Predstavitev mnenj o odnosu med materami, vzgojiteljicami in medicinskimi sestrami pri hranjenju predšolskih otrok (ii. del)

V prispevku je predstavljena primerjava mnenj o odnosu med materami, vzgojiteljicami in medicinskimi sestrami pri hranjenju predšolskih otrok. Namen raziskave je bil dobiti oceno o tem, kolikšno pozornost namenjajo hranjenju in odnosu do otroka med hranjenjem ključne osebe, vključene v otrokovo aktivnost hranjenja. Podatki so bili zbrani s tremi vsebinsko različno oblikovanimi vprašalniki v juniju 2004, v vzgojno-varstvenem zavodu Vrtec Murska Sobota, enota Gozdiček in v Splošni bolnišnici Murska Sobota, na otroškem oddelku, na odseku za predšolske otroke. V raziskavo je bilo vključenih deset mater predšolskih otrok, ki so že kdaj bolnišnično zdravljeni, pet vzgojiteljic iz vrtca ter pet medicinskih sester iz bolnišnice. Primerjave mnenj so pokazale, da so matere po prehodu iz dojenja ali hranjenja po steklenički na gosto hrano v večini prosto dopuščale, da so se v aktivnost hranjenja otroka vključevale druge osebe. Večina mater je prepustila vključevanje drugih oseb v aktivnost hranjenja otroka tudi takrat, ko je otrok postal samostojen pri jedi, čeprav je večini čas dopuščal, da bi lahko bile ob otroku. Dobljeni podatki nakazujejo med drugim tudi oceno pomanjkljivejšega dela medicinskih sester v vrtcih glede pogostosti sodelovanja s starši in vzgojitelji

Diagnostic accuracy and temporal impact of ultrasound in patients with dyspnea admitted to the emergency department

Objective Few studies have prospectively evaluated the diagnostic accuracy and temporal impact of ultrasound in the emergency department (ED) in a randomized manner. In this study, we aimed to perform a randomized, standard therapy controlled evaluation of the diagnostic accuracy and temporal impact of a standardized ultrasound strategy, versus standard care, in patients presenting to the ED with acute dyspnea. Methods The patients underwent a standardized ultrasound examination that was blinded to the team caring for the patient. Ultrasound results remained blinded in patients randomized to the treating team but were unblinded in the interventional cohort. Scans were performed by trained emergency physicians. The gold standard diagnosis (GSDx) was determined by two physicians blinded to the ultrasound results. The same two physicians reviewed all data >30 days after the index visit. Results Fifty-nine randomized patients were enrolled. The mean±standard deviation age was 54.4±11 years, and 37 (62%) were male. The most common GSDx was acute heart failure with reduced ejection fraction in 13 (28.3%) patients and airway diseases such as acute exacerbation of asthma or chronic obstructive pulmonary disease in 10 (21.7%). ED diagnostic accuracy, as compared to the GSDx, was 76% in the ultrasound cohort and 79% in the standard care cohort (P=0.796). Compared with the standard care cohort, the final diagnosis was obtained much faster in the ultrasound cohort (mean±standard deviation: 12±3.2 minutes vs. 270 minutes, P<0.001). Conclusion A standardized ultrasound approach is equally accurate, but enables faster ED diagnosis of acute dyspnea than standard care

Stereotactic Body Radiotherapy as a Curative Treatment for De Novo Mucosal Carcinoma of the Head and Neck: A Feasible Alternative Option for Fragile Patients with Small Lesion: A Systematic Review †

Stereotactic body radiotherapy (SBRT) is characterized by a high dose per fraction, well-defined small targets, superior dose conformity, and a steep off-target dose gradient. A literature search was conducted to examine the experience with SBRT as a curative treatment for newly diagnosed mucosal carcinoma of the head and neck (MCHN). Four retrospective case series and one prospective phase I clinical trial published between 2012 and 2020 described 124 patients. SBRT was mainly performed in older patients with different tumor sites. The median size of the planning target volumes ranged from 5.3 to 41 cm3. Different approaches were used to create margins. In two studies, limited elective nodal irradiation was performed. The equivalent doses used were 60–83.33 Gy delivered in five fractions. Considerable heterogeneity was observed in the radiation dose specification. The incidence of grade ≥3 late toxicity was 0–8.3%, with local and regional control ranging from 73% to 100%. Improved or stable quality of life after SBRT was reported in two studies. Curative-intent SBRT for de novo MCHN appears to be an effective and relatively safe treatment for small tumor targets, preferably without concomitant elective tissue irradiation. Standardization of SBRT practice and well-designed prospective clinical trials are needed to better define the role of SBRT in this setting

