RESUMEN
BACKGROUND: Smoking is an important modifiable risk factor of morbidities and mortality. Although healthcare professionals play an important role in smoking cessation, their adoption of such practices is relatively low because of inadequate training. To address this issue, we incorporated a service-learning model to operate the Youth Quitline. Undergraduate nursing students were trained and received supervision while delivering smoking cessation counseling through the Youth Quitline as their clinical placement. OBJECTIVES: We evaluated the effectiveness of the placement by assessing students' knowledge, attitudes and practices regarding smoking cessation and tobacco control. DESIGN: One-group pretest-posttest design. SETTING: Youth Quitline. PARTICIPANTS: A total of 61 third-year students in a mental health nursing program. METHODS: Students were required to complete 80 h at the Youth Quitline. The 80 h were divided into 20 sessions; students used four sessions to approach and recruit youth smokers in the community, then provided them with telephone counseling for the rest of the time. Prior to the placement, students attended a 2-day workshop. The outcomes were changes in students' knowledge, attitudes and practices regarding smoking cessation and tobacco control 3 months after the placement compared with baseline. RESULTS: From January-June 2021, students conducted 105 outreach activities to identify 3142 smokers in the community, and provided telephone counseling for 336 smokers via Youth Quitline. Compared with baseline, significant improvements were observed in students' knowledge, attitudes and practices regarding smoking cessation and tobacco control at 3-month follow-up. CONCLUSIONS: The clinical placement improved students' knowledge, attitudes and practices regarding smoking cessation and tobacco control, enhancing their competency in providing support to assist smokers to quit in their future practice. Incorporating the service-learning model in existing community-based services can provide additional venues for nursing students to practice. This is particularly important because many venues have restricted access during the COVID-19 pandemic.
Asunto(s)
COVID-19 , Bachillerato en Enfermería , Cese del Hábito de Fumar , Estudiantes de Enfermería , Adolescente , Consejo , Atención a la Salud , Humanos , Pandemias , Cese del Hábito de Fumar/psicologíaRESUMEN
We retrospectively reviewed 102 patients with esophageal cancer (97.1% squamous cell carcinoma, 96.1% stage III) received FDG-PET staging and were treated by chemoradiotherapy with or without resection to assess whether the pretreatment [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) maximum standardized uptake value (SUVmax) of the primary tumor and metastatic lymph nodes can predict the prognosis of patients with esophageal cancer. Receiver operating characteristic analysis was performed to find the cutoff values for primary tumor SUVmax and nodal SUVmax. The influence of clinical factors including primary tumor SUVmax and nodal SUVmax on local progression-free survival, nodal progression-free survival (NPFS), distant metastases-free survival (DMFS), and overall survival (OS) were evaluated using univariate and multivariate analyses. A total of 40 patients received esophagectomy after neoadjuvant chemoradiotherapy (trimodality), while 62 patients received definitive chemoradiotherapy (dCRT). The median follow-up was 26.4 months. The SUVmax of primary tumor had no significant predictive value on all outcomes, while the SUVmax of metastatic lymph nodes had predictive value on several outcomes. High nodal SUVmax (≥7) predicted for worse outcomes than low nodal SUVmax (<7) in the patients who received dCRT (two-year DMFS, 17% vs. 92%, P < 0.001; NPFS, 14% vs. 81%, P = 0.001; OS, 21% vs. 50%, P = 0.003), but not in those received trimodality. On multivariate analysis of patients receiving dCRT, nodal SUVmax was the strongest independent predictor on DMFS (hazard ratio [HR] 13.93, P < 0.001), NPFS (HR 3.99, P = 0.026), PFS (HR 2.90, P = 0.003), and OS (HR 3.80, P = 0.001). High pretreatment nodal SUVmax predicts worse treatment outcomes for the patients treated with dCRT.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico por imagen , Neoplasias Esofágicas/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Ganglios Linfáticos/diagnóstico por imagen , Tomografía de Emisión de Positrones/estadística & datos numéricos , Radiofármacos , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/terapia , Quimioradioterapia , Supervivencia sin Enfermedad , Neoplasias Esofágicas/terapia , Carcinoma de Células Escamosas de Esófago , Esofagectomía/métodos , Esofagectomía/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tomografía de Emisión de Positrones/métodos , Valor Predictivo de las Pruebas , Pronóstico , Valores de Referencia , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
