Development of an early warning index system for emerging respiratory infectious diseases in Shanghai / 上海预防医学

Objective:To develop an early warning index system to identify the outbreak of respiratory infectious diseases and to assess the epidemic risk of these diseases in Shanghai. Methods:A two-round Delphi survey with a panel of 31 experts was used to select the modifying indicators. All indicators were evaluated for necessity，feasibility，stability， and sensitivity through online questionnaires. Results:The consultation recovery rates of both rounds were 100%. The authority coefficient was 0.88， and the Kendall's W of the second-round consultation was 0.138 （P<0.001）， suggesting a good coordination among experts’ opinion. Our early warning index system was developed after the two-round Delphi survey and included two sets of indicators， one for rapid risk assessment and another for monitoring and tracing risk. Both sets of the indicators involved three aspects： transmissibility， clinical severity and potential influence of emerging diseases. The rapid risk assessment system part covered 10 indicators while the risk monitor system part covered 23 indicators. In the rapid risk assessment system part， the weight value of the top three indicators were greater than 0.10， with the highest weight value of 0.171 for titled visiting rate of influenza-like illness patients in the Emergency Department or other outpatient visits. In the risk monitor system part， the weight value of the top eight indicators were greater than 0.05， and the greatest was 0.087 for R0 （basic reproductive number）. Conclusion:The developed scientific and reliable evaluation indicator system can be used to forecast the outbreak and epidemic risk of respiratory infectious diseases. However， sensitivity and stability of the indicators need further validation and evaluation.

Validation of Questionnaire for Chewing and Swallowing Function of the Elderly / 대한연하장애학회지

OBJECTIVE: This study aims to develop a new screening dysphagia questionnaire for elderly people. METHOD: Initial questionnaire for mastication and swallowing function of elderly people were composed of 20 questions. Total of 30 experts were invited to participate in the Delphi survey, including physiatrists, occupational therapists and dietitians. Modified Delphi method was performed into two rounds. Twenty young adults and twenty elderly volunteers were tested with these items and were compared with other pre-existing tests. Also, validity of selected evaluating items was tested using VFSS. RESULT: For the first round of surveys, a consensus was reached on 72.5% of the questionnaire. Final agreement was reached on 98% of the questionnaire. The results of the first round survey with the 20 evaluation items and second round showed that the content validity ratio (CVR) and stability were high enough and met the criteria of consistent agreement from a group of specialists. The final round survey following the 1st and 2nd round survey was implemented, which finally reduced to 14 items from initial 20 items. The researcher allocated the items into the 3 categories. The score of the developed item were highly correlated with that of the pre-existing screening questionnaire and time parameters of the VFSS showing a significant difference according to the score. CONCLUSION: We developed a screening tool for evaluation of chewing nad swallowing function for the elderly people. Though it is necessary to be verified through large scale clinical studies, it may be simply applicable to the elderly people with mastication and swallowing dysfunction or could be evaluated by caregivers.

Identifying Research Direction for Mental Health of North Korean Refugees Using Delphi Technique / 신경정신의학

OBJECTIVES: Refugees from North Korea are at risk of a range of mental health problems, posing urgent problems to their care. A review of research on mental health prevalence and services can indicate directions for further study. METHODS: The authors administered a Delphi survey to 16 professionals who are working for North Korean refugees, including professors and field workers. The collected data was analyzed by descriptive statistics including mean and standard deviation and verified with content validity ratio. RESULTS: The results are as follows: 1) The most serious problem in the research area is the importance of quantitative research rather than qualitative for North Korean refugees, who are often very negative and uncooperative with questionnaires. 2) There is a great need to develop competence of mental health professionals who are working for North Korean refugees. 3) Most participants agreed to the necessity of longitudinal study to define the factors facilitating successful adaptation among North Korean refugees. CONCLUSION: The following are our recommendations: 1) Appropriate measurements for North Korean refugees need to be developed reflecting their uniqueness. 2) Research of North Koreans has inherent selection bias. 3) It is essential to provide primary education on mental health to North Korean refugees.

The Major Elements of Psychological Assessment and Intervention for Children and Adolescents after a Disaster: A Professional Delphi Preliminary Survey

OBJECTIVES: This study attempted to evaluate the usefulness and direction of development of post-traumatic assessment and interventions based on the opinions of psychiatrics and disaster and trauma-related experts using the Delphi survey technique. METHODS: In-depth individual interviews served as the pre-survey and were followed by Delphi primary and secondary surveys. Specialists in child and adolescent mental health, psychological support professionals specialized in disasters and related practitioners with experience of disasters in Korea completed a set of questionnaires and participated in focus group interviews and in-depth individual interviews on post-traumatic assessment and intervention. RESULTS: We found that the following issues have a significant impact on the interventions after disasters: the proper time of the initial interview in the event of a disaster, assessment notices, aged assessment services, mandatory enforcement measures, scale screening and treatment intervention elements, symptoms degree classification, intervention standardization, the use of a levelled program, care unit environment, and operation plan. CONCLUSION: This study proposed effective mental health intervention measures and has implications for the development of evaluation treatment protocols after disasters.