Proceedings of the 8th Annual Conference on the Science of Dissemination and Implementation

A1 Introduction to the 8(th) Annual Conference on the Science of Dissemination and Implementation: Optimizing Personal and Population Health David Chambers, Lisa Simpson D1 Discussion forum: Population health D&I research Felicia Hill-Briggs D2 Discussion forum: Global health D&I research Gila Neta, Cynthia Vinson D3 Discussion forum: Precision medicine and D&I research David Chambers S1 Predictors of community therapists’ use of therapy techniques in a large public mental health system Rinad Beidas, Steven Marcus, Gregory Aarons, Kimberly Hoagwood, Sonja Schoenwald, Arthur Evans, Matthew Hurford, Ronnie Rubin, Trevor Hadley, Frances Barg, Lucia Walsh, Danielle Adams, David Mandell S2 Implementing brief cognitive behavioral therapy (CBT) in primary care: Clinicians' experiences from the field Lindsey Martin, Joseph Mignogna, Juliette Mott, Natalie Hundt, Michael Kauth, Mark Kunik, Aanand Naik, Jeffrey Cully S3 Clinician competence: Natural variation, factors affecting, and effect on patient outcomes Alan McGuire, Dominique White, Tom Bartholomew, John McGrew, Lauren Luther, Angie Rollins, Michelle Salyers S4 Exploring the multifaceted nature of sustainability in community-based prevention: A mixed-method approach Brittany Cooper, Angie Funaiole S5 Theory informed behavioral health integration in primary care: Mixed methods evaluation of the implementation of routine depression and alcohol screening and assessment Julie Richards, Amy Lee, Gwen Lapham, Ryan Caldeiro, Paula Lozano, Tory Gildred, Carol Achtmeyer, Evette Ludman, Megan Addis, Larry Marx, Katharine Bradley S6 Enhancing the evidence for specialty mental health probation through a hybrid efficacy and implementation study Tonya VanDeinse, Amy Blank Wilson, Burgin Stacey, Byron Powell, Alicia Bunger, Gary Cuddeback S7 Personalizing evidence-based child mental health care within a fiscally mandated policy reform Miya Barnett, Nicole Stadnick, Lauren Brookman-Frazee, Anna Lau S8 Leveraging an existing resource for technical assistance: Community-based supervisors in public mental health Shannon Dorsey, Michael Pullmann S9 SBIRT implementation for adolescents in urban federally qualified health centers: Implementation outcomes Shannon Mitchell, Robert Schwartz, Arethusa Kirk, Kristi Dusek, Marla Oros, Colleen Hosler, Jan Gryczynski, Carolina Barbosa, Laura Dunlap, David Lounsbury, Kevin O'Grady, Barry Brown S10 PANEL: Tailoring Implementation Strategies to Context - Expert recommendations for tailoring strategies to context Laura Damschroder, Thomas Waltz, Byron Powell S11 PANEL: Tailoring Implementation Strategies to Context - Extreme facilitation: Helping challenged healthcare settings implement complex programs Mona Ritchie S12 PANEL: Tailoring Implementation Strategies to Context - Using menu-based choice tasks to obtain expert recommendations for implementing three high-priority practices in the VA Thomas Waltz S13 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Siri, rate my therapist: Using technology to automate fidelity ratings of motivational interviewing David Atkins, Zac E. Imel, Bo Xiao, Doğan Can, Panayiotis Georgiou, Shrikanth Narayanan S14 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Identifying indicators of implementation quality for computer-based ratings Cady Berkel, Carlos Gallo, Irwin Sandler, C. Hendricks Brown, Sharlene Wolchik, Anne Marie Mauricio S15 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Improving implementation of behavioral interventions by monitoring emotion in spoken speech Carlos Gallo, C. Hendricks Brown, Sanjay Mehrotra S16 Scorecards and dashboards to assure data quality of health management information system (HMIS) using R Dharmendra Chandurkar, Siddhartha Bora, Arup Das, Anand Tripathi, Niranjan Saggurti, Anita Raj S17 A big data approach for discovering and implementing patient safety insights Eric Hughes, Brian Jacobs, Eric Kirkendall S18 Improving the efficacy of a depression registry for use in a collaborative care model Danielle Loeb, Katy Trinkley, Michael Yang, Andrew Sprowell, Donald