A number of investigators have reported elevated left temporal alpha power in marksmen during response preparation. This finding has been interpreted to indicate the suppression of irrelevant cognitive processes. However, lower-order motor processes have not been excluded as a possible explanation. Event-related alpha power (11-13 Hz) was examined at sites T3, T4, C3, and C4 in eight skilled marksmen during shooting and two control tasks varying in perceptual-motor complexity. Over an 8-s period preceding the trigger pull, the marksmen exhibited higher power and slope at T3 than at all other sites during shooting compared with the control conditions. No such difference between conditions was detected at C3 and C4. The relative synchrony of left temporal alpha power during shooting, in conjunction with the lack of change at central sites, is inconsistent with the explanation that the effect is accounted for by 'lower-order' motor processes exclusively involving the central region.
Asunto(s)
Cognición , Destreza Motora , Lóbulo Temporal/fisiología , Adulto , Potenciales Evocados/fisiología , Armas de Fuego , Humanos , Masculino , Procesos MentalesRESUMEN
This study evaluated outcomes of an inpatient program designed to reduce severe agitated behavior in geriatric patients with dementia who could not be successfully treated on an outpatient basis. An individualized treatment plan was created for each patient (N = 250) that involved pharmacological and nonpharmacological interventions with behavioral, environmental, and psychological components. Assessment of behavioral, cognitive, and functional status was conducted for each patient on admission to the program and at discharge. Significant improvements on these assessments were observed. We conclude that the longitudinal, multidisciplinary approach used in this study was effective in significantly reducing intrusive and dangerous behaviors while preserving or enhancing patients' cognitive and functional abilities.
Asunto(s)
Demencia/complicaciones , Servicios de Salud para Ancianos/estadística & datos numéricos , Trastornos Mentales/tratamiento farmacológico , Evaluación de Resultado en la Atención de Salud , Agitación Psicomotora/tratamiento farmacológico , Instituciones de Cuidados Especializados de Enfermería/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Femenino , Servicios de Salud para Ancianos/organización & administración , Humanos , Tiempo de Internación , Estudios Longitudinales , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/etiología , Persona de Mediana Edad , Minnesota , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos , Agitación Psicomotora/etiología , Perfil de Impacto de Enfermedad , Instituciones de Cuidados Especializados de Enfermería/organización & administraciónRESUMEN
BACKGROUND: There has been a surge of heroin abuse in Taiwan in recent years making it necessary to study and understand the characteristics, drug use patterns and behavior among heroin users. MATERIALS AND METHODS: Two hundred and eighty-three patients hospitalized for heroin detoxification received a diagnostic interview and a semi-structured interview which rendered the demographic information, medical history, and patterns of and reasons for heroin use. Differences between male and female drug users were also compared. RESULTS: More than half of the subjects (54.3%) were unemployed. The percentage of unemployment of female patients was significantly greater than that of male patients (75.9% vs. 48.0%, p<0.05). Women were significantly younger (p<0.001) and had a significantly earlier (p< 0.001) onset of heroin use than men. About one-third of the subjects (33.9%) were multiple drug users, with amphetamines as the most common (79.2%) concomitant drug of abuse. More men reported curiosity as the reason for first use, while more women reported peer influence as the reason for first use. CONCLUSION: This study showed that significant gender differences in employment status, age of first use, and reasons for drug use among heroin addicts. Further exploration of gender and cross-cultural differences could have important theoretical and treatment implications.