PURPOSE: Since 1997, private postnatal care facilities (San-hu-jo-ri-won in Korean) have emerged to take the role of the family. As a result, neonates are now exposed to many people and are very vulnerable to infection. However, there has been no study on the influence of postnatal care facilities on neonatal infection. The aim of this study was to determine the risk factors of neonatal infection in full-term babies in Korea. MATERIALS and METHODS: We followed up 556 pregnant women and their babies for 4 weeks after their births at 2 hospitals in Seoul and Daejeon from October 2004 to September 2005. Among 512 full-term babies, 58 had infectious diseases. To determine the risk factors for infection, 53 infected neonates at 4-28 days of life and 413 healthy neonates were compared. RESULTS: The incidence of neonatal infection at 4 to 28 days after birth was 10.5%. After adjusting the related factors, the number of siblings (OR = 2.05, 95% CI = 1.13-3.71 for 1 or more) and postnatal care facilities or home aides (OR = 1.91, 95% CI = 1.07-3.45) were significant risk factors. Formula or mixed feeding (OR = 1.66, 95% CI = 0.91-3.04) increased the risk of neonatal infection but it was not statistically significant. CONCLUSION: When the newborns had siblings, stayed at postnatal care facilities, or were cared for by home aides, the risk of neonatal infections significantly increased. Further research on the feeding effect on neonatal infection and evaluation of prevention efforts are needed.
Communicable Diseases/*epidemiology ; Female ; Humans ; Infant, Newborn ; Korea/epidemiology ; Mothers ; Risk Factors ; *Term Birth

PURPOSE: The purpose of this study was to identify attributes of the concept of cancer survivorship. METHODS: Walker & Avant's concept analysis framework (2005) was used to review the medical & nursing text books, medical and nursing research articles related to cancer survivorship and published from 1985 to 2011. RESULTS: There were nine aspects of the concept of cancer survivorship: A process, liminality, uncertainty, life-changing experience, complexity, unique experience, duality of positive and negative aspects, partnership, and need for support. Antecedents of cancer survivorship were cancer diagnosis and perception as a cancer survivor. Empirical referents of cancer survivorship were survival rate, quality of life, adaptation to the survivorship experience, and health-related hardiness, social support, spirituality, and health behavior. The consequences of cancer survivorship were effects on the physical, psychosocial, spiritual and socio-economic well-being of the patients. CONCLUSION: This concept analysis of cancer survivorship is expected to contribute to promotion of survivorship care in the clinical field by removing conceptual ambiguity and confirming the true meaning of survivorship care.
Health Behavior ; Humans ; Nursing Research ; Quality of Life ; Spirituality ; Survival Rate ; Survivors ; Uncertainty

PURPOSE: There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. METHODS: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. RESULTS: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was 3.6+/-2.8 year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period (4.18+/-2.10 vs 4.79+/-1.49 days, P=.17) and total fever duration (5.32+/-2.07 vs 6.41+/-3.25 days, P=.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. CONCLUSION: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.
Bacterial Infections ; Bronchiolitis ; Bronchitis ; Child* ; Croup ; Fever ; Hospitalization ; Hospitals, University* ; Humans ; Influenza B virus* ; Influenza, Human ; Inpatients ; Medical Records ; Oseltamivir* ; Outpatients ; Pneumonia ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Thorax

No abstract available.
Chest Pain* ; Emergencies* ; Emergency Service, Hospital* ; Thorax*

PURPOSE: The purpose of this study was to develop and evaluate a school-based peer leader centered smoking prevention program. METHODS: Non-equivalent control group with a pre/post-test design was used. Students (n=174) in two boys' junior high schools located in D city, Korea participated with 85 being selected for the experimental group and 89 for the control group. Five sessions were given to the experimental group and a 50 minute lecture to the control group. Knowledge, attitude, non-smoking intention, and non-smoking efficacy were measured for the both experimental and control group at two weeks before the program and one month after the program was completed. Data were analyzed using chi2-test, Fisher's exact test, independent t-test and paired t-test with the SPSS 21.0 program. RESULTS: The experimental group showed higher overall knowledge, negative attitude toward smoking, and higher non-smoking intention and efficacy. After receiving the school based peer leader centered smoking prevention program scores for attitude toward smoking and non-smoking efficacy increased in the experimental group were higher than in the control group. CONCLUSION: The school-based peer leader centered smoking prevention program needs longitudinal evaluation, but from this study, there is an indication that this program can be used with junior high school students and effectively change students' attitude toward smoking and promote non-smoking efficacy.
Adolescent ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Peer Group ; *Program Evaluation ; Questionnaires ; School Health Services ; Smoking/*prevention & control ; Students/*psychology

