Diffuse alveolar hemorrhage (DAH) is associated with severe outcomes. We report a case of acute respiratory failure that required mechanical ventilation and was clinically and pathologically diagnosed as DAH related to exposure to organic dust. A 39-year-old man, who had visited a warehouse to grade beans for purchase, was referred to our hospital for impending respiratory failure. His initial radiographic examinations revealed diffuse bilateral ground-glass opacities in his lungs and bronchoalveolar lavage resulted in progressively bloodier returns, which is characteristic of DAH. He underwent bedside open lung biopsy of his right lower lobe in the intensive care unit. Biopsy results revealed DAH and organization with accumulation of hemosiderin-laden macrophages and a few fibroblastic foci. The patient was treated with empirical antibiotics and high-dose corticosteroids and successfully weaned from mechanical ventilation. DAH might be considered in the differential diagnosis of patients with acute respiratory failure after exposure to organic particles.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Biopsy ; Bronchoalveolar Lavage ; Diagnosis, Differential ; Dust* ; Fibroblasts ; Hemoptysis ; Hemorrhage* ; Humans ; Intensive Care Units ; Lung ; Macrophages ; Respiration, Artificial ; Respiratory Insufficiency*

Background: The purpose of this study was to examine the association between the consumption frequency of sugar-sweetened beverages including soda and sweet drinks and sleep duration and quality among Korean adolescents. Methods: Data on 137,101 boys and 130,806 girls of students in middle and high school were obtained from the 2014-2017 Korean Youth Risk Behavior Web-based Survey, a national-wide cross-sectional school-based survey. Respondents self-reported soda and sweet drinks consumption, sleep hours, and sleep quality. The associations between these variables were analyzed by complex sampling multivariate logistic regression analysis. Results: 76.4% and 84.7% of respondents consumed soda and sweet drinks at least one time per week. Sleep deprivation (<8 hours/day) was associated with higher soda and sweet drinks consumption (adjusted odds ratio [aOR], 95% confidence interval [CI]) for 5 times a week for soda 1.44 (1.33-1.59) in boys and 1.25 (1.12-1.40) in girls: and sweet drinks 1.54 (1.43-1.66) in boys and 1.41 (1.28-1.55) in girls. Similarly, unsatisfactory sleep quality was also associated with higher soda and sweet drinks consumption (aOR, 95% CI) for 5 times a week for soda 1.19 (1.13-1.26) in boys and 1.27 (1.19-1.35) in girls: and sweet drinks 1.36 (1.29-1.44) in boys and 1.34 (1.28-1.41) in girls. Conclusions Both sleep deprivation and poor sleep quality was associated with higher consumption of soda and sweet drinks among Korean adolescents.

Purpose: This review explored trends in studies on learning outcomes in nursing education using gamification, to provide directions for future research. Methods: This scoping review was conducted according to the Joanna Briggs Institute's guidelines. The literature search date was February 1, 2021. Results: Thirty-two studies were included. The largest proportion of studies were quantitative descriptive studies, including qualitative mixed methods (34.4%). More studies applied gamification in practical classes (53.1%) than in theoretical classes. Virtual simulation games (37.9%) and simple quiz games (34.4%) were most often used. Commonly used gamification elements included scores/points, feedback, badges, countdowns, challenges, competitions, and levels. Two themes emerged regarding the impact of gamification on learning: learners’ experiences and achievement outcomes with cognitive, affective, and psychomotor subthemes. Nursing education using gamification improved engagement, motivation, and learning achievement. However, there was less evidence for affective and psychomotor outcomes than for cognitive outcomes. Conclusion Gamification can be an effective educational strategy if educator's have sufficient understanding and readiness and appropriate gamification elements are applied to nursing education. Further research should investigate knowledge retention in the cognitive domain, collaboration and empathy in the affective domain, and the improvement of nursing skills using new technologies in the psychomotor domain.