Nease S19 Measurement feedback systems as a strategy to support implementation of measurement-based care in behavioral health Aaron Lyon, Cara Lewis, Meredith Boyd, Abigail Melvin, Semret Nicodimos, Freda Liu, Nathanial Jungbluth S20 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Common loop assay: Methods of supporting learning collaboratives Allen Flynn S21 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Innovating audit and feedback using message tailoring models for learning health systems Zach Landis-Lewis S22 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Implementation science and learning health systems: Connecting the dots Anne Sales S23 Facilitation activities of Critical Access Hospitals during TeamSTEPPS implementation Jure Baloh, Marcia Ward, Xi Zhu S24 Organizational and social context of federally qualified health centers and variation in maternal depression outcomes Ian Bennett, Jurgen Unutzer, Johnny Mao, Enola Proctor, Mindy Vredevoogd, Ya-Fen Chan, Nathaniel Williams, Phillip Green S25 Decision support to enhance treatment of hospitalized smokers: A randomized trial Steven Bernstein, June-Marie Rosner, Michelle DeWitt, Jeanette Tetrault, James Dziura, Allen Hsiao, Scott Sussman, Patrick O’Connor, Benjamin Toll S26 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - A patient-centered approach to successful community transition after catastrophic injury Michael Jones, Julie Gassaway S27 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - Conducting PCOR to integrate mental health and cancer screening services in primary care Jonathan Tobin S28 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - A comparative effectiveness trial of optimal patient-centered care for US trauma care systems Douglas Zatzick S29 Preferences for in-person communication among patients in a multi-center randomized study of in-person versus telephone communication of genetic test results for cancer susceptibility Angela R Bradbury, Linda Patrick-Miller, Brian Egleston, Olufunmilayo I Olopade, Michael J Hall, Mary B Daly, Linda Fleisher, Generosa Grana, Pamela Ganschow, Dominique Fetzer, Amanda Brandt, Dana Farengo-Clark, Andrea Forman, Rikki S Gaber, Cassandra Gulden, Janice Horte, Jessica Long, Rachelle Lorenz Chambers, Terra Lucas, Shreshtha Madaan, Kristin Mattie, Danielle McKenna, Susan Montgomery, Sarah Nielsen, Jacquelyn Powers, Kim Rainey, Christina Rybak, Michelle Savage, Christina Seelaus, Jessica Stoll, Jill Stopfer, Shirley Yao and Susan Domchek S30 Working towards de-implementation: A mixed methods study in breast cancer surveillance care Erin Hahn, Corrine Munoz-Plaza, Jianjin Wang, Jazmine Garcia Delgadillo, Brian Mittman Michael Gould S31Integrating evidence-based practices for increasing cancer screenings in safety-net primary care systems: A multiple case study using the consolidated framework for implementation research Shuting (Lily) Liang, Michelle C. Kegler, Megan Cotter, Emily Phillips, April Hermstad, Rentonia Morton, Derrick Beasley, Jeremy Martinez, Kara Riehman S32 Observations from implementing an mHealth intervention in an FQHC David Gustafson, Lisa Marsch, Louise Mares, Andrew Quanbeck, Fiona McTavish, Helene McDowell, Randall Brown, Chantelle Thomas, Joseph Glass, Joseph Isham, Dhavan Shah S33 A multicomponent intervention to improve primary care provider adherence to chronic opioid therapy guidelines and reduce opioid misuse: A cluster randomized controlled trial protocol Jane Liebschutz, Karen Lasser S34 Implementing collaborative care for substance use disorders in primary care: Preliminary findings from the summit study Katherine Watkins, Allison Ober, Sarah Hunter, Karen Lamp, Brett Ewing S35 Sustaining a task-shifting strategy for blood pressure control in Ghana: A stakeholder analysis Juliet Iwelunmor, Joyce Gyamfi, Sarah Blackstone, Nana Kofi Quakyi, Jacob Plange-Rhule, Gbenga Ogedegbe S36 Contextual adaptation of the consolidated framework for implementation research (CFIR) in a tobacco cessation study in Vietnam Pritika Kumar, Nancy Van Devanter, Nam Nguyen, Linh Nguyen, Trang Nguyen, Nguyet Phuong, Donna Shelley S37 Evidence check: A knowledge brokering approach to systematic reviews for policy Sian Rudge S38 Using Evidence Synthesis to Strengthen Complex Health Systems in Low- and Middle-Income Countries Etienne Langlois S39 Does it matter: timeliness or accuracy of results? The choice of rapid reviews or systematic reviews to inform