Objectives: ：The purpose of this study was to examine the clinical utility of the internalization and externalization higher-order scales of the Minnesota Multiphasic Personality Inventory-Adolescent Restructured Form (MMPI-A-RF), compared with those scales of the Korean Child Behavior Checklist (K-CBCL). Methods: ：43 adolescents with internalizing disorders and 44 adolescents with externalizing disorders and their parents were administered the MMPI-A-RF and K-CBCL each. To verify the difference between the internalization and externalization scales of the MMPI-A-RF and K-CBCL for each group, independent-sample t test was performed. To compare the agreement between the MMPI-A-RF and K-CBCL, correlation analysis was also conducted. Lastly, to identify which scales significantly best predict each of the internalizing and externalizing disorder, logistic regression analysis was conducted. Results: ：Internalization scales of the MMPI-A-RF and K-CBCL were significantly higher in the internalizing disorder group, and the externalization scales were significantly higher in the externalizing disorder group. The positive correlation was significant only for internalization problems between the two evaluation measures in both groups (each r=0.360, p<0.05, r=0.572, p<0.05). In addition, the scales significantly predicted internalizing and externalizing disorders were the internalization and externalization scales of the MMPI-A-RF, followed by the externalization scale of the K-CBCL (R2 =0.407, p<0.05). Conclusions ：The internalization and externalization higher-order scales of the MMPI-A-RF were found to reliably reflect the characteristics of each disorder in adolescents and be useful evaluative scales to differentiate dis-orders. Moreover, if adolescents show externalization problems, additional information from the K-CBCL can be more useful to differentiate disorders.

PURPOSE: The study was conducted to investigate the effect of career barrier, satisfaction, and career decision making pattern on career search behaviors in male nursing students. METHODS: Data were collected through structured questionnaires that included general characteristics, career barrier, satisfaction, career decision making pattern and career search behaviors and were analyzed by descriptive statistics, ANOVA, t-test, Pearson correlation coefficient and multiple regression using SPSS/PC+ program. RESULTS: The results of the research suggest the two aspects of career search behaviors as being self-exploration and environmental exploration. The rational pattern, among the types of satisfaction and career decision making pattern, was found to have a meaningful effect on self-expression. On the other hand, dependent pattern, among the satisfaction and career decision making pattern, was found to have an effect on career search patterns. CONCLUSION: It is considered that, based on the results of this study, diversified approaches that consider individual career decision making patterns such as rational pattern and dependent pattern as well as the methods to enhance the satisfaction of male nursing college students for career guidance are needed.
Decision Making* ; Hand ; Humans ; Male* ; Nursing* ; Students, Nursing*

No abstract available.
Infection Control* ; Seoul*

BACKGROUND: As information technology evolves rapidly computer-based surveillance systems for nosocomial infection have been developed. Well designed computerized system could provide an opportunity for improving, enlarging, and conducting hospital-wide surveillance more efficiently in the situation with limited resources. Recently, we launched a new computerized monitoring system in a hospital where digital medical information system has been operated without paper chart. METHODS: We developed a new surveillance program based on the total Electronic Medical Record (EMR) system. Numerous critical medical information can be easily accessible through this system without further work. This includes major demographic data, essential information from the inpatient medical record, the laboratory information system, and the pharmacy information, Comprehensive Clinical Data Repository (CDR) system was also developed. CDR is potentially very useful to conduct a hospital-wide surveillance by integrating all the available information. RESULTS: This system consists of several programs in the EMR and the CDR environment. In the EMR system, inquiry for patients with fever, case ascertainment and registration of nosocomial infections, inquiry for patients with indwelling devices, microbiological reports, and data on antibiotic prescriptions were included. The CDR has integrated comprehensive inquiries for frequency of major pathogens in clinical isolates and their trends of antibiotic resistance, nosocomial infection rates based on the duration of the devices or hospitalization, and the history of antimicrobial usage based on defined daily dosage. Data obtained from the EMR and the CDR systems could be easily accessed by infectious diseases specialists and healthcare workers of infection control services at any place within the hospital. A new reporting system has been built up to facilitate identification of notifiable diseases among the list of diagnoses on the EMR. In addition, the "Alert" notice was designed to highlight isolation precautions for indicated cases. CONCLUSION: This new computerized surveillance program might be a valuable model to which other hospitals can refer to develop newer version of programs in the future.
Clinical Laboratory Information Systems ; Communicable Diseases ; Cross Infection ; Delivery of Health Care ; Diagnosis ; Drug Resistance, Microbial ; Electronic Health Records* ; Fever ; Hospitalization ; Humans ; Infection Control ; Information Systems ; Inpatients ; Medical Records ; Pharmacy ; Prescriptions ; Specialization