BACKGROUND: Health illiteracy is a problem often unrecognized by health care providers. It influences medical costs and the health status of adults. The purposes of this study were to determine the level of health literacy in community-dwelling adults and to identify the factors influencing it. METHODS: A cross-sectional survey was conducted in Seoul, Gyeonggi and Chungcheong province. A total of 420 adults aged 18 or older were interviewed by trained nursing students between November 1 to December 30, 2011. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Data were analyzed using the PASW 18.0 program. RESULTS: The mean score of health literacy was 50.64+/-19.18. In the multiple linear regression analysis, health literacy was significantly associated with education (beta=0.17, P=0.001), alcohol use (beta=-0.12, P=0.010), and perceived health status (beta=0.11, P=0.029). These factors accounted for about 7% of health literacy. CONCLUSIONS: Health literacy is a very important public health issue. Our findings showed that educational level, alcohol use and perceived health status should be considered when assessing this issue in patients. Furthermore, the development of a standardized Korean assessment tool for health literacy and specified interventions for enhancing health literacy are needed to improve health outcomes.
Adult* ; Cross-Sectional Studies ; Education ; Gyeonggi-do ; Health Literacy* ; Health Personnel ; Health Status ; Humans ; Linear Models ; Literacy ; Primary Prevention ; Public Health ; Seoul ; Students, Nursing

OBJECTIVE: Treatment with sulfonylureas in combination with metformin improves glycemic control in type 2 diabetes mellitus (T2DM), but is associated with hypoglycemia and weight gain. This retrospective study aims to compare the effectiveness of dipeptidylpeptidase-4 (DPP-4) inhibitors and sulfonylureas as an add-on therapy to metformin in patients with T2DM. METHODS: Data from medical records of 355 T2DM patients received therapy either DPP-4 inhibitors (DPP-4 inhibitor group) or sulfonylurea (SU group) in combination with metformin from 1 March 2009 to 30 September 2011 were retrospectively reviewed. Of total 355 patients, 231 patients were in DPP-4 inhibitor group and 124 patients were in SU group. Baseline Hemoglobin A1c (HbA(1c)) level in SU group was higher than DPP-4 inhibitor group with a statistically significant difference (8.6% vs. 7.8%). Comparative analysis between DPP-4 inhibitor group and SU group was performed for HbA(1c) values, amounts of HbA(1c) changes, and rates of HbA(1c) changes from baseline at 6-month intervals and incidence rates of major cardiocerebral events. RESULTS: SU group showed larger HbA(1c) changes in both amounts and rates compared to DPP-4 inhibitor group, although statistical significance was not found in all study periods. Proportions of patients with stable HbA(1c) <6.5% or 7% were significantly higher in DPP-4 inhibitor group than SU group (<6.5%: 30.4% vs. 13.4%, <7%: 72.3% vs. 41.2%). Time to achieve stable HbA(1c) <6.5% was not significantly different, but time to achieve stable HbA(1c) <7% was shorter in DPP4 inhibitor group than SU group with a significant difference. The incidence rate of cardiocerebral events in group of patients with or without previous events was 1.7%, not significantly lower than that in DPP-4 inhibitor group (4.0%). For newly encountered cardiocerebral events during the treatment, incidence rates of two groups did not differ significantly. CONCLUSION: DPP-4 inhibitors were as effective as sulfonylureas in achieving the HbA(1c) goal of less than 6.5% or 7% and cardiocerebral event rates did not differ between the two drugs.
Diabetes Mellitus, Type 2* ; Humans ; Hypoglycemia ; Incidence ; Medical Records ; Metformin* ; Retrospective Studies ; Weight Gain