decision-making Andrea Tricco S40 Evaluation of the veterans choice program using lean six sigma at a VA medical center to identify benefits and overcome obstacles Sherry Ball, Anne Lambert-Kerzner, Christine Sulc, Carol Simmons, Jeneen Shell-Boyd, Taryn Oestreich, Ashley O'Connor, Emily Neely, Marina McCreight, Amy Labebue, Doreen DiFiore, Diana Brostow, P. Michael Ho, David Aron S41 The influence of local context on multi-stakeholder alliance quality improvement activities: A multiple case study Jillian Harvey, Megan McHugh, Dennis Scanlon S42 Increasing physical activity in early care and education: Sustainability via active garden education (SAGE) Rebecca Lee, Erica Soltero, Nathan Parker, Lorna McNeill, Tracey Ledoux S43 Marking a decade of policy implementation: The successes and continuing challenges of a provincial school food and nutrition policy in Canada Jessie-Lee McIsaac, Kate MacLeod, Nicole Ata, Sherry Jarvis, Sara Kirk S44 Use of research evidence among state legislators who prioritize mental health and substance abuse issues Jonathan Purtle, Elizabeth Dodson, Ross Brownson S45 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 1 designs Brian Mittman, Geoffrey Curran S46 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 2 designs Geoffrey Curran S47 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 3 designs Jeffrey Pyne S48 Linking team level implementation leadership and implementation climate to individual level attitudes, behaviors, and implementation outcomes Gregory Aarons, Mark Ehrhart, Elisa Torres S49 Pinpointing the specific elements of local context that matter most to implementation outcomes: Findings from qualitative comparative analysis in the RE-inspire study of VA acute stroke care Edward Miech S50 The GO score: A new context-sensitive instrument to measure group organization level for providing and improving care Edward Miech S51 A research network approach for boosting implementation and improvement Kathleen Stevens, I.S.R.N. Steering Council S52 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - The value of qualitative methods in implementation research Alison Hamilton S53 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - Learning evaluation: The role of qualitative methods in dissemination and implementation research Deborah Cohen S54 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - Qualitative methods in D&I research Deborah Padgett S55 PANEL: Maps & models: The promise of network science for clinical D&I - Hospital network of sharing patients with acute and chronic diseases in California Alexandra Morshed S56 PANEL: Maps & models: The promise of network science for clinical D&I - The use of social network analysis to identify dissemination targets and enhance D&I research study recruitment for pre-exposure prophylaxis for HIV (PrEP) among men who have sex with men Rupa Patel S57 PANEL: Maps & models: The promise of network science for clinical D&I - Network and organizational factors related to the adoption of patient navigation services among rural breast cancer care providers Beth Prusaczyk S58 A theory of de-implementation based on the theory of healthcare professionals’ behavior and intention (THPBI) and the becker model of unlearning David C. Aron, Divya Gupta, Sherry Ball S59 Observation of registered dietitian nutritionist-patient encounters by dietetic interns highlights low awareness and implementation of evidence-based nutrition practice guidelines Rosa Hand, Jenica Abram, Taylor Wolfram S60 Program sustainability action planning: Building capacity for program sustainability using the program sustainability assessment tool Molly Hastings, Sarah Moreland-Russell S61 A review of D&I study designs in published study protocols Rachel Tabak, Alex Ramsey, Ana Baumann, Emily Kryzer, Katherine Montgomery, Ericka Lewis, Margaret Padek, Byron Powell, Ross Brownson S62 PANEL: Geographic variation in the implementation of public health services: Economic, organizational, and network determinants - Model simulation techniques to estimate the cost of implementing foundational public health services Cezar Brian Mamaril, Glen Mays, Keith Branham, Lava Timsina S63 PANEL: Geographic variation in the implementation of public health services: Economic, organizational, and network determinants - Inter-organizational network effects on the implementation of public health services Glen Mays, Rachel Hogg S64 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Implementation