PURPOSE: Hospice volunteers are serving an invisible yet pivotal role in the hospice and palliative care team. This study investigated how effectively a continuing education program could enhance hospice volunteers' competency.METHODS: A total of 20 hours (four hours per week) of training was provided to 30 hospice volunteers who participated in the continuing education for hospice volunteers. Efficiency of the education was analyzed with an exploratory mixed-methods design. For quantitative analysis, the volunteers were asked, before and after the training, about their attitudes towards hospice care, what makes a meaningful life, self-efficacy and satisfaction with their volunteer service. Descriptive statistics, paired t-tests, and Wilcoxon signed-rank test were performed using SPSS Window 20.0. For qualitative research, participants were placed in three groups for a focus group interview, and data were analyzed by content analysis.RESULTS: A quantitative study result shows that this training can significantly affect hospice volunteers' attitudes and improve their self-efficacy. A qualitative study result shows that participants wanted to receive continuous education from the physical/psychosocial/spiritual aspects to better serve end-of-life patients and their family members even though they have to spare significant time for the volunteer service. They wanted to know how to take good care of patients without getting themselves injured and how to provide spiritual care.CONCLUSION: The continuing education program reflecting volunteers' requests is strongly needed to improve their competency. An effective continuing education requires continuous training and support in areas where hospice volunteers are interested in. A good alternative is to combine web-based and hands-on training, thereby allowing hospice volunteers freely take training that suits their interest.
Education ; Education, Continuing ; Focus Groups ; Hospice Care ; Hospices ; Hospital Volunteers ; Humans ; Palliative Care ; Qualitative Research ; Volunteers

OBJECTIVE: Various educational programs have been implemented to achieve skill, willingness and self-confidence in performing cardiopulmonary resuscitation (CPR). Paramedic students usually participate in clinical practice in emergency department as one of their educational courses. We investigated the effects of hospital based clinical practice and participation in real cardiac arrest situation on paramedic students' CPR performance and recognition. METHODS: Eighty-one paramedic students from 10 different universities who received hospital based clinical practice for 3 or 4 weeks in a regional emergency medical center from December 2016 to August 2017 were enrolled in our study. Subjects were asked, using a questionnaire, about their confidence and willingness to perform CPR before and after clinical practice. We also objectively measured two minute-CPR performance using the Laerdal skill reporter before and after clinical practice. During clinical practice, students participated in real CPR situations and took several theoretical examinations; however, additional CPR practical training was not included. RESULTS: This study included 48.1% male volunteers and 70.4% respondents who had Basic Life Support provider certification. The average number of real CPR situations participated in was 8.35 times. Scores in confidence of CPR increased significantly (3.80 vs. 4.36, P < 0.001) after clinical practice; however, scores in willingness to conduct CPR were high in both groups (4.46 vs. 4.48, P=0.787). Average chest compression depth also increased significantly (51.3 mm vs. 55.5 mm, P < 0.001) after clinical practice, but average compression rate showed no difference (111 vs. 111, P=0.694). Correct hand positioning and chest recoil also showed no difference between groups. CONCLUSION: Hospital based clinical practice of paramedic students could provide extra confidence in student's ability to perform CPR and lead to adequate chest compression depth.
Allied Health Personnel* ; Cardiopulmonary Resuscitation* ; Certification ; Education ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; Emergency Service, Hospital ; Hand ; Heart Arrest ; Humans ; Male ; Surveys and Questionnaires ; Thorax ; Volunteers

Telmisartan is an angiotensin II receptor antagonist and chlorthalidone is a thiazide-like diuretics. In this study, we report serious adverse events (SAEs) during clinical trial for pharmacokinetic interaction between telmisartan and chlorthalidone in healthy Korean subjects. Two separate, randomized, multiple-dose, two-period, one-sequence studies were conducted at Kyungpook National University Hospital. In part A, 43 volunteers received telmisartan for 7 days, and then chlorthalidone for 14 days (days 8-21). Telmisartan was co-administered during day 15-21 to evaluate the effects of chlorthalidone on the pharmacokinetics of telmisartan at steady state. A healthy 36-year-old male in part A was referred to the emergency room due to severe nausea and vomiting developed about 3 h after administration of chlorthalidone on day 9. Hypokalemia and QT prolongation were observed during his initial laboratory examination and electrocardiogram (ECG) monitoring in the emergency unit. Nausea and vomiting improved after conservative management with hospitalization for 9 days. We consider that the episodes of excessive nausea and vomiting resulted in hypokalemic state which was potentiated by chlorthalidone. And the hypokalemic state caused the lengthening of the QT interval on ECG.
Adult ; Arrhythmias, Cardiac ; Chlorthalidone* ; Diuretics ; Electrocardiography ; Emergency Service, Hospital ; Gyeongsangbuk-do ; Hospitalization ; Humans ; Hypokalemia ; Male ; Nausea ; Pharmacokinetics ; Receptors, Angiotensin ; Volunteers ; Vomiting