Background: Healthcare professionals often experience moral distress while providing endof-life care. This study explored how physicians and nurses experienced moral distress when they cared for critically and terminally ill patients in tertiary hospitals in South Korea. Methods: This study used semi-structured in-depth interviews. A total of 22 people in two tertiary hospitals were interviewed, nine (40.9%) of which were physicians and 13 (59.1%) were nurses. The recorded interview files and memos were analyzed using grounded theory. Results: Most physicians and nurses encountered similar feelings of anger, helplessness, and burden owing to a lack of appropriate resources for end-of-life care. However, the factors and contexts of their moral distress differed. Nurses mainly addressed poorly organized end-of-life care, intensive labor conditions without support for nurses, and providing care without participation in decision-making. Meanwhile, physicians addressed the prevailing misperceptions on end-of-life care, communication failure between physicians owing to hierarchy and fragmented disciplines, the burden of responsibility in making difficult decisions, and the burden of resource allocation. Conclusion Differences in moral distress between physicians and nurses leave them isolated and can affect communication regarding healthcare. Mutual understanding between job disciplines will enhance their communication and help resolve conflicts in end-of-life care.

OBJECTIVES: Non-completion rate of cognitive behavioral therapy (CBT) for Obsessive Compulsive Disorder (OCD) was reported to be higher than expected and it could interfere with the effectiveness of treatment. The aim of this study was to investigate predictors of treatment non-completion and to compare the effectiveness of CBT for OCD between completers and non-completers. METHODS: We studied 107 patients with a principal diagnosis of OCD who initiated a 13-week CBT for OCD from June 2004 to June 2011. Demographic and clinical characteristics, psychiatric co-morbidity, and medication of 20 participants who did not complete therapy were compared with those of treatment completers (n=87). Clinical Global Impression scores were also compared between the two groups in order to evaluate the effect of CBT for OCD at the 13th week. RESULTS: The results showed a difference in marital status between treatment completers and non-completers : more non-completers were not married (p=0.04). Patients with aggressive obsessions at baseline showed a trend (p=0.06) toward lower treatment completion than those with only non-aggressive obsession. In addition, the non-completer group showed a trend of not being medicated (p=0.08). No other differences were observed between completers and non-completers. The 13th week Clinical Global Impression-Improvement scores were significantly different ; completers (2.5+/-0.8) and non-completers (3.2+/-0.8) (p<0.001). CONCLUSION: In this study, we confirmed that CBT could affect symptom improvement of OCD and treatment non-completion interfered with effectiveness of CBT. However, in the current state of our knowledge, no factor is clinically applicable as a predictor of treatment non-completion. Therefore, these results suggest that clinicians should monitor compliance during CBT for OCD patients.
Cognitive Therapy* ; Compliance* ; Diagnosis ; Fibrinogen ; Humans ; Marital Status ; Obsessive Behavior ; Obsessive-Compulsive Disorder*

OBJECTIVE: Metabolic syndrome (MS) is associated with increased left ventricular (LV) mass and diastolic dysfunction. This study uses relatively load-independent Doppler tissue echocardiography to examine whether MS is associated with decreased longitudinal contractile reserve during dynamic exercise. METHODS: A total of 112 patients with relatively well-controlled, treated hypertension who complained of exertional dyspnea were enrolled (average age, 56.7+/-10.5 years). Fifty-six were non-diabetic patients with MS (group 1), and 56 were age-sex matched hypertensive patients without MS (group 2). Exercise stress echo was performed using a symptom-limited, multistage, supine bicycle exercise test. Multiple Doppler parameters were obtained at baseline, at each stage of exercise. RESULTS: There was no significant difference between the two groups in terms of age, gender, and hemodynamic variables. E/E', an index of LV filling pressure, was significantly higher in the MS group at rest and during exercise. The longitudinal contractile reserve, the change in S' (longitudinal tissue velocity) from baseline to peak exercise, was significantly lower in the MS group (2.00+/-1.65 vs. 2.90+/-1.66, P=0.015). Multiple regression analysis showed independent association of MS with longitudinal contractile reserve when controlled for confounding factors, such as LV mass index, gender, blood pressure, and age (beta=-0.235, P=0.035). CONCLUSION: Longitudinal contractile reserve was reduced in MS patients compared to others, although both groups demonstrated similar longitudinal contractile function at rest. We present the first demonstration that metabolic syndrome is independently associated with LV systolic dysfunction during exercise in hypertensive patients.
Blood Pressure ; Dyspnea ; Echocardiography ; Exercise Test ; Hemodynamics ; Humans ; Hypertension