PURPOSE: The purpose of this study was to develop a heart health diary to promote self-care ability among patients with heart failure (HF), and to identify the diary's effect on self-care adherence, self-efficacy, and physical activity. METHODS: A randomized control-group pretest-posttest design was adopted using block randomization. A calender-typed health diary was developed and it included a self-care checklist and education information on HF management. The experimental group were given guided counseling and education for 8 weeks and wrote a daily health diary during that period. Data were collected from the outpatient department of a tertiary medical center from February to April 2016. To verify the hypotheses, data for the experimental group (n=28) and control group (n=33) were analysed using the independent t-test with SPSS/WIN 21.0. RESULTS: At the end of 8 weeks the experimental group had significantly higher scores for self-care adherence (t=-2.48, p =.016) and exercise related self-efficacy (t=-3.44, p =.001) compared to the control group. CONCLUSION: The findings show that the application of a patient-directed heart health diary is an effective nursing intervention for improving HF patients' self-care adherence and exercise self-efficacy. Strategies to promote dietary self-efficacy are necessary along with further studies including repeated research with an increasing intervention period. Healthcare providers need to encourage the utilization of a health diary for HF patients as a tool for evaluation and for implementation that leads to self-care.
Checklist ; Counseling ; Education ; Health Personnel ; Heart Failure* ; Heart* ; Humans ; Medical Records* ; Motor Activity ; Nursing ; Nursing Care ; Outpatients ; Random Allocation ; Self Care*

No abstract available.
Angiofibroma* ; Estrogens* ; Progesterone* ; Receptors, Progesterone*

Usually the histologic response of muscle to the ischemia range from mild, reversible change to extensive necrosis and fibrosis in the case of anterior tibial compartment syndrome. But dystmphic calcification in the late stages is very rare condition.Only three cases were previously reported by Gallie and Broder et al in the literature. We are reporting six cases of dystrophic calcification following anterior tibial compartment syndrome in late stages. Onsets of dystrophic calcifications after original injuries ranged from twelve years to thirty-two years. Two out of six cases revealed painless maas in the anterior tibial compartment and remaining four cases revealed painful aases. At surgery, tooth-paste like, calcified material was evacuated in one of five operated cases and yellowish grey, brittle materials were evacuated in the remaining four cases.
Compartment Syndromes ; Fibrosis ; Ischemia ; Leg ; Necrosis

BACKGROUND AND OBJECTIVES: This examined the association of cognitive function with self-care and major adverse cardiac events (MACE) among heart failure (HF) patients. SUBJECTS AND METHODS: In this prospective study, 86 outpatients with HF completed face-to-face interviews including neuropsychological testing to evaluate cognitive function and the use of the Self-Care of Heart Failure Index to measure self-care. Functional status was assessed with the New York Heart Association (NYHA) classification. Follow-up data on MACE were obtained at 24 months after enrollment. RESULTS: Compared with the Korean norm values, more than half of the HF patients had cognitive deficits in global function (33.0%), immediate recall (65.1%), delayed recall memory (65.1%), and executive function (60.5%). Patients with symptomatic HF (> or =NYHA class II) had the higher risk for substantially poor cognitive function in all areas of cognitive function than asymptomatic HF patients (NYHA class I, p<0.05). Most patients demonstrated poor self-care adequacy in maintenance (84.9%), management of symptoms (100%), and confidence (86.0%). After adjustment for age and gender, memory function was significantly associated with self-care confidence (odds ratio 1.41, 95% confidence interval 1.03-1.92, p=0.033). No relationship was found between cognition and self-care maintenance. There were 19 MACE's during the 24-month follow-up. Patients without MACE had a significantly higher global cognitive function (p=0.024), while no cognitive domains were significant predictors of MACE when adjusted for age and gender. CONCLUSION: HF patients with memory loss have poorer self-care confidence. Studies are warranted to examine the functional implication of cognitive deficits and adverse outcomes in a larger sample.
Classification ; Cognition ; Executive Function ; Follow-Up Studies ; Heart ; Heart Failure* ; Humans ; Memory ; Memory Disorders ; Memory, Short-Term ; Neuropsychological Tests ; Outpatients ; Prospective Studies ; Self Care*

