OBJECTIVES: This study was to investigate the psychