BACKGROUND: Direct observation of healthcare workers is commonly used in hospitals to investigate hand hygiene compliance. However, the hand hygiene compliance rate may increase due to the Hawthorne effect, which is the modification of behavior simply because subjects become aware that they are being observed. The objective of this study was to investigate the occurrence of the Hawthorne effect when directly observing hand hygiene compliance in intensive care unit (ICU) healthcare personnel. METHODS: A total of 87 staff members from the coronary care unit and cardiac surgery ICU of a general hospital in Seoul were included in this study: 24 residents and interns, 55 nurses, and 8 nursing assistants. Both covert and overt observations, where subjects were either unaware or aware of any direct observation, were performed on separate occasions. RESULTS: A total of 1,052 covert and 1,336 overt observations were documented over 30 and 34 occasions, respectively. Overall hand hygiene compliance was significantly higher with overt observation than with covert observation (1,041/1,336, 77.9% vs. 659/1,052, 62.6%, P<0.001). The Hawthorne effect was present in all professions and behaviors, with the exception of nursing assistants, and prior to touching a patient. CONCLUSION: Direct observation of hand hygiene compliance was associated with the Hawthorne effect when observations were made overtly and this was likely to contribute to an overestimation of compliance rate.
Compliance ; Coronary Care Units* ; Delivery of Health Care* ; Effect Modifier, Epidemiologic* ; Hand Hygiene* ; Health Personnel ; Hospitals, General ; Humans ; Intensive Care Units* ; Nursing ; Seoul ; Thoracic Surgery*

Purpose: The purpose of this study was to identify the factors influencing nurses’ caring behavior. Methods: The descriptive study included 178 intensive care unit (ICU) nurses who completed a self-report structured questionnaire. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, and Pearson’s correlation and multiple regression analysis using the IBM SPSS/WIN 23.0 program. Results: Significant correlation existed between perception of Patient- and Family-Centered Care (PFCC) and nurses’ caring behaviors (r = .36, p < .001). Multiple regression analysis showed that perception of support (β = .36, p < .001), total career length (β = .33, p < .001), and familiarity with PFCC (β = .15, p = .018) affected the caring behavior of ICU nurses. These variables explained 30.0% of the variance in caring behavior. Conclusion Effective strategies are needed to improve perceptions of support as well as to promote PFCC for increasig the frequency of caring behavior among ICU nurses.

Purpose: The purpose of this study was to identify the factors influencing nurses’ caring behavior. Methods: The descriptive study included 178 intensive care unit (ICU) nurses who completed a self-report structured questionnaire. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, and Pearson’s correlation and multiple regression analysis using the IBM SPSS/WIN 23.0 program. Results: Significant correlation existed between perception of Patient- and Family-Centered Care (PFCC) and nurses’ caring behaviors (r = .36, p < .001). Multiple regression analysis showed that perception of support (β = .36, p < .001), total career length (β = .33, p < .001), and familiarity with PFCC (β = .15, p = .018) affected the caring behavior of ICU nurses. These variables explained 30.0% of the variance in caring behavior. Conclusion Effective strategies are needed to improve perceptions of support as well as to promote PFCC for increasig the frequency of caring behavior among ICU nurses.

PURPOSE: The aim of this study was to determine the survival rates of implants placed in grafted maxillary sinuses and compare the results obtained with graft materials, implant surfaces and timing of implant placement. MATERIALS AND METHODS: Between January 1996 and December 2005, 391 implants were placed in 161 patients who underwent sinus grafting treatment simultaneously or separately at Ewha Womans University Hospital. According to inclusion criteria, 272 implants were placed in 102 patients with 112 sinus grafts (30 females, 72 males), aged 26 to 88 years (mean age 49.0+/-9.7). The follow-up period ranged from 12 to 134 months (mean F/U 47+/-32). Survival rates were evaluated according to graft material, implant surface and timing of implant placement. The Kaplan-Meier procedure and the log rank (Mantel-Cox) test were used to estimate survival rates and test for equality of survival rates between different groups of patients. RESULTS: Ten-year cumulative survival rate for implants placed in the grafted sinuses was 90.1%. The survival rates for autogenous bone, combination and bone substitutes were 94.6%, 85.9% and 100%, respectively (p > 0.05). According to implant surface, survival rates were 84.8% in machined group and 97.5% in rough group (p < 0.05). The survival rates were 92.9% in delayed group and 86.0% in simultaneous group (p > 0.05). CONCLUSION: Ten-year cumulative survival rate for implants placed in the grafted sinuses was 90.1%. Rough-surfaced implants have a higher survival rate than machined-surfaced implants when placed in grafted sinuses (p < 0.05).
Aged ; Bone Substitutes ; Female ; Follow-Up Studies ; Humans ; Maxillary Sinus ; Retrospective Studies ; Survival Rate ; Transplants

Leigh's disease is a rare progressive neurological disorder that is characterized light microscopically by focal spongy necrosis in the brain and electron microscopically by mitochondriopathy. We report an autopsy case of Leigh's disease that showed abnormalities in the liver, kidney and skeletal muscle as well as the central nervous system. The patient was an 18-month-old girl who has carried a diagnosis of cerebral palsy ever since her birth to a 20-year-old mother. The baby was generally hypertonic and mentally retarded. She died of severe metabolic acidosis. Postmortem examination showed growth retardation, fatty liver, fatty kidney and soft brain. Brain section showed multifocal softenings in the brainstem, basal ganglia and periventricular areas. Microscopically increased capillaries with endothelial proliferation, vacuolar degeneration and mild gliosis were seen in the brain. The axons were relatively preserved. Liver and kidneys showed microvesicular fatty change. Myofiber degeneration of the skeletal muscle was also noted. Electron microscopic examination showed markedly increased mitochondria in the parenchymal cells of the brain, liver and kidney. The mitochondria showed round to ovoid ballooned appearance including electron-dense core-like structures and pseudoinclusions of glycogen granules.
Brain/pathology/ultrastructure ; Female ; Humans ; Infant ; Kidney/pathology/ultrastructure ; Leigh Disease/*pathology ; Liver/pathology/ultrastructure ; Mitochondrial Encephalomyopathies/pathology ; Muscles/pathology

Total 8,341 pregnant women who visited Obstetric Clinic Cheil General Hospital from Jaunary 1991 to July 1992 were screened for HBsAg. Sixty five women with positive HBsAg who delivered healthy babies during that period and their infants are included in the study. HBsAg, Anti-HBs, Anti-HBc, HBeAg and Anti-HBe were tested by radioimmunoassay and hepatitis B virus DNA were studied by polymerase chain reaction technique in both mothers' and babies serum. The results were as follow: 1) Among 8,341 pregnant women who were screened for HBsAg 374 were asymptomatic carriers(4.5%). 2) The newborn babies born to 65 mothers who were positive HBsAg showed HBsAg in 4.6%, HBeAg 75.0%, anti-HBc 98.4% and hepatitis B virus DNA in 26.2%. 3) It showed discordance of HBeAg/anti-HBe, with hepatitis B virus DNA in newborn infants. 4) Follow up study at 8~20 months showed HBeAg and hepatitis B virus DNA in 2 infants out of 20.
DNA ; Female ; Follow-Up Studies ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Hospitals, General ; Humans ; Infant ; Infant, Newborn ; Mothers* ; Polymerase Chain Reaction* ; Pregnant Women ; Radioimmunoassay

PURPOSE: There are very few reports of adverse drug reactions (ADR) and almost no study of drug provocation test (DPT) in Korean children. We aimed to assess the role of DPT in children with unpredictable ADRs, and compare the causative drugs and clinical characteristics between detailed history of ADRs and result of DPTs. METHODS: We included 16 children who were experienced ADRs referred to pediatric allergy clinic at Ajou University Hospital (January 2006 to December 2009). With various suspected drugs, 71 DPTs were done in 16 patients using our own protocol, and skin tests to antibiotics were combined in ADRs to antibiotics in medical history. RESULTS: There were 17 (23.9%) positive DPTs results out of 71 individual DPTs, and 11 patients (68.8%) from 16 patients were positive to at least one drug. Drugs causing positive reactions were acetaminophen in 5 (31%), Non-steroidal anti-inflammatory drugs in 4 (25%), penicillin in 3 (19%), cephalosporin in 2 (13%), and cotrimoxazole, macrolide and lactose in 1 each. CONCLUSION: DPT seems a safe and useful procedure to confirm causative drug and identify safely administering alternative drugs in children with ADR.
Acetaminophen ; Anti-Bacterial Agents ; Child ; Drug Toxicity ; Humans ; Hypersensitivity ; Lactose ; Penicillins ; Skin Tests ; Thiones ; Trimethoprim, Sulfamethoxazole Drug Combination

PURPOSE: The aim of this study was to evaluate adhesion and gene expression of the MC3T3-E1 cells cultured on machined titanium surface (MS) and anodized titanium surface (AS) using MTT test, Scanning electron micrograph and cDNA microarray. MATERIALS AND METHODS: The MTT test assay was used for examining the proliferation of MC3T3-E1 cells, osteoblast like cells from Rat calvaria, on MS and AS for 24 hours and 48 hours. Cell cultures were incubated for 24 hours to evaluate the influence of the substrate geometry on both surfaces using a Scanning Electron Micrograph (SEM). The cDNA microarray Agilent Rat 22K chip was used to monitor expressions of genes. RESULTS: After 24 hours of adhesion, the cell density on AS was higher than MS (p<0.05). After 48 hours the cell density on both titanium surfaces were similar (p>0.05). AS had the irregular, rough and porous surface texture. After 48 hours incubation of the MC3T3-E1 cells, connective tissue growth factor (CTGF) was up-regulated on AS than MS (more than 2 fold) and the insulin-like growth factor 1 receptor was down-regulated (more than 2 fold) on AS than MS. CONCLUSION: Microarray assay at 48 hours after culturing the cells on both surfaces revealed that osteoinductive molecules appeared more prominent on AS, whereas the adhesion molecules on the biomaterial were higher on MS than AS, which will affect the phenotype of the plated cells depending on the surface morphology.
Animals ; Cell Count ; Cell Culture Techniques ; Connective Tissue Cells ; DNA ; DNA, Complementary ; Electrons ; Gene Expression ; Oligonucleotide Array Sequence Analysis ; Organothiophosphorus Compounds ; Osteoblasts ; Phenotype ; Rats ; Skull ; Titanium

To identify the neonates at the risk of having meconium aspiration syndrome, the perinatal characteristics and finding of fetal heart rate monitorings in 366 neonates who had meconium-stained amniotic fluid were retrospectively reviewed. The results were as follows; 1) Overall incidence of MAS was 0.7%. 2) Mortality rate of MAS was 5.8%. 3) The mean Apgar scores at 1-and 5-minute were significantly different in the two groups with and without meconium aspiration sydrome (MAS)(p<0.001). 4) PROM, postterm delivery and IUGR were the major obstetric risk factors associated with MAS. 5) Although severe variable decelaeration and decreased variability on FHR monitoring were present more often in the group with MAS, it showed no statistically significant difference between the two groups. 6) The presence of above findings on monitoring and thick meconium in amniotic fluid should alert clinicians to the possibility of a fetus that requires intervention.
Amniotic Fluid ; Female ; Fetal Growth Retardation ; Fetal Heart* ; Fetus ; Heart Rate, Fetal* ; Humans ; Incidence ; Infant, Newborn ; Meconium Aspiration Syndrome* ; Meconium* ; Mortality ; Pregnancy ; Retrospective Studies ; Risk Factors

OBJECTIVES: This study assessed the accuracy of the 24-hour diet recall method for estimating the energy intake of elderly men using the doubly labeled water as a reference method. METHODS: Seventeen subjects (mean age 72.5 ± 3.9 years), who maintained the same body weight during the two weeks study period, were included in this study. Three 24-hour diet recalls (two weekdays and one weekend) were obtained over a 14 day period to estimate the mean energy intake. The total energy expenditure was measured over the same 14 days using the doubly labeled water method. The total energy intake and total energy expenditure were compared by paired t-test. RESULTS: The total energy intake from the 24-hour diet recalls method was 2536.7 ± 350.6 kcal/day, and the total energy expenditure from the doubly labeled water method was 2659.8 ± 306.8 kcal/day. The total energy intake was slightly under-reported by −123.2 ± 260.8 kcal/day (−4.4%). On the other hand, no significant difference was observed between the total energy intake and total energy expenditure of the subjects (p=0.069). The percentage of accurate predictions was 64.7%. The correlation between the total energy intake and total energy expenditure was statistically significant (r=0.697, p < 0.005). CONCLUSIONS: The present study supports the use of the 24-hour diet recall method to estimate the mean energy intake in elderly men group. More studies are needed to assess the validity of 24-hour diet recall method in other population groups, including elderly women, adults and children.
Adult ; Aged ; Body Weight ; Child ; Diet ; Energy Intake ; Energy Metabolism ; Female ; Hand ; Humans ; Male ; Methods ; Population Groups ; Water