Purpose: This study investigated the scope of patient navigation studies on women’s health care for maternal health and noncancerous gynecologic conditions and aimed to report the characteristics of the identified patient navigation programs. Methods: A scoping review was conducted following Arksey and O’Malley’s framework. Five electronic databases were searched for relevant studies published in English: PubMed, Embase, Cochrane Library, CINAHL, and PsycInfo. There were no restrictions on the publication date and the search was completed in July 2023. Results: This scoping review included 14 studies, which collectively examined seven patient navigation programs. All selected studies were related to maternal health issues (e.g., perinatal health problems and contraception for birth spacing). Close to two-thirds of the patient navigation services were provided by women (n=9, 64.3%) and half by lay navigators (n=7, 50.0%). The majority incorporated the use of mobile health technologies (n=11, 78.6%). All of the patient navigation programs included in the review coordinated the necessary clinical and social support services to improve women’s access to care. Conclusion Patient navigation appears to be in its nascent phase in the field of maternal health. The results of this study suggest that the implementation of patient navigation services could potentially improve access to care for socially disadvantaged women and families. Furthermore, providing patient navigation services that are specifically tailored to meet women’s needs could improve the quality of maternity care.

The hospital water environment serves as a reservoir for Gram-negative multidrug-resistant organisms. Drains, sinks, drink dispensers, toilets, and shower equipment were identified as sources of the outbreak. Plumbing systems with variable nutrient and microbial loads promote bacterial colonization and biofilm formation. Plumbing traps (P-traps) in sinks are the primary source of sink-related outbreaks. Pathogens are introduced into P-traps through handwashing and disposal of waste or nutrients. Some pathogens can survive and develop biofilms in P-traps. When nutrients are introduced, the biofilm can extend upwards, reaching the sink strainer. During faucet operation, aerosols and drain contents are dispersed into the surrounding environment. Guidelines for handwash basin design generally recommend that large basins contain splashes and taps that are not aligned directly over the drains to minimize aerosol generation. Ensuring that basins are not used for the disposal of patient-related waste or nutrients and prohibiting the storage of clean patient material near the sink is important. Daily cleaning and disinfection of sink surfaces with bleach (sodium hypochlorite) are essential. Additionally, self-disinfecting traps that use heat, vibration, or ultraviolet radiation have been reported to reduce microbial burden and prevent further biofilm formation. Eradicating sink and drain contamination is often difficult and outbreaks can recur. Even after the replacement of the sink, the sink component had only temporary effects, suggesting a persistent reservoir in the retained sink fit. Further research is needed to develop continuous and effective disinfection methods for sinks and drains.

Purpose: This study investigated the scope of patient navigation studies on women’s health care for maternal health and noncancerous gynecologic conditions and aimed to report the characteristics of the identified patient navigation programs. Methods: A scoping review was conducted following Arksey and O’Malley’s framework. Five electronic databases were searched for relevant studies published in English: PubMed, Embase, Cochrane Library, CINAHL, and PsycInfo. There were no restrictions on the publication date and the search was completed in July 2023. Results: This scoping review included 14 studies, which collectively examined seven patient navigation programs. All selected studies were related to maternal health issues (e.g., perinatal health problems and contraception for birth spacing). Close to two-thirds of the patient navigation services were provided by women (n=9, 64.3%) and half by lay navigators (n=7, 50.0%). The majority incorporated the use of mobile health technologies (n=11, 78.6%). All of the patient navigation programs included in the review coordinated the necessary clinical and social support services to improve women’s access to care. Conclusion Patient navigation appears to be in its nascent phase in the field of maternal health. The results of this study suggest that the implementation of patient navigation services could potentially improve access to care for socially disadvantaged women and families. Furthermore, providing patient navigation services that are specifically tailored to meet women’s needs could improve the quality of maternity care.