Distribution of the Korean Dental Hygiene Research Agenda Suggested by the Korean Dental Hygienists Association and Affiliated Groups / 치위생과학회지

The objective of this study was to realize research demands by gathering the research agenda from the Korean Dental Hygienists Association and affiliated groups through a Delphi survey. The study subjects were the heads of eight groups. The Delphi survey was conducted by e-mail after a researcher explained the objective of the study to the heads. The research agenda was classified according to the Korean dental hygiene academic classification and the National Dental Hygiene Research Agenda classification. To compare the number of research agendas according to classification among the groups, we conducted a chi-squared test by using IBM SPSS 20.0. In total, 316 agendas were submitted. According to the Korean dental hygiene academic classification, there was a significant difference among the groups, and the agendas associated with clinical dental hygiene (36.7%) were the best. According to the National Dental Hygiene Research Agenda classification, there was no significant difference and the agendas associated with health promotion and disease prevention (27.8%) were the best. In conclusion, the Korean Dental Hygienists Association and affiliated groups demanded similar research agendas, corresponding to the purpose of each establishment. However, the groups did not seem to show unique characteristics according to the purpose of each establishment. In other words, the groups should corroborate such characteristics and suggest a corresponding agenda to establish specific areas of research in dental hygiene. Also, dental hygiene researchers should mark the academic classification of the studies they want to submit.

Study on the rapid as essm enti ndxe es for sfa ety manga emen t of high pathogenic biool giac l samplet rans portatoi n bya dopting the Delphi survey / 上海预防医学

Objective To determine key indicators from the current assessment indicators for rapid and safe transportation of high pathogenic biological samples. Methods Based on the current assessment tables of biological safety inspection for high pathogenic biological samples, a total of seven experts were consulted on the 21 indicators by Delphi method.Key assessment indicators were selected through two rounds of consultation and analysis of indexes with boundary value method. Results A total of seven key assessment indexes were selected as the rapid evaluation indexes for safe transportation of high pathogenic biological samples including effective certificate, the management of transportation personnel and transportation vehicles, the safety of transportation packaging, and transportation report. Conclusion A system of rapid assessment indexes about the safe transportation of high pathogenic biological samples have been established.The rapid assessment system can shorten the evaluation time and improve the efficiency of transportation safety supervision for health supervision departments, and can provide a set of rapid self-assessment indexes for the transport sector, thus the biological safety of transportation can be greatly enhanced.

Research and development of evaluation criteria for premedical curriculum / 한국의학교육

PURPOSE: The purpose of this study was to develop criteria to evaluate a premedical curriculum to ultimately improve the quality of premedical education. METHODS: The first draft of the evaluation criteria was developed through a literature review and expert consultation. The Delphi survey was conducted to ensure the validity of the draft. RESULTS: The final premedical curriculum criteria consisted of three evaluation areas (curriculum development, curriculum implementation, and curriculum outcome), five evaluation items (educational objective, organization of curriculum, instructional method, class management, and educational outcome), and 18 evaluation indicators. CONCLUSION: There should be further discussion on the evaluation questionnaire and the content for each evaluation indicator with regard to its practical application. Also, a concrete evaluation system, including evaluation standards and rating scales, should be developed.

Application of the nominal group technique and Delphi survey technique in modifying nursing standard of baccalaureate program / 中国实用护理杂志

Objective To develop a nursing standard of baccalaureate program for Shanghai Jiaotong University to guide and improve the training quality of nursing students.Methods On the basis of literature review,the nominal group technique and Delphi survey technique were used to develop the standard.Results The training objective and the training plan included attitude,knowledge and ability constituted the standard.Conclusions The deficient of dominating personalities or obedience to authority which existed in traditional group discussion can be diminished in this study.The nominal group technique is a scientific and professional method for the construction and evaluation of nursing program.

Analysis by Delphi Survey of a Performance Evaluation Index for a Salt Reduction Project

The purpose of this study was to analyze the performance evaluation index for a salt reduction project. Questionnaires were developed in order to investigate salt reduction programs nationwide. The evaluation index and programs were analyzed through the case study of a salt reduction program in public health centers. The validity of the salt reduction program's evaluation index was determined based on study of the Delphi survey and on discussion with nutrition and health care professionals. The Delphi survey showed that daily salt intake was the most valid nutritional evaluation index. Stroke mortality and stomach cancer mortality were good health care evaluation indexes. The method for measuring salt intake that had the greatest validity was a 24-hour urine collection. However, 24-hour urine collection had the lowest score for ease of performance. The combined scores of validity and ease of performance showed that the survey method for dietary attitude and dietary behavior, dietary frequency analysis (DFQ 15), and a salty taste assessment, in that order, were proper methods. The high reliability of the salty taste assessment indicated that the percentage of the population that exhibits proper salt intake (2,000 mg sodium or less daily) and the percentage of the population that consumes low-salt diets as nutritional evaluation indexes also will be helpful to evaluate performance of salt reduction programs.

Service Priority and Standard Performance of Community Mental Health Centers in South Korea: A Delphi Approach

OBJECTIVE: The role of community mental health centers (CMHCs) in Korea is quite different than that of these centers in Western countries due to nation-specific health care system characteristics. For example, CMHCs of Korea are expected to provide services for serious mental illness in addition to other services in response to community needs, such as internet addiction of adolescents. Consequently, it is important to determine service priorities of CMHCs and to define standard service performances in order to maximize their effectiveness with limited resources. The present study aimed to generate expert consensus on service priorities and to identify standard service performances of CMHCs in South Korea. METHODS: Forty-five mental health professionals participated as experts in a Delphi survey. We made a survey questionnaire based on Korean and international data and guidelines of some countries such as the UK and Australia. Experts answered the first and second round questionnaires and their answers were analyzed using frequency analysis. RESULTS: For the question about future directions of CMHCs, twenty-two experts (49%) answered that the growth of services for serious mental illness should be preferred to other areas. The service for chronic mental illness was thought to be the most important service area (27.1%) and, early psychosis (10.5%) is included, the services for serious mental illness should be regarded as the most important service area of Korean CMHCs. It is followed by child and adolescent services (13.2%) and mental health promotion services (10.8%). The relative importance of service performances on each service domain were given by answers of experts. CONCLUSION: CMHCs in Korea should focus their priority on the management of serious mental illness. Service standardization by the relative importance of service performances on each service domain is needed.