Purpose: This study was conducted to identify the effect of verbal violence, clinical practice stress, and coping with stress on the major satisfaction in nursing students during clinical practice. Methods: A cross-sectional study was used. A survey was conducted from May 3 to May 10, 2022, on 200 nursing students who were in their junior and seneior years at two universities in Gyeongsangbuk-do. Descriptive statistics, frequency analysis, independent t-test, one-way ANOVA, Scheffé’s test, Pearson correlation coefficient, and hierarchical regression analysis were employed to analyze the data. Results: Major satisfaction was found to be significantly negatively correlated with verbal violence (r=-.30, p<.001) and clinical practice stress (r=-.15, p=.032) and to be positively correlated with coping with stress (r=.24, p<.001). Their satisfaction with clinical practice (β=.29, p=.037), verbal violence (β=-.23, p<.001), coping with stress (β=.16, p=.015), religion (β=.14, p=.041), and clinical practice stress (β=-.13, p=.048) explained 19.3% of the variance in nursing students’ major satisfaction during clinical practice. Conclusion A verbal violence and coping with stress program for nursing students should be developed to increase nursing students’ major satisfaction during clinical practice.

Purpose: Adequate nutrition is to be provided for normal growth and development during early childhood. Currently, childcare teachers provide lunch to most children in Korea. The purpose of this study was to investigate the portion size provided by teachers and examine the effect of education on food serving size. Methods: The subjects were childcare teachers (n = 120) in charge of children aged 3–5 years at a daycare center in Hanam-si. The survey was conducted through questionnaires which included questions on the general characteristics of the teachers, their nutritional education status, and the source of nutrition information. In addition, the portion sizes of items on the menu currently provided to children were measured and the data were analyzed. To assess the effectiveness of education in determining serving size, the subjects were randomly equally divided into two groups. In the first group (n = 60) theoretical education on nutrition and serving sizes was given, whereas in the second (n = 60), practical education on these topics was provided. Results: The difference between the actual portion size of rice and the serving size announced on the menu was observed to decrease along with the increase in the experience of the teacher, although the differences in the main dish and kimchi were higher. The gap between the serving size mentioned in the menu and the portion size distributed widened as the age of the teachers increased. Notably, the difference between the portion size and the serving size of food decreased after both practical and theoretical education. Furthermore, the effect of education on the serving size of the main dishes (p < 0.001), side dishes (p < 0.01), and kimchi (p < 0.01) was observed to be greater in the practical education group than in the theoretical education group. Conclusion Regular education should be provided to teachers on the serving sizes mentioned in the menu, as the quantity of food served depends on the experience and age of teachers. In the case of rice, theoretical education alone sufficed to ensure a proper serving size. However, hands-on training on the main and side dishes, and kimchi would be much more helpful.

When treating trauma patients with severe hemorrhage, massive transfusions are often needed. Damage control resuscitation strategies can be used for such patients, but an adequate fresh frozen plasma: packed red blood cell (FFP:PRBC) administration ratio must be established. We retrospectively reviewed the medical records of 100 trauma patients treated with massive transfusions from March 2010 to October 2012. We divided the patients into 2 groups according to the FFP:PRBC ratio: a high-ratio (> or =0.5) and a low-ratio group (<0.5). The patient demographics, fluid and transfusion quantities, laboratory values, complications, and outcomes were analyzed and compared. There were 68 patients in the high-ratio and 32 in the low-ratio group. There were statistically significant differences between groups in the quantities of FFP, FFP:PRBC, platelets, and crystalloids administered, as well as the initial diastolic blood pressure. Bloodstream infections were noted only in the high-ratio group, and the difference was statistically significant (P=0.028). Kaplan-Meier plots revealed that the 24-hr survival rate was significantly higher in the high-ratio group (71.9% vs. 97.1%, P<0.001). In severe hemorrhagic trauma, raising the FFP:PRBC ratio to 0.5 or higher may increase the chances of survival. Efforts to minimize bloodstream infections during the resuscitation must be increased.
Acute Lung Injury/epidemiology/etiology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacterial Infections/epidemiology ; *Blood Transfusion/adverse effects ; *Erythrocyte Transfusion/adverse effects ; Female ; Hemorrhage/etiology/*prevention & control ; Hospital Mortality ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Patients ; Respiratory Distress Syndrome, Adult/epidemiology/etiology ; Resuscitation ; Retrospective Studies ; Wounds and Injuries/complications/mortality/*therapy ; Young Adult

