BACKGROUND: Insufficient training in infection control and occupational health among healthcare workers (HCWs) in countries with high human immunodeficiency virus (HIV) and tuberculosis (TB) burdens requires attention. We examined the effectiveness of a 1-year Certificate Program in Occupational Health and Infection Control conducted in Free State Province, South Africa in an international partnership to empower HCWs to become change agents to promote workplace-based HIV and TB prevention. METHODS: Questionnaires assessing reactions to the program and Knowledge, Attitudes, Skills, and Practices were collected pre-, mid-, and postprogram. Individual interviews, group project evaluations, and participant observation were also conducted. Quantitative data were analyzed using Wilcoxon signed-rank test. Qualitative data were thematically coded and analyzed using the Kirkpatrick framework. RESULTS: Participants recruited (n = 32) were mostly female (81%) and nurses (56%). Pre-to-post-program mean scores improved in knowledge (+12%, p = 0.002) and skills/practices (+14%, p = 0.002). Pre-program attitude scores were high but did not change. Participants felt empowered and demonstrated attitudinal improvements regarding HIV, TB, infection control, and occupational health. Successful projects were indeed implemented. However, participants encountered considerable difficulties in trying to sustain improvement, due largely to lack of pre-existing knowledge and experience, combined with inadequate staffing and insufficient management support. CONCLUSION: Training is essential to strengthen HCWs' occupational health and infection control knowledge, attitudes, skills, and practices, and workplace-based training programs such as this can yield impressive results. However, the considerable mentorship resources required for such programs and the substantial infrastructural supports needed for implementation and sustainability of improvements in settings without pre-existing experience in such endeavors should not be underestimated.
Capacity Building ; Delivery of Health Care* ; Education ; Female ; HIV* ; Humans* ; Infection Control ; Interviews as Topic ; Mentors ; Methods* ; Occupational Health* ; South Africa ; Tuberculosis*

PURPOSE: Breast-conserving surgery (BCS) is a standard treatment for breast cancer. Occasionally, patients may be dissatisfied with the breast shape due to deformity after BCS. To ensure satisfactory cosmetic results, a procedure with absorbable mesh after BCS was introduced in 2005. The purpose of this study was to identify the safety and effectiveness of this procedure. METHODS: From November 2013 to December 2015, patients who underwent BCS for a malignant breast mass at Jeonju Presbyterian Medical Center were reviewed, and 63 patients were included in this study. Based on data collected from medical records and telephone interviews, the subjects were divided into two groups as follows and retrospectively compared and analyzed: BCS with absorbable mesh (n=31) and BCS without absorbable mesh (n=32). Patient data included age, body mass index, underlying disease, tumor location and size, specimen size, operative time, axillary dissection based on frozen biopsy results, postoperative wound infection, postoperative radiotherapy, adjuvant chemotherapy, and follow-up period. To compare patient satisfaction between the two groups, a brief questionnaire consisting of four items was administered. RESULTS: Infection occurred in six patients (19.4%) in the absorbable mesh group and one (3.1%) in the BCS only group; however, the difference was not significant (p=0.053). Overall satisfaction, postoperative pain and postoperative motion limitation between the two groups were also not statistically significantly different. However, patients who underwent BCS with absorbable mesh insertion were better satisfied with the breast shape than those who underwent BCS without mesh from 1 year after operation (p=0.011). CONCLUSION: BCS with absorbable mesh is a simple and easy method to improve patient satisfaction for breast shape.
Biopsy ; Body Mass Index ; Breast ; Breast Neoplasms ; Congenital Abnormalities ; Drug Therapy ; Follow-Up Studies ; Humans ; Interviews as Topic ; Jeollabuk-do ; Mastectomy, Segmental* ; Medical Records ; Methods ; Operative Time ; Pain, Postoperative ; Patient Satisfaction* ; Polyglactin 910 ; Protestantism ; Radiotherapy, Adjuvant ; Retrospective Studies ; Surgical Wound Infection

BACKGROUND AND OBJECTIVES: This study was designed to review our experience with patients undergoing revision septoplasty and to evaluate the causes of persistent nasal obstruction and treatment outcomes of revision septoplasty. SUBJECTS AND METHOD: The medical records of 58 patients (53 men) who underwent revision septoplasty by the author of this study between 2006 and 2012 at our institute were retrospectively reviewed. Data on demographics, symptoms, anatomic site of deviation, surgical techniques performed, and postoperative complications were collected. Patient satisfaction scores were graded with a grading scale from 1 (excellent) to 4 (poor). RESULTS: All of the patients visited our hospital for persistent nasal obstruction after prior septoplasty. Forty-seven patients (81%) showed caudal septal deviation and 11 (19%) showed some other forms of septal deviation. Twenty-one cases (36.2%) were treated with the batten graft with cutting and suture technique, 20 (34.5%) with a batten graft alone, 10 (17.3%) with resection of remnant deviated septal bone and cartilage, 4 (6.8%) with the cutting and suture technique, 2 (3.5%) with a relocation suture, and 1 (1.7%) with a spreader graft. The median patient satisfaction score for 31 patients who answered the telephone interview was 2.06±0.93. CONCLUSION: A considerable number of patients who undergo revision septoplasty have remnant or recurrent caudal septal deviation that was not properly corrected in previous surgery. We recommend the batten grafting and the cutting and suture technique for the correction of caudal septal deviation in revision septoplasty.
Cartilage ; Demography ; Humans ; Interviews as Topic ; Medical Records ; Methods ; Nasal Obstruction ; Patient Satisfaction ; Postoperative Complications ; Retrospective Studies ; Suture Techniques ; Sutures ; Transplants ; Treatment Outcome*