Purpose: This study investigated the scope of patient navigation studies on women’s health care for maternal health and noncancerous gynecologic conditions and aimed to report the characteristics of the identified patient navigation programs. Methods: A scoping review was conducted following Arksey and O’Malley’s framework. Five electronic databases were searched for relevant studies published in English: PubMed, Embase, Cochrane Library, CINAHL, and PsycInfo. There were no restrictions on the publication date and the search was completed in July 2023. Results: This scoping review included 14 studies, which collectively examined seven patient navigation programs. All selected studies were related to maternal health issues (e.g., perinatal health problems and contraception for birth spacing). Close to two-thirds of the patient navigation services were provided by women (n=9, 64.3%) and half by lay navigators (n=7, 50.0%). The majority incorporated the use of mobile health technologies (n=11, 78.6%). All of the patient navigation programs included in the review coordinated the necessary clinical and social support services to improve women’s access to care. Conclusion Patient navigation appears to be in its nascent phase in the field of maternal health. The results of this study suggest that the implementation of patient navigation services could potentially improve access to care for socially disadvantaged women and families. Furthermore, providing patient navigation services that are specifically tailored to meet women’s needs could improve the quality of maternity care.

The hospital water environment serves as a reservoir for Gram-negative multidrug-resistant organisms. Drains, sinks, drink dispensers, toilets, and shower equipment were identified as sources of the outbreak. Plumbing systems with variable nutrient and microbial loads promote bacterial colonization and biofilm formation. Plumbing traps (P-traps) in sinks are the primary source of sink-related outbreaks. Pathogens are introduced into P-traps through handwashing and disposal of waste or nutrients. Some pathogens can survive and develop biofilms in P-traps. When nutrients are introduced, the biofilm can extend upwards, reaching the sink strainer. During faucet operation, aerosols and drain contents are dispersed into the surrounding environment. Guidelines for handwash basin design generally recommend that large basins contain splashes and taps that are not aligned directly over the drains to minimize aerosol generation. Ensuring that basins are not used for the disposal of patient-related waste or nutrients and prohibiting the storage of clean patient material near the sink is important. Daily cleaning and disinfection of sink surfaces with bleach (sodium hypochlorite) are essential. Additionally, self-disinfecting traps that use heat, vibration, or ultraviolet radiation have been reported to reduce microbial burden and prevent further biofilm formation. Eradicating sink and drain contamination is often difficult and outbreaks can recur. Even after the replacement of the sink, the sink component had only temporary effects, suggesting a persistent reservoir in the retained sink fit. Further research is needed to develop continuous and effective disinfection methods for sinks and drains.

The hospital water environment serves as a reservoir for Gram-negative multidrug-resistant organisms. Drains, sinks, drink dispensers, toilets, and shower equipment were identified as sources of the outbreak. Plumbing systems with variable nutrient and microbial loads promote bacterial colonization and biofilm formation. Plumbing traps (P-traps) in sinks are the primary source of sink-related outbreaks. Pathogens are introduced into P-traps through handwashing and disposal of waste or nutrients. Some pathogens can survive and develop biofilms in P-traps. When nutrients are introduced, the biofilm can extend upwards, reaching the sink strainer. During faucet operation, aerosols and drain contents are dispersed into the surrounding environment. Guidelines for handwash basin design generally recommend that large basins contain splashes and taps that are not aligned directly over the drains to minimize aerosol generation. Ensuring that basins are not used for the disposal of patient-related waste or nutrients and prohibiting the storage of clean patient material near the sink is important. Daily cleaning and disinfection of sink surfaces with bleach (sodium hypochlorite) are essential. Additionally, self-disinfecting traps that use heat, vibration, or ultraviolet radiation have been reported to reduce microbial burden and prevent further biofilm formation. Eradicating sink and drain contamination is often difficult and outbreaks can recur. Even after the replacement of the sink, the sink component had only temporary effects, suggesting a persistent reservoir in the retained sink fit. Further research is needed to develop continuous and effective disinfection methods for sinks and drains.