PURPOSE: This study aimed to determine the mortality rate in patients with severe trauma and the risk factors for trauma mortality based on 3 years' data in a regional trauma center in Korea. METHODS: We reviewed the medical records of severe trauma patients admitted to Ajou University Hospital with an Injury Severity Score (ISS) > 15 between January 2010 and December 2012. Pearson chi-square tests and Student t-tests were conducted to examine the differences between the survived and deceased groups. To identify factors associated with mortality after severe trauma, multivariate logistic regression was performed. RESULTS: There were 915 (743 survived and 172 deceased) enrolled patients with overall mortality of 18.8%. Age, blunt trauma, systolic blood pressure (SBP) at admission, Glasgow Coma Scale (GCS) at admission, head or neck Abbreviated Injury Scale (AIS) score, and ISS were significantly different between the groups. Age by point increase (odds ratio [OR], 1.016; P = 0.001), SBP < or = 90 mmHg (OR, 2.570; P < 0.001), GCS score < or = 8 (OR, 6.229; P < 0.001), head or neck AIS score > or = 4 (OR, 1.912; P = 0.003), and ISS by point increase (OR, 1.042; P < 0.001) were significant risk factors. CONCLUSION: In severe trauma patients, age, initial SBP, GCS score, head or neck AIS score, and ISS were associated with mortality.
Abbreviated Injury Scale ; Blood Pressure ; Glasgow Coma Scale ; Head ; Humans ; Injury Severity Score ; Korea ; Logistic Models ; Medical Records ; Mortality* ; Neck ; Risk Factors* ; Trauma Centers ; Wounds and Injuries

In Korea, which still lacks a well-established trauma care system, the inability to transport patients to adequate treatment sites in a timely manner is a cause of low trauma patient survival. As such, this study was conducted to serve as a basis for the establishment of a future trauma transport system. We performed a comparative analysis of the transport time, and treatment outcomes between trauma victims transported by ground ambulance (GAMB) and those transported via the helicopter emergency medical service (HEMS) through the National Emergency Management Agency's 119 reporting system, which is similar to the 911 system of the United States, from March 2011 to May 2014. The HEMS-transported patients received treatment instructions, by remote communication, from our trauma specialists from the time of accident reporting; in certain instances, members of the trauma medical staff provided treatment at the scene. A total of 1,626 patients were included in the study; the GAMB and HEMS groups had 1,547 and 79 patients, respectively. The median transport time was different between 2 groups (HEMS, 60 min vs. GAMB, 47 min, P<0.001) but for all patients was 49 min (less than the golden hour). Outcomes were significantly better in the HEMS compared to the GAMB, using the trauma and injury severity score (survival rate, 94.9% vs. 90.5%; Z score, 2.83 vs. -1.96; W score, 6.7 vs. -0.8). A unified 119 service transport system, which includes helicopter transport, and the adoption of a trauma care system that allows active initial involvement of trauma medical personnel, could improve the treatment outcome of trauma patients.
Air Ambulances/*utilization ; Emergency Service, Hospital/*statistics & numerical data ; Female ; Humans ; Injury Severity Score ; Male ; Prognosis ; Republic of Korea ; Survival Rate ; Time Factors ; Trauma Centers ; Treatment Outcome ; Wounds, Nonpenetrating/*mortality/therapy ; Wounds, Penetrating/*mortality/therapy

In Korea, which still lacks a well-established trauma care system, the inability to transport patients to adequate treatment sites in a timely manner is a cause of low trauma patient survival. As such, this study was conducted to serve as a basis for the establishment of a future trauma transport system. We performed a comparative analysis of the transport time, and treatment outcomes between trauma victims transported by ground ambulance (GAMB) and those transported via the helicopter emergency medical service (HEMS) through the National Emergency Management Agency's 119 reporting system, which is similar to the 911 system of the United States, from March 2011 to May 2014. The HEMS-transported patients received treatment instructions, by remote communication, from our trauma specialists from the time of accident reporting; in certain instances, members of the trauma medical staff provided treatment at the scene. A total of 1,626 patients were included in the study; the GAMB and HEMS groups had 1,547 and 79 patients, respectively. The median transport time was different between 2 groups (HEMS, 60 min vs. GAMB, 47 min, P<0.001) but for all patients was 49 min (less than the golden hour). Outcomes were significantly better in the HEMS compared to the GAMB, using the trauma and injury severity score (survival rate, 94.9% vs. 90.5%; Z score, 2.83 vs. -1.96; W score, 6.7 vs. -0.8). A unified 119 service transport system, which includes helicopter transport, and the adoption of a trauma care system that allows active initial involvement of trauma medical personnel, could improve the treatment outcome of trauma patients.
Air Ambulances/*utilization ; Emergency Service, Hospital/*statistics & numerical data ; Female ; Humans ; Injury Severity Score ; Male ; Prognosis ; Republic of Korea ; Survival Rate ; Time Factors ; Trauma Centers ; Treatment Outcome ; Wounds, Nonpenetrating/*mortality/therapy ; Wounds, Penetrating/*mortality/therapy