The aim of this study was to investigate time trends in the public awareness of stroke and its predicting factors. The target population was 9,600 community-dwelling adults, aged 19–79 years, in 16 metropolitan cities and provinces in Korea. The survey samples in 2012 and 2014 were selected separately (entirely different sets of subjects) using a proportionate quota sampling method. Information concerning knowledge of stroke and demographics was collected by trained telephone interviewers using random digit dialing. After excluding subjects with a non-response or refusal to answer any question, the analyses included 8,191 subjects in 2012 and 8,127 subjects in 2014. Respondents’ awareness of stroke warning signs (numbness or weakness, difficulty speaking or understanding speech, dizziness, visual impairment, and severe headache) was highest for difficulty speaking or understanding speech (80.9% in 2012 and 86.4% in 2014). There were significant increases in the proportion of respondents understanding the appropriate action (i.e., calling an ambulance) at the time of stroke occurrence (59.6% to 67.1%), and in the proportion aware of the general need for prompt treatment (86.7% to 89.8%). In multivariable logistic regression analysis, older age, higher education level, higher household income, current non-smoking, exposure to stroke-related public relations materials, and experience of stroke education were significantly associated with both high knowledge of stroke warning signs and awareness of the need for prompt treatment. Between 2012 and 2014, the public’s awareness of stroke increased significantly. More specialized interventions, including public relations materials and education, should focus on subgroups who have lower stroke knowledge.
Adult ; Demography ; Dizziness ; Education ; Family Characteristics ; Health Services Needs and Demand ; Humans ; Interviews as Topic ; Korea* ; Logistic Models ; Methods ; Public Relations ; Stroke* ; Surveys and Questionnaires ; Telephone* ; Vision Disorders

PURPOSE: During clinical placements, nursing students who come into close contact with patients and provide nursing interventions may be exposed to harmful pathogens. However, little is known about nursing students' experiences with standard precautions (SP) in clinical settings. METHODS: We conducted interviews with six focus groups of nursing students (n = 38) from two universities in South Korea. The focus group interviews each took 90e120 minutes and included 6e7 participants from two different universities. The meetings used semi-structured interview protocols. Qualitative content analysis was employed. RESULTS: Four themes and 9 subthemes were identified: (a) attitudes (knowledge deficit, sensitivity), (b) subjective norms (negative role models, classroom and in-field gaps, blind spots), (c) perceived behavioral control (psychological barriers, physical barriers, lack of information), and (d) intention (changes in compliance awareness). CONCLUSIONS: These focus groups revealed that many nursing students worked in vulnerable environments and risked pathogen exposure. Nursing students expressed the importance of SP but reported witnessing many instances of failure to comply with established measures. Several barriers were explored as reasons of SP noncompliance. By removing the barriers presented in this study, nursing students would be able to perform their duties in a safe clinical environment.
Focus Groups ; *Health Knowledge, Attitudes, Practice ; Humans ; Infection Control/*methods ; Interviews as Topic ; *Nursing Methodology Research ; Republic of Korea ; Students, Nursing/*psychology ; Universities

PURPOSE: To develop a Critical Thinking Skill Test for Nursing Students. METHODS: The construct concepts were drawn from a literature review and in-depth interviews with hospital nurses and surveys were conducted among students (n=607) from nursing colleges. The data were collected from September 13 to November 23, 2012 and analyzed using the SAS program, 9.2 version. The KR 20 coefficient for reliability, difficulty index, discrimination index, item-total correlation and known group technique for validity were performed. RESULTS: Four domains and 27 skills were identified and 35 multiple choice items were developed. Thirty multiple choice items which had scores higher than .80 on the content validity index were selected for the pre test. From the analysis of the pre test data, a modified 30 items were selected for the main test. In the main test, the KR 20 coefficient was .70 and Corrected Item-Total Correlations range was .11-.38. There was a statistically significant difference between two academic systems (p=.001). CONCLUSION: The developed instrument is the first critical thinking skill test reflecting nursing perspectives in hospital settings and is expected to be utilized as a tool which contributes to improvement of the critical thinking ability of nursing students.
Education, Nursing/*methods ; Female ; Humans ; Interviews as Topic ; Male ; *Program Development ; Questionnaires ; Students, Nursing/*psychology ; *Thinking ; Young Adult