PURPOSE: Purpose of this research was to identify nursing activities and the time required in the psychiatric ward to provide basic knowledge for development of cost of psychiatric nursing. METHODS: In this research 'a list of psychiatric nursing activities' was used to identify the issues. A list of psychiatric nursing activities was developed by a professional psychiatric nursing panel, and 138 nursing activities in 15 domains were identified. RESULTS: The result of this research showed that the average number of work hours per duty was 515.1 minutes and the average number of minutes per patient per nurse while on duty was 35.7 minutes. Also the results showed that the nurses used the majority of their time in 'Nursing care and information management' (528.0 minutes/day, 33.6%), followed by 'communication and coordination' (209.2 minutes, 13.3%), 'safety care' (185.3 minutes, 11.8%), and 'medication' (120.9 minutes, 13.3%). CONCLUSION: The result of this research indicate that the number of nursing staff is insufficient for the performance of necessary therapeutic activities. Nursing practices such as counseling, activity therapy, and psychiatric treatment and specific therapy need to be developed and nursing care fees need to be included in psychiatric nursing fields.
Counseling ; Fees and Charges ; Humans ; Nursing Care ; Nursing Staff ; Psychiatric Nursing

Activation of the sympathetic nervous system in mediating the stress response attends traumatic brain injury. Plasma dopamine(DA), epinephrine(E), norepinephrine(NE) levels were measured in 26 severe traumatically brain injured patients to determine whether catecholamine levels obtained within 24 hours after injury provide reliable prognostic endogenous markers of outcome. Patient outcome was determine at 1 week using the Glasgow Coma Scale(GCS) and at the time of discharge the Glasgow Outcome Scale(GOS), 7 patients with diseases except those with a severe traumatic brain injury were selected as a control group. Firstly, we analyzed the difference of the average DA, E, and NE between the control group and severe traumatic brain injury patients. Secondly, we analyzed the difference of the average catecholamine levels in the 3 groups according to admission GCS scores(respectively 3~4, 5~7, 8~9). Third, we analyzed the difference of the average catecholamine levels in the 5 groups according to GOS scores at 1 week(respectively dead, 3~4, 5~7, 8~11, >11). Finally, we analyzed the difference of the average catecholamine levels in the 5 groups according to GOS at the time of discharge. As a result, there was no statical difference between the level of DA in the control group and those of the severe brain injury patients. But the level of E an NE in the experimental group were higher than the control group(respectively p<0.03, p<0.04). The admission GCS score correlated highly with the catecholamine levels(NE : r=0.69, p<0.001 ; E ; r=0.42, p<0.03 ; DA ; r=0.42, p<0.03). In patients with admission GCS of 3 to 4, NE levels increaed fourfold above other group(p<0.005). In the 13 patients with GCS scores of 3 or 4 on admission. NE levels predicted outcome at 1 week. All two patients with NE levels less then 750 pg/ml were survived, while 10 of 11 with NE levels greater than 750 pg/ml were died(p<0.02). The levels of NE was significantly higher in patients who died than in those with better outcome(p<0.02). Therefore, these findings indicated that the level of circulating NE is an excellent endogenous marker that appear to reflect the extent of brain injury and that may predict the likelihood of recovery.
Brain ; Brain Injuries* ; Coma ; Dopamine ; Epinephrine ; Humans ; Negotiating ; Norepinephrine ; Plasma* ; Prognosis* ; Sympathetic Nervous System

BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae are main pathogens of bloodstream infection. We compared the epidemiology of ESBL-producing E. coli and K. pneumoniae. METHODS: From January 2003 through March 2007, we retrospectively investigated the clinical characteristics and comorbidities of patients with bloodstream infection by ESBL-producing E. coli and K. pneumoniae. RESULTS: During the study period, 79 patients (54 with E. coli and 25 with K. pneumoniae) with blood cultures positive for ESBL-producing E. coli or K. pneumoniae were studied. When comparing the source of bloodstream infections, urinary tract infections (UTIs) were more commonly caused by E. coli (24% vs. 0; P=0.007), and respiratory tract and soft tissue infection (36% vs. 15%; P=0.04, 12% vs. 0; P=0.03, respectively) were more commonly associated with K. pneumoniae. Among hospital-acquired bloodstream infection, third-generation cephalosporin was more commonly used in patients with E. coli than patients with K. pneumoniae (81% vs. 24%, P<0.001). Medical devices (central venous catheter and urinary catheter) were more commonly used in patients with K. pneumoniae. CONCLUSION: ESBL-producing E. coli bloodstream infection is more common in urinary tract infections. ESBL-producing K. pneumoniae is more common in respiratory tract infections and in skin and soft tissue infections. In hospital-acquired infections, ESBL-producing E. coli bloodstream infection is more common in biliary tract infection. ESBL-producing E. coli was more commonly associated with prior frequent antibiotics use and K. pneumoniae was more commonly associated with use of medical devices.
Anti-Bacterial Agents ; beta-Lactamases ; Biliary Tract ; Catheters ; Comorbidity ; Epidemiology* ; Escherichia coli* ; Humans ; Klebsiella pneumoniae* ; Pneumonia ; Respiratory System ; Respiratory Tract Infections ; Retrospective Studies ; Skin ; Soft Tissue Infections ; Urinary Tract Infections

The autonomic nervous system plays an important role in maintaining homeostasis mediated by the parasympathetic, sympathetic and enteric systems. Autonomic failure adversely affects body function and may increase morbidity and mortality. Therefore, the scoring systems, such as Ewing’s classification and Composite Autonomic Scoring Scale (CASS), were developed to detect and quantify autonomic deficits, primarily focusing on the cardiovascular reflex system. Autonomic disorders manifest with a myriad of symptoms resulting from the dysfunction of the gastrointestinal, genitourinary, secretomotor, pupillomotor systems as well as cardiovascular system. Several self-report questionnaires, such as Composite Autonomic Symptom Scale (COMPASS), Scale for Outcomes in Parkinson’s disease for Autonomic Symptoms (SCOPA-AUT), Survey of Autonomic Symptom (SAS), were also used to support to detect various signs and symptoms of autonomic dysfunction in clinical settings. In this review, we introduce clinically useful assessment scales in autonomic nervous system disorders.

As the need for medical services increases, interest in the quality improvement of healthcare and patient safety is also increasing. This study aimed to propose a surgical hospitalist or surgicalist system in Korea. Specifically, it has been suggested that the essential capacities of the surgicalist, including their understanding of surgery, wound management, emergency management, surgical nutrition, and education, may be useful in improving the quality of healthcare and patient safety. The key characteristic of the surgicalist system is that surgeons are “readily available” in the hospital ward to provide primary care for hospitalized patients. Surgicalists provide both perioperative and advanced primary care. As the population ages, the number of high-risk patients who are undergoing major operations increases. The surgicalist system, which is responsible for the perioperative management and advanced primary care of inpatients, is expected to expand rapidly. The shift from the vertical surgeon-resident-centered system to the horizontal surgeon-surgicalist-centered system can help provide high-quality care for patients, and a systematic training system for residents. In addition, it is necessary to define the essential capacities of the surgicalist, and to determine the research and education that can promote them.

The autonomic nervous system plays an important role in maintaining homeostasis mediated by the parasympathetic, sympathetic and enteric systems. Autonomic failure adversely affects body function and may increase morbidity and mortality. Therefore, the scoring systems, such as Ewing’s classification and Composite Autonomic Scoring Scale (CASS), were developed to detect and quantify autonomic deficits, primarily focusing on the cardiovascular reflex system. Autonomic disorders manifest with a myriad of symptoms resulting from the dysfunction of the gastrointestinal, genitourinary, secretomotor, pupillomotor systems as well as cardiovascular system. Several self-report questionnaires, such as Composite Autonomic Symptom Scale (COMPASS), Scale for Outcomes in Parkinson’s disease for Autonomic Symptoms (SCOPA-AUT), Survey of Autonomic Symptom (SAS), were also used to support to detect various signs and symptoms of autonomic dysfunction in clinical settings. In this review, we introduce clinically useful assessment scales in autonomic nervous system disorders.