No abstract available.
Gynecology/*organization & administration/*standards ; Humans ; Patient Escort Service/*organization & administration/*standards ; Physical Examination/*methods/*standards ; Physicians/*ethics ; Sex Factors

PURPOSE: To manage a critically ill patient effectively, an emergency physician must make an accurate assessment of the patient's hemodynamic status. Although the hemodynamic status can be accurately measured through the use of a pulmonary artery catheter, this device has significant limitations in the emergency department. Instead, the most commonly used method of measuring cardiac output (CO) in the emergency department is transthoracic echocardiography (TTE). However, TTE has been reported to underestimate the CO. Impedance cardiography (ICG) is an established and accurate technique for noninvasive determination of hemodynamic parameters. Thus, this study aimed to assess the agreement between CO measurements made by using TTE and ICG. METHODS: In 20 healthy volunteers, the hemodynamic parameters (stroke volume and CO) obtained by TTE were compared with the parameters derived from simultaneous measurements by ICG. RESULTS: The mean stroke volumes and COs were 63.9+/-11.6 ml and 4.1+/-0.7 L/min, respectively, by TTE, and 77.2+/-10.2 ml and 5.0+/-0.6 L/min by ICG. The correlation coefficients for stroke volume and CO between TTE and ICG were 0.77 and 0.64. The mean difference in stroke volume between TTE and ICG was -13.3+/-6.4 ml (-19.5+/-10.5 %), and the mean difference in CO was -0.88+/-0.48 L/min (-20.1+/-11.6 %). CONCLUSION: In healthy volunteers, the comparison between TTE and ICG showed a good correlation for stroke volume and CO. However, the mean differences in stroke volume and CO between TTE and ICG were -19.5+/-10.5 % and -20.1+/-11.6 %, respectively.
Cardiac Output* ; Cardiography, Impedance ; Catheters ; Critical Illness ; Echocardiography* ; Emergencies ; Emergency Service, Hospital ; Healthy Volunteers ; Hemodynamics ; Humans ; Male* ; Pulmonary Artery ; Stroke Volume ; Volunteers*

PURPOSE: The determination of tetanus prophylaxis according to patients' memories of past immunization is inaccurate. However, by using the Tetanos Quick Stick(R) test, it is possible to select Korean adults with low tetanus antibody titers and to perform tetanus prophylaxis in the emergency department. In 1996, Ha reported that tetanus toxoid injection into healthy Korean adults revealed significant differences between the tetanus antibody titers at the beginning and the tetanus antibody titers after 1 week. Our purpose is to determine the effect of a single tetanus toxoid in Korean adults with low tetanus antibody titers. METHODS: Blood samples were taken from 44 volunteers for a period of 6 weeks. All samples were analyzed using the Tetanus IgG ELISA (enzyme-linked immunosorbent assay) method. RESULTS: The results for tetanus antibody titers at the beginning and after 1 week, 2 weeks, 4 weeks, and 6 weeks were 0.04+/-0.05 IU/mL, 1.22+/-3.63 IU/mL, 4.99+/-7.3 6 IU/mL, 8.36+/-11.10 IU/mL and 6.59+/-9.21 IU/mL respectively. There was a statistically significant defference between the tetanus antibody titers at the beginning and the tetanus antibody titers after 2 weeks. There was no statistically significant defference between the tetanus antibody titers after 2 weeks and 6 weeks. After 4 weeks, all subjects' tetanus antibody titers were at the protective level. CONCLUSIONS: A single tetanus toxoid injection is effective in Korean adults with low tetanus antibody titers.
Adult* ; Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunization ; Immunoglobulin G ; Tetanus Toxoid* ; Tetanus* ; Volunteers

OBJECTIVES: Recently, polymorphisms of several serotonin genes have been suggested to be associated with suicide, but the results are still unclear. We examined whether the T102C polymorphisms of the serotonin 2A receptor gene and the G861C polymorphisms of the serotonin 1B receptor gene were associated with suicidal behavior using drug intoxication. METHODS: The subjects were 52 patients who visited emergency room with suicidal behaviors. Fifty controls were selected from healthy volunteers matched for sex and age to the suicide subjects. The polymorphisms were analyzed with TaqMan(R) assay using primers based on previous studies. RESULTS: The T102C polymorphism of the serotonin 2A receptor gene showed no significant difference between the suicidal attempters and controls in both genotype and allele frequency analyses(p=0.179 and p=0.422, respectively). There was no statistically significant difference between the suicidal attempters and the controls in the G861C polymorphism of the serotonin 1B receptor gene and any significant effect of the genotype distributions or the allele frequencies was not observed(p=0.092 and p=0.987, respectively). CONCLUSION: These findings suggest that the T102C polymorphism in serotonin 2A receptor gene and the G861C polymorphism in serotonin 1B receptor gene are not related to the susceptibility to suicide attempts using drugs. To clarify the genetic influences of the serotonergic system on suicidal behavior, the polymorphisms of other candidate genes in the serotonergic system should be studied with larger numbers of subjects.
Emergency Service, Hospital ; Gene Frequency ; Genotype ; Healthy Volunteers ; Humans ; Receptor, Serotonin, 5-HT1B ; Receptor, Serotonin, 5-HT2A ; Serotonin* ; Suicide