PURPOSE: The purpose of this study was to investigate the effectiveness of an educational intervention that used both cellular phones and the Internet to provide a short messaging service (SMS) relating to blood glucose, blood pressure, and serum lipid levels in postmenopausal women with impaired fasting glucose (IFG). METHODS: Twenty-eight postmenopausal women were assigned to an intervention group and twenty-one postmenopausal women to a control group. The intervention was provided for 12 weeks. Patients in the intervention group were asked to access a web site by using a cellular phone or to use the Internet directly and input their blood glucose and blood pressure levels weekly. Participants were sent the optimal recommendations weekly by both cellular phone and Internet. RESULTS: The intervention group had a mean decrease in systolic blood pressure (SBP) level of 8.1 mmHg but changes for the control group were not significant. There was a significant mean change in diastolic blood pressure (DBP) level for the intervention group (-7.7 mmHg). The mean change in the control group was not significant. CONCLUSION: This educational intervention using the Internet and a SMS by cellular phone improved levels of SBP and DBP in postmenopausal women with IFG.
Blood Glucose/*analysis ; *Blood Pressure ; *Cellular Phone ; Diabetes Mellitus, Type 2/blood ; Fasting ; Female ; *Health Education/methods/standards ; Humans ; *Internet ; Interviews as Topic ; Lipids/blood ; Middle Aged ; *Postmenopause ; Program Evaluation

Youth violence is a public health and social issue of global concern. It will be helpful to reduce the incidence of youth violence if the risk factors and prediction methods can be fully comprehended. This paper summarized the risk factors of youth violence in the aspects of the individual factors, the social psychological factors and the biological factors. Meanwhile, the status of prediction and assessment of youth violence are reviewed, with expectation to reduce youth violence and contribute to further research.
Adolescent ; Adolescent Behavior/psychology* ; Age Factors ; Craniocerebral Trauma/psychology* ; Family/psychology* ; Female ; Forecasting ; Forensic Psychiatry ; Humans ; Interviews as Topic ; Juvenile Delinquency/statistics & numerical data* ; Male ; Models, Statistical ; Predictive Value of Tests ; Public Health ; Risk Assessment/methods* ; Risk Factors ; Socioeconomic Factors ; Violence/statistics & numerical data* ; Young Adult

INTRODUCTIONThis paper describes the epidemiology and control of a community outbreak of novel influenza A (H1N1-2009) originating from a dance club in Singapore between June and July 2009.

MATERIALS AND METHODSCases of novel influenza A (H1N1-2009) were confirmed using in-house probe-based real-time polymerase chain reaction (PCR). Contact tracing teams from the Singapore Ministry of Health obtained epidemiological information from all cases via telephone.

RESULTSA total of 48 cases were identified in this outbreak, of which 36 (75%) cases were patrons and dance club staff, and 12 (25%) cases were household members and social contacts. Mathematical modelling showed that this outbreak had a reproductive number of 1.9 to 2.1, which was similar to values calculated from outbreaks in naïve populations in other countries.

CONCLUSIONThis transmission risk occurred within an enclosed space with patrons engaged in intimate social activities, suggesting that dance clubs are places conducive for the spread of the virus.

Adolescent ; Adult ; Commerce ; Contact Tracing ; methods ; Dancing ; Disease Outbreaks ; Female ; Humans ; Influenza A Virus, H1N1 Subtype ; isolation & purification ; Influenza, Human ; diagnosis ; epidemiology ; Interviews as Topic ; Male ; Models, Statistical ; Polymerase Chain Reaction ; Singapore ; epidemiology ; Travel ; Young Adult

INTRODUCTIONOver the years, surveys have become powerful tools for assessing a wide range of outcomes among patients. Healthcare managers and professionals now consider patient satisfaction as an outcome by itself. This study aims to determine if results of a patient satisfaction survey are affected by the manner by which the survey instrument is administered.

MATERIALS AND METHODSA patient satisfaction survey was conducted from May 2006 to October 2007 in a tertiary level acute care facility. All patients admitted to the observation unit during the study period were invited to participate. Using a contextualized version of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospital Survey, data was collected through either a phone interview, face to face interview or self-administered questionnaire. Each of these survey modes was administered during 3 different phases within the study period.

RESULTSEight hundred thirty-two (832) patients were included in the survey. Based on results of univariate analysis, out of the 18 questions, responses to 11 (61.1%) were related to survey mode. Face-to-face interview resulted in the greatest proportion of socially desirable responses (72.7%), while phone interview yielded the highest proportion of socially undesirable responses (63.3%). After controlling for possible confounders, logistic regression results showed that responses to 55.6% of the questions were affected by survey mode. Variations in response between phone interview and self-administered questionnaire accounted for 87.5% of the observed differences.

CONCLUSIONSResearchers must be aware that the choice of survey method has serious implications on results of patient satisfaction surveys.

Adult ; Emergency Service, Hospital ; Female ; Health Care Surveys ; methods ; Hospitals ; standards ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Patient Satisfaction ; Quality Assurance, Health Care ; Singapore ; Young Adult