Background and Objectives: Airway reconstruction surgery in children is still challenging, especially in cases of combined subglottic and posterior glottic stenosis (PGS). The aim of this study was to review the underlying reasons of failure in open airway reconstruction surgeries performed for children with combined subglottic and PGS.Subjects and Method We reviewed medical records of seven children who received more than two open airway reconstruction surgeries to finally achieve and maintain decannulation status for more than one year. Twenty-two reconstructive surgeries were performed and they consisted of 19 laryngotracheal reconstruction (LTR), 2 cricotracheal resection with end-toend anastomosis (CTR) and one extended CTR. For each patient, the following potential causes of failure were evaluated; preoperative evaluation (PE), type of reconstruction (TR), single vs. double staging (SDS), type of stent (TS), and perioperative optimization (PO). Results: The median age of patients at the time of surgery was 32 months (range, 4-64 months). Successful decannulation was achieved after the median open surgery of three (range, 2-5 times for each patient). Recognized causes of failure were as follows: 8 insufficient PE, 10 inadequate TR, 3 improper SDS, 8 ill-chosen TS, and 2 inappropriate PO. Conclusion PE of dynamic airway is important, especially vocal fold mobility and tracheomalacia. Types of reconstruction should be carefully decided after full consideration of potential causes of failure, and adequate laryngotracheal stent is essential.

Psoriasis is an auto-immune skin disease, which is characterized by the excessive generation of plaques on the skin with typically a long-lasting red, itchy and scaly symptoms. Imiquimod, which has been used for the treatment of external genital warts, actinic keratosis, and superficial basal cell carcinoma, induced of psoriasis-like skin disorders with skin erythema and thickness in mice. In the present study, we tried to find the bioactive herbal extract against imiquimod-induced psoriasis-like skin disorder in mice. During the searching of the herbal extract with anti-psoriatic effect, the ethanolic extract of Cnidium officinale ameliorated imiquimodinduced psoriasis-like skin disorder in mice. The morphological evaluation, H&E staining and Psoriasis Area and Severity Index (PASI) score showed that ear and back thickness, and erythema induced by imiquimod were significantly reversed after the treatment of the cream of the ethanolic extract of C. officinale. The overexpressed myeloperoxidase (MPO) and keratin 6A levels were decreased by the treatment of C. officinale cream. Also, IFN-γ, c-fos and IκB-α mRNA levels, which are related to the progression of psoriasis, were reduced by C. officinale cream. Thus, the ethanolic extract of C. officinale ameliorated psoriasis-like skin disorder induced by imiquimod and might be the therapeutic agent for psoriasis.
Animals ; Carcinoma, Basal Cell ; Cnidium ; Condylomata Acuminata ; Ear ; Erythema ; Ethanol ; Keratin-6 ; Keratosis, Actinic ; Mice ; Peroxidase ; Psoriasis ; RNA, Messenger ; Skin Diseases ; Skin

Background: We evaluated the household secondary attack rate (SAR) of the omicron and delta severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, according to the vaccination status of the index case and household contacts; further, in vaccinated index cases, we evaluated the effect of the antibody levels on household transmission. Methods: A prospective cross-sectional study of 92 index cases and 197 quarantined household contacts was performed. Tests for SARS-CoV-2 variant type and antibody level were conducted in index cases, and results of polymerase chain reaction tests (during the quarantine period) were collected from contacts. Association of antibody levels in vaccinated index cases and SAR was evaluated by multivariate regression analysis. Results: The SAR was higher in households exposed to omicron variant (42%) than in those exposed to delta variant (27%) (P = 0.040). SAR was 35% and 23% for unvaccinated and vaccinated delta variant exposed contacts, respectively. SAR was 44% and 41% for unvaccinated and vaccinated omicron exposed contacts, respectively. Booster dose immunisation of contacts or vaccination of index cases reduced SAR of vaccinated omicron variant exposed contacts. In a model with adjustment, anti-receptor-binding domain antibody levels in vaccinated index cases were inversely correlated with household transmission of both delta and omicron variants.Neutralising antibody levels had a similar relationship. Conclusion Immunisation of household members may help to mitigate the current pandemic.