fidelity, coalition functioning, and community prevention system transformation using communities that care Abigail Fagan, Valerie Shapiro, Eric Brown S65 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Expanding capacity for implementation of communities that care at scale using a web-based, video-assisted training system Kevin Haggerty, David Hawkins S66 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Effects of communities that care on reducing youth behavioral health problems Sabrina Oesterle, David Hawkins, Richard Catalano S68 When interventions end: the dynamics of intervention de-adoption and replacement Virginia McKay, M. Margaret Dolcini, Lee Hoffer S69 Results from next-d: can a disease specific health plan reduce incident diabetes development among a national sample of working-age adults with pre-diabetes? Tannaz Moin, Jinnan Li, O. Kenrik Duru, Susan Ettner, Norman Turk, Charles Chan, Abigail Keckhafer, Robert Luchs, Sam Ho, Carol Mangione S70 Implementing smoking cessation interventions in primary care settings (STOP): using the interactive systems framework Peter Selby, Laurie Zawertailo, Nadia Minian, Dolly Balliunas, Rosa Dragonetti, Sarwar Hussain, Julia Lecce S71 Testing the Getting To Outcomes implementation support intervention in prevention-oriented, community-based settings Matthew Chinman, Joie Acosta, Patricia Ebener, Patrick S Malone, Mary Slaughter S72 Examining the reach of a multi-component farmers’ market implementation approach among low-income consumers in an urban context Darcy Freedman, Susan Flocke, Eunlye Lee, Kristen Matlack, Erika Trapl, Punam Ohri-Vachaspati, Morgan Taggart, Elaine Borawski S73 Increasing implementation of evidence-based health promotion practices at large workplaces: The CEOs Challenge Amanda Parrish, Jeffrey Harris, Marlana Kohn, Kristen Hammerback, Becca McMillan, Peggy Hannon S74 A qualitative assessment of barriers to nutrition promotion and obesity prevention in childcare Taren Swindle, Geoffrey Curran, Leanne Whiteside-Mansell, Wendy Ward S75 Documenting institutionalization of a health communication intervention in African American churches Cheryl Holt, Sheri Lou Santos, Erin Tagai, Mary Ann Scheirer, Roxanne Carter, Janice Bowie, Muhiuddin Haider, Jimmie Slade, Min Qi Wang S76 Reduction in hospital utilization by underserved patients through use of a community-medical home Andrew Masica, Gerald Ogola, Candice Berryman, Kathleen Richter S77 Sustainability of evidence-based lay health advisor programs in African American communities: A mixed methods investigation of the National Witness Project Rachel Shelton, Lina Jandorf, Deborah Erwin S78 Predicting the long-term uninsured population and analyzing their gaps in physical access to healthcare in South Carolina Khoa Truong S79 Using an evidence-based parenting intervention in churches to prevent behavioral problems among Filipino youth: A randomized pilot study Joyce R. Javier, Dean Coffey, Sheree M. Schrager, Lawrence Palinkas, Jeanne Miranda S80 Sustainability of elementary school-based health centers in three health-disparate southern communities Veda Johnson, Valerie Hutcherson, Ruth Ellis S81 Childhood obesity prevention partnership in Louisville: creative opportunities to engage families in a multifaceted approach to obesity prevention Anna Kharmats, Sandra Marshall-King, Monica LaPradd, Fannie Fonseca-Becker S82 Improvements in cervical cancer prevention found after implementation of evidence-based Latina prevention care management program Deanna Kepka, Julia Bodson, Echo Warner, Brynn Fowler S83 The OneFlorida data trust: Achieving health equity through research & training capacity building Elizabeth Shenkman, William Hogan, Folakami Odedina, Jessica De Leon, Monica Hooper, Olveen Carrasquillo, Renee Reams, Myra Hurt, Steven Smith, Jose Szapocznik, David Nelson, Prabir Mandal S84 Disseminating and sustaining medical-legal partnerships: Shared value and social return on investment James Teufe

Comparison of the community nurse\u27s educational function in health care for individuals in various cultural and social environments