OBJECTIVES: This study was conducted to develop a smartphone application (app) as an educational learning instrument for coronary artery disease (CAD) patients and to assess the users' level of satisfaction. METHODS: This methodological research involves elicited learning content for CAD patients to develop a learning instrument using the smartphone app. The app was developed according to the steps of Assessment, Design, Development, Implementation, and Evaluation, which is a systematic instructional design model. The levels of satisfaction with the developed smartphone app among 30 outpatients with CAD were assessed via a questionnaire during their visits to a cardiology outpatient department. RESULTS: A smartphone app 'Strong Heart' was developed through reviewing the literature associated with education for CAD patients under professional supervision and searching for medical smartphone apps that are already available. The learning contents include six main sections containing essential learning issues in managing CAD and additional information to attract the user's attention, such as patient cases and quizzes. After modification with feedback from experts, the app was finally developed and evaluated by patients who reported that they were satisfied with the usefulness of the app. CONCLUSIONS: The developed smartphone app is available on both the iPhone App Store and the Android Play Store. Patients with CAD may utilize the app for supporting educational material without limitations of time and space.
Cardiology ; Coronary Artery Disease* ; Education ; Educational Technology ; Humans ; Learning ; Mobile Applications ; Organization and Administration ; Outpatients ; Patient Education as Topic ; Surveys and Questionnaires

PURPOSE: This study was conducted to develop an integrated undergraduate course including a PBL based on a blended learning strategy, and evaluate learners' responses. METHODS: The learning contents of cardiovascular, respiratory, and musculoskeletal medical systems, and nursing diagnoses of 'activity and rest' domain (NANADA's classification II, 2005) were analyzed. Six clinical scenarios with the clients in different life cycles were developed for PBL. Classical lecture and group presentation with on-line self learning were implemented in addition to PBL. The developed course was implemented on 84 junior nursing students in a university for 7 weeks with 5 hours per day, two days per week. Students were asked to complete structured questionnaires including problem solving, critical thinking, and nursing diagnosis differentiation abilities. RESULTS: Learner's evaluation was positive in problem solving skills and in the differentiation ability of nursing diagnoses relevant to an 'activity and rest' functional health pattern. CONCLUSION: Development and implementation of integrated courses based on a blended learning method need to be continued to enhance students' thinking and self-directed learning abilities. Supporting strategies for individual learners should be added for successful blended learning such as individual on-line feedback and consideration of individual learning outcomes.
Classification ; Humans ; Learning ; Life Cycle Stages ; Nursing Diagnosis ; Problem Solving ; Problem-Based Learning ; Students, Nursing ; Thinking ; Surveys and Questionnaires

No abstract available.
Granuloma, Lethal Midline*

Autoimmune Diseases ; Collagen ; Cyclosporine ; Fibroblasts ; Gingival Hyperplasia ; Gingival Overgrowth ; Graft Rejection ; Humans ; Intercellular Signaling Peptides and Proteins ; Metabolism ; RNA, Messenger ; Tissue Donors ; Tissue Inhibitor of Metalloproteinase-1 ; Transforming Growth Factor beta1

BACKGROUND AND OBJECTIVES: Cystic fibrosis (CF) is an autosomal recessive disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Nasal polyps are also prominent features of cystic fibrosis. The purpose of this study is to investigate the CFTR expression and CF mutation genes in nasal polyps to verify genetic influence in the nasal polyp formation. MATERIALS AND METHODS: We have evaluated 30 nasal polyps, 10 recurrent nasal polyps, and 10 inferior turbinates. RT-PCR was done for the CFTR mRNA expression and mutaion genes were studied by RFLP. Immunohistochemical study and western blotting were done for CFTR expression. RESULTS: RT-PCR revealed no differences in the expressions of CFTR transcripts between nasal polyps and nasal turbinates. The expression of CFTR protein was localized on apical portion of some ciliated cells on immunohistochemistry, and western blotting showed no differences in expression levels of CFTR protein. Three different mutations (deltaF508, 591 del 18, G551D) were analysed. One case of deltaF508 was detected in the samples. CONCLUSIONS: The expression levels of CFTR mRNA and CFTR protein may not be associated with the pathogenesis of nasal polyps, but it needs to be studied further on the physiological base. We also need to study further regarding the relation between CFTR mutaion genes and the development of nasal polyps with more mutaional screenings in cDNA levels.
Blotting, Western ; Cystic Fibrosis Transmembrane Conductance Regulator ; Cystic Fibrosis* ; DNA, Complementary ; Immunohistochemistry ; Mass Screening ; Nasal Polyps* ; Polymorphism, Restriction Fragment Length ; RNA, Messenger ; Turbinates

No abstract available.
Butterflies