Designing technological process to assess bioequivalence of oral antibiotic products. Method: Choosing volunteers, setting experiment, taking specimens, following volunteers' health, quantifying cephalexine in specimens, and analysing experiment data. The method assessed by drug's hardness, accuracy, limitation of quantification, stability
Cephalexine ; Biological Products ; Hospital Volunteers

OBJECTIVE: Until now,no effective screening tools have been available for evaluating the neurotoxicity of organic solvents and metals. The aim of this study was to evaluate the usefulness of posturography as a screening tool for the chronic neurotoxicity of organic solvents. METHOD: 36 workers in 4 septic tank manufacturers,who were exposed to styrene over a period of 1 year (exposed group),and 15 hospital volunteer manual workers were examined by posturography.The subjects' physical,medical,and occupational characteristics were obtained by means of a physical examination and a questionnaire. We excluded from both groups those persons who had psychiatric problems, diabetes, neurologic symptoms, gait disturbance,or a history of stroke.The sway area of the exposed group was compared to that of the non-exposed group using bivariate and multiple regression analysis. We controlled a number of variables including age, alcohol consumption,smoking, weight, height, and body mass index. RESULT: The sway area of the exposed group was found to be higher than that of the non-exposed group after taking into consideration the effects of other characteristics by means of multiple regression analysis. CONCLUSION: We concluded the posturography would be an effective tool for the screening of chronic neurotoxicity in workers exposed to styrene.
Body Mass Index ; Gait ; Hospital Volunteers ; Humans ; Mass Screening ; Metals ; Neurologic Manifestations ; Physical Examination ; Questionnaires ; Solvents ; Styrene*

PURPOSE: The aim of this study is to evaluate the medical students' consciousness on volunteer activities. What kinds of volunteer activities they had done, what kinds of volunteer activities they want to participate in, how they think about making volunteer program as school regular curriculum, and how they feel about volunteer activity. MATERIALS AND METHODS: Study subjects are first, second grade premedical students and first, second grade medical students. Self-administered questionnaire was conducted at October, 1999. Finally, 119 questionnaire is collected, which is 74% of all students except 3rd, 4th grade students. RESULTS: Study subjects had participated in several volunteer activities. 44.5% of them had participated in some volunteer activities since they had become to college student, 30.8% of them participated in summer rural volunteer activity, and 39.3% of them had donated their blood. Many students(79.66%) agreed that volunteer activities are required as college students, and if they might have some opportunities to participate in volunteer activities, they would like to(54.17%). However, Only 22.50% of subjects agreed to make volunteer activities as regular medical curriculum. Even though the percentage showed low, they intended to apply to the curriculum (40.83%). Most of them agreed there were in need of participating in hospital volunteer activities(82.50%) and community volunteer activities(78.33%). Among hospital volunteer activities, they wanted to participate in volunteer activities at supporting department(26.05%), emergency room (22.69%), out-patient department(21.01%), and in-patient department(21.01%). They wanted to have volunteer activities at institution(66.39%) rather than to individual person(33.61%). They wanted to participate in friendly supports(40.34%), out-going supports(28.57%), house work supports(22.69%). Factor analysis showed that recognition of volunteer activities had 5 latent dimensions: 'self-achievement'(16.15%), 'social exchange and the pursue of experience(13.93%)', 'social responsibility of college(13.03%)', 'leisure of worth and expert activity(12.40%)', 'passive and meeting other's expectation(9.03%)' CONCLUSION: From above results, We found premedical and medical students had participated in various volunteer activities and they had much more intention to participate in. Before developing and designing volunteer programmes, One should consider they have various aspects on the programmes. The programmes should not be emphasized on altruistic aspect and social responsibility extremely, but rather it should be considered how the programmes could give the opportunities for the social exchange, social relationship, sense of solidarity, and usefulness of acquired medical knowledge and skill.
Consciousness* ; Curriculum ; Emergency Service, Hospital ; Hospital Volunteers ; Humans ; Intention ; Outpatients ; Schools, Medical* ; Social Responsibility ; Students, Medical ; Students, Premedical ; Volunteers* ; Surveys and Questionnaires