Patronažna medicinska sestra pri svojem delu vstopa v posameznikovo domače okolje in tako spoznava njegov vpliv na zdravje posameznika, družine in skupnosti. Vse, kar pri neposrednem stiku z domačim okoljem spozna, lahko koristno uporabi pri načrtovanju vzgoje za zdravje posameznika, družine in skupnosti. Z vključevanjem patronažnih medicinskih sester v skrb za zdravje posameznikov in z zadovoljevanjem njihovih potreb po zdravstveni negi se ponujajo tudi možnosti za vpeljavo izboljšav na tem področju. V magistrskem delu smo predstavili vzgojno funkcijo patronažne medicinske sestre in z raziskavo ugotavljali posebnosti pri obravnavi posameznikov v kulturno in socialno različnih okoljih – pri osnovni in romski populaciji. Ugotavljali smo tudi, ali imajo patronažne medicinske sestre dovolj znanja in spretnosti, da lahko vplivajo na posameznikov način razmišljanja, s čimer posredno vplivajo na spremembe v družini in skupnosti, ter ali patronažne medicinske sestre izkazujejo različne delovne pristope v vzgojni funkciji glede na obravnavo populacije. Raziskovalna metodologija. Uporabili smo kvantitativno deskriptivno in kavzalno neeksperimentalno metodo raziskovanja. Za kvantitativne podatke in grafični prikaz rezultatov je bil uporabljen program Microsoft Excel. S pomočjo Chi–Square Testa smo izračunali P-vrednost (Sig < 0,05) za vrednotenje zastavljenih hipotez. V raziskavo je bilo vključenih 24 patronažnih medicinskih sester (PMS) iz Zdravstvenega doma Murska Sobota, 50 posameznikov iz osnovne populacije in 50 posameznikov iz romske populacije, ki so bili v stiku s patronažno službo in živijo na širšem geografskem območju Upravne enote Murska Sobota. Za tehniko zbiranja podatkov smo uporabili prilagojen anketni vprašalnik s trditvami o pomenu vključenosti PMS v skrb za zdravje posameznika in o njeni vzgojni funkciji. Rezultati. Osnovna populacija za razliko od romske ni bolj osveščena v skrbi za zdravje. Romski posamezniki so izkazali potrebo po vključenosti patronažne medicinske sestre tudi v času zdravja, posamezniki osnovne populacije pa ne. Večina patronažnih medicinskih sester je bila mnenja, da morajo prilagajati svoje delovne naloge v zvezi z vzgojno funkcijo v skrbi za zdravje posameznika glede na vključenost v različna okolja. Oboji posamezniki bi se v večini udeleževali predavanj na tematiko o izboljšanju zdravja in skrbi zanj, obenem so oboji pozitivno ocenili znanje patronažnih medicinskih sester kot izvajalk tovrstnih predavanj. Sklep. Vključenost v skrb za zdravje posameznika in vzgojna funkcija patronažne medicinske sestre pri povečanju tovrstne skrbi, sta potrebni in zaželeni tako pri osnovni kot pri romski populaciji. Posamezniki obeh sodelujočih skupin so bili enotnega mnenja, da zase in za svoje zdravje ne skrbijo dovolj dobro in potrebujejo nasvete, zato si želijo predavanj na temo zdravja ter odlično ocenjujejo sposobnosti patronažnih medicinskih sester pri njihovi izvedbi. Patronažne medicinske sestre so ocenile potrebo po različnih pristopih v delovnih okoljih in romskih posameznikov niso ocenile kot odklonilnih do sprejemanja nasvetov. Učinkovito bi bilo izpeljati obsežnejšo raziskavo obravnavanega problema, tako da bi vključili udeležence podobnih skupin v preostalih regijah slovenskega prostora. Glede na rezultate pa bi bilo potrebno oblikovati poenoten model izvajanja aktivnosti in ukrepov v patronažni zdravstveni negi z osrednjim ciljem izboljšati odnos do lastnega zdravja tako pri osnovni kot tudi romski populaciji, upoštevajoč seveda regijske, kulturne in socialne raznolikosti.Community nurses enter in their work the individual\u27s home environment and thus learn about the impact of this environment on the health of individuals, families, and communities. Everything the community nurses learn through direct contact with the home environment, is usefully used when planning the health education for healthy individuals, families and communities. With the involvement of community nurses in the health care of individuals and meeting their health care needs, opportunities to introduce improvements in this area are at hand. In this Master’s thesis, we have presented the educational function of community nurses and researched the specificities in the treatment of individuals with various cultural and social contexts – in general and Roma populations. We have also researched whether community nurses have sufficient knowledge and skills so that they can affect individuals\u27 way of thinking and thus influence the changes in their families and communities. Furthermore, we have researched whether community nurses show various working approaches in their educational function according to the treatment of the population. Research Methodology. We have used quantitative descriptive and causal non-experimental method of research. For quantitative data and graphical presentation of the results, Microsoft Excel was used. Using the Chi-Square Test, we have calculated the P value (Sig < 0.05) to evaluate the set hypotheses. The study included 24 community nurses (CN) from the Health Centre Murska Sobota, 50 individuals from the general population, and 50 individuals from the Roma population, who have been in contact with the home care service and are living on a large geographical area of the administrative unit of Murska Sobota. For the data collection technique, we have used an adjusted questionnaire with the statements about the importance of the inclusion of CN in the care of the individual’s health and its educational function. Results. The general population, unlike the Roma population, is not more aware of health issues. The Roma individuals have demonstrated the need for involvement of the community nurses also in time of health, while the individuals of the general population have not. Most community nurses believed that they must adjust their work duties in connection with the educational function in protecting the health of the individuals according to the involvement in various environments. Both types of individuals would mainly attend the lectures on health improvement and health care improvement – while both have positively assessed the knowledge of community nurses as providers of such lectures. Conclusion. The involvement in and the educational function of community nurses in enhancing health care in individuals (general or Roma population) are necessary and desirable in general, as well as in the Roma population. Individuals of both participating groups were of the same opinion, i.e. that they do not take enough care of themselves and their own health, and need advice in this area. Thus, they want lectures on health issues and assess the abilities of community nurses in the implemention of lectures, excellently. Community nurses have assessed the need for various approaches in their work environments, and have not assessed the Roma individuals as not wanting to accept advice. It would be effective to perform an extensive research of the discussed problem – with the involvement of participants of similar groups in other regions of Slovenia. According to the results, it would be necessary to create a unified (taking into account the regional, cultural, and social diversities) model of the performance of activities and measures in home care service with the central objective on improving the relation to one’s own health – whether in general or in the Roma population

The Developmental and Physiological Interactions between Free Radicals and Antioxidant Defense System: Effect of Environmental Pollutants

This review explores the relation between antioxidant defense system and reactive oxygen species (ROS) during the development and shows the effect of environmental pollutants on this process. In normal state, the decline in levels of free radicals is coupled with increased antioxidant and the reverse is true, but there is a critical balance between them during the development. Also, redox signaling induced by environmental pollutants (stressors) involves both alterations in antioxidant defenses and accumulation of ROS leading to oxidative stress which acts as a critical pathophysiological mechanism. This disturbance has deleterious effect on male/female reproductive functions, on the development of the blastocysts and on the health of the embryos, newborns (perinatal life) and adulthood. Also, this overview shows that sperm, egg, zygote or blastocyst derived during the abnormal production of ROS due to environmental pollutants may result into offspring with high risk of any type of diseases producing developmental delay, embryopathy, teratogenic changes and apoptosis. These early insults may then lead to an increased rate of miscarriage and congenital anomalies depending on free radicals signaling and cell-death pathways. Thus, maintaining the balance between antioxidants and ROS during pregnancy or lactation period may modulate normal fetal/neonates growth and development, and may play an important role in a healthy life for the newborns. However, this argument is still ambiguous because of the difficulties of to what degree oxidants could participate as signaling molecules controlling fundamental and developmentally relevant cellular processes such as proliferation, differentiation, and death