PURPOSE: This study was carried out to describe the process and evaluation of a critical thinking class for new community health practitioners. METHODS: The case study design was used to develop and evaluate a critical thinking class for 46 participants in the community health practitioners training program. The class was held two hours a week for 8 weeks. Critical thinking disposition was tested before and after the class and critical skill was graded according to the final test score. Data analysis was performed using descriptive statistics and paired t-tests using SPSS WIN 20.0. RESULTS: Clinical critical thinking competences were identified through the literature review. The case situations with questions guiding the problem-solving process were developed and used for group discussion. Critical thinking disposition of participants was determined to have increased slightly after having taken the class. 17.4% of the participants had a competency level high enough to solve a problem and half of them stayed at the level of understanding of critical thinking. Compared with the class's satisfaction with the relevance to their jobs, the satisfaction with the learning method and instructor was high. CONCLUSION: The findings of this research will serve as the basis for developing critical thinking classes for community health nurses in order to improve their critical thinking competence.
Education ; Learning ; Mental Competency ; Nurses, Community Health ; Primary Health Care ; Problem-Based Learning ; Statistics as Topic ; Thinking*

PURPOSE: Osteitis refers to the development of new bone formation and remodeling of bone in chronic rhinosinusitis (CRS) patients; it is typically associated with eosinophilia, nasal polyps (NPs), and recalcitrant CRS. However, the roles of ossification in CRS with or without NPs remain unclear due to the lack of appropriate animal models. Thus, it is necessary to have a suitable animal model for greater advances in the understanding of CRS pathogenesis.METHODS: BALB/c mice were administered ovalbumin (OVA) and staphylococcal enterotoxin B (SEB). The numbers of osteoclasts and osteoblasts and bony changes were assessed. Micro computed tomography (micro-CT) scans were conducted to measure bone thickness. Immunofluorescence, immunohistochemistry, and quantitative polymerase chain reaction were performed to evaluate runt-related transcription factor 2 (RUNX2), osteonectin, interleukin (IL)-13, and RUNX2 downstream gene expression. Gene set enrichment analysis was performed in mucosal tissues from control and CRS patients. The effect of resveratrol was evaluated in terms of osteogenesis in a murine eosinophilic CRS NP model.RESULTS: The histopathologic changes showed markedly thickened bones with significant increase in osteoblast numbers in OVA/SEB-treated mice compared to the phosphate-buffered saline-treated mice. The structural changes in bone on micro-CT were consistent with the histopathological features. The expression of RUNX2 and IL-13 was increased by the administration of OVA/SEB and showed a positive correlation. RUNX2 expression mainly co-localized with osteoblasts. Bioinformatic analysis using human CRS transcriptome revealed that IL-13-induced bony changes via RUNX2. Treatment with resveratrol, a candidate drug against osteitis, diminished the expression of IL-13 and RUNX2, and the number of osteoblasts in OVA/SEB-treated mice.CONCLUSIONS: In the present study, we found the histopathological and radiographic evidence of osteogenesis using a previously established murine eosinophilic CRS NP model. This animal model could provide new insights into the pathophysiology of neo-osteogenesis and provide a basis for developing new therapeutics.
Animals ; Computational Biology ; Core Binding Factor Alpha 1 Subunit ; Enterotoxins ; Eosinophilia ; Eosinophils ; Fluorescent Antibody Technique ; Gene Expression ; Humans ; Immunohistochemistry ; Interleukin-13 ; Interleukins ; Mice ; Models, Animal ; Mucous Membrane ; Nasal Polyps ; Nose ; Osteitis ; Osteoblasts ; Osteoclasts ; Osteogenesis ; Osteonectin ; Ovalbumin ; Polymerase Chain Reaction ; Sinusitis ; Transcription Factors ; Transcriptome

Objective: The incidence of bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest has increased rapidly over the past 10 years. On the other hand, automated external defibrillators (AEDs) are still only used in a minority of cases. This study investigated the feasibility of mobile video call guidance to facilitate AED use for laypeople. Methods: Ninety laypersons were randomized into three groups: mobile video call guided, voice call guided, and nonguided. The participants were exposed to a simulated cardiac arrest requiring AED use and guided by video call, voice call, or not. The simulation experiments were saved as a video clip, and other researchers blinded to simulation assessed the performance according to a prespecified checklist after the simulations. The performance score and analyzed time intervals from AED arrival to defibrillation in the three groups were compared. Results: The basic characteristics were similar in the three groups. Performance scores in the checklist for using AEDs were higher in the mobile video call guided group, particularly in a category of ‘power on AED’ and ‘correctly attaches pads’ than non-guided groups. The performance scores in the category of ‘safely delivers a shock and resume compression’ were also higher in the mobile video call group. On the other hand, the time interval to defibrillation was significantly longer in the mobile video call group. Conclusion This study showed that mobile video call guidance might be an alternative method for laypeople to facilitate AED use, but further well-designed research will be needed.

PURPOSE: Tension pneumothorax is a life threatening condition. As an emergency treatment, needle thoracostomy with 50mm angiocatheter at the second intercostal space on the mid-clavicular line (2nd ICS/MCL) is recommended in the current guidelines. However, another site has been suggested in some studies. The purpose of this study was to determine whether the current procedure should be changed, by comparing the chest wall thicknesses (CWT) at the 2(nd) ICS/MCL and the 5(th) ICS/AAL (anterior axillary line) of injured patients. METHODS: A retrospective observational study was performed in an emergency center between May 2009 and December 2011. Medical records and computed tomography (CT) images of 140 included patients were reviewed. CWT at the 2(nd) ICS/MCL was compared with the 5(th) ICS/AAL. Moreover, the relationship between BMI (body mass index) and CWT was evaluated. RESULTS: CWT of the 2(nd) ICS/MCL was 31.7±8.5 mm on the right and 31.6±8.8 mm on the left, with no differences (p=0.42). CWT of the 5(th) ICS/AAL was 28.1±8.5 mm on the right and 27.8±7.7 mm on the left, also with no differences (p=0.30). CWT of the 2(nd) ICS/MCL was thicker than that of the 5(th) ICS/AAL (p<0.001). Nevertheless, CWT of all sites were not thicker than 50 mm (p<0.001). BMI was positively correlated with CWT. CONCLUSION: There was insufficient amount of evidences shown in this study to change the current guidelines of needle thoracostomy. However, in case of obvious patients, a long needle and 5(th) ICS/AAL site should be considered for needle thoracostomy, because CWT tended to increase as BMI increased.
Emergencies ; Emergency Treatment ; Humans ; Medical Records ; Needles* ; Observational Study ; Pneumothorax ; Retrospective Studies ; Thoracic Injuries ; Thoracic Wall ; Thoracostomy* ; Thorax*