where the superaurale was located at the upper area of the eyebrow line and cases where the superaurale was between the eyebrow line and the upper eyelid showed similar rates among males. However, in 87.5% of the female group, the superaurale was located between the eyebrow line and the upper eyelid. The major shape of the helix were oval type (32.6%) and quadrilateral type (30.5%) in males, but oval type (32.7%) and triangular type (33.0%) in females. We believe that the data obtained in this study have generated standard measurements for ear reconstruction and can be used as basic data that show physical anthropologic characteristics of the Korean auricle.

Anterolateral thigh flap for head and neck reconstruction : anatomic study

Development of a Website-Based Nutrition Education Program for Female College Students and Young Women / 대한지역사회영양학회지

This study was designed to develop a website for providing nutrition information and education for college women and young women. The website focuses on two topics ; general nutrition and desirable weight control. This program is located at http : // www.ezydiet.co.kr. This program is composed of 5 major sections. The first two sections were designed to provide information ; one for general nutrition, and the other for providing information regarding weight control. The first section includes information regarding young adult women's diet, nutrition standards, such as the RDA or Korean Food Pyramid, drinking and smoking. The second section coveres information regarding desirable control, foods with high or low calories, eating disorders and popularly used dieting methods. The third section is for simple nutrition assessment, consisting of assessment of ideal body weight and obesity, energy requirements, and eating habits. The fourth section was designed to introduce and help users to apply behavioral modification techniques, such as monitoring, goal setting, stimulus control and reinforcement. The final section was designed for meal planning, by introducing a food exchange list and menu examples for one week. The characteristics of this web-based program are as follows ; 1) provide nutrition information systematically, 2) involve sections for the participation of the user, 3) include food pictures to help understanding of nutrition information, 4) include management modules for some sections to revise or update the information. One-hundred and ten female university students participated in the evaluation of this website. The evaluation results were favorable. About 90% of subjects rated that this program covers major topics 'well ' or 'very well', and that it was 'easy'to 'very easy'to understand the contents on website. Two-thirds of subjects rated quite positively on questions regarding attractiveness, overall quality and technical quality of website. In addition, about three-fourths of subjects answered that this website was helpful in increasing nutrition knowledge and in applying nutrition information into daily life. These results suggested the possibility of using a website as a means of providing nutrition information and education for young adult women.

Evaluation of Vitamin C Supplementation and Effectiveness of Smoking Cessation Intervention in Adolescent Male Smokers / 대한지역사회영양학회지

Smoking can increase oxidative stress and thereby change the antioxidant defense system in the body. Supplementation of antioxidant vitamins might improve antioxidant status in the body. The purpose of this study was to evaluate the effectiveness of vitamin C supplementation and smoking cessation education on changes of antioxidant status and psychosocial factors related to smoking. To obtain above purposes, we investigated the effectiveness of intervention for male adolescent smokers were evalnate by assessing changes in dietary intakes, plasma antioxidant vitamin concentration, and psychosocial factors related to smoking after program completion. Subjects, male adolescent smokers, were assigned into four groups : Control group(19 students), Educ. group(19 students), Vit. C supple. group(19 students), and Educ. + Vit. C suppl. group(19 students). The Educ. group and Educ.+Vit. C suppl. group received nutrition and smoking cessation education once a week for 5 weeks. Vit. C suppl. group and Educ.+Vit. C suppl. group received 500 mg per day of ascorbic acid for 35 days. All data were collected before and after intervention. Vit. B2 and Vit. C intakes of all groups were increased, but the only Ca intake was increased in the Educ. group. Plasma Vit. C concentration and Ratio(plasma Vit. C/Vit. C intakes) were increased in the Vit. C suppl. group and Educ.+Vit. C suppl. group, and the Vit. C deficiency status of these groups(Vit. C suppl. group and Educ.+Vit. C suppl. group) disappeared. Showing the effects of Vit. C supplementation, plasma alpha-tocopherol was increased in the Educ. and Educ.+Vit. C suppl. group, and especially high increases were seen in the Educ.+Vit. C suppl. group. Psychosocial factors related to smoking changed after the education a little. This intervention program had an impact on nutrition intakes, plasma antioxidant vitamins, and some beliefs related to smoking in male adolescent students. Various programs of nutrition and smoking cessation education and vitamin supplementation for quitting smoking must be implemented for adolescent smokers, and further studies are needed regarding sorts and amount of antioxidant nutrients and supplementation periods.

Evaluation of Vitamin C Supplementation and Effectiveness of Smoking Cessation Intervention in Adolescent Male Smokers / 대한지역사회영양학회지

Smoking can increase oxidative stress and thereby change the antioxidant defense system in the body. Supplementation of antioxidant vitamins might improve antioxidant status in the body. The purpose of this study was to evaluate the effectiveness of vitamin C supplementation and smoking cessation education on changes of antioxidant status and psychosocial factors related to smoking. To obtain above purposes, we investigated the effectiveness of intervention for male adolescent smokers were evalnate by assessing changes in dietary intakes, plasma antioxidant vitamin concentration, and psychosocial factors related to smoking after program completion. Subjects, male adolescent smokers, were assigned into four groups : Control group(19 students), Educ. group(19 students), Vit. C supple. group(19 students), and Educ. + Vit. C suppl. group(19 students). The Educ. group and Educ.+Vit. C suppl. group received nutrition and smoking cessation education once a week for 5 weeks. Vit. C suppl. group and Educ.+Vit. C suppl. group received 500 mg per day of ascorbic acid for 35 days. All data were collected before and after intervention. Vit. B2 and Vit. C intakes of all groups were increased, but the only Ca intake was increased in the Educ. group. Plasma Vit. C concentration and Ratio(plasma Vit. C/Vit. C intakes) were increased in the Vit. C suppl. group and Educ.+Vit. C suppl. group, and the Vit. C deficiency status of these groups(Vit. C suppl. group and Educ.+Vit. C suppl. group) disappeared. Showing the effects of Vit. C supplementation, plasma alpha-tocopherol was increased in the Educ. and Educ.+Vit. C suppl. group, and especially high increases were seen in the Educ.+Vit. C suppl. group. Psychosocial factors related to smoking changed after the education a little. This intervention program had an impact on nutrition intakes, plasma antioxidant vitamins, and some beliefs related to smoking in male adolescent students. Various programs of nutrition and smoking cessation education and vitamin supplementation for quitting smoking must be implemented for adolescent smokers, and further studies are needed regarding sorts and amount of antioxidant nutrients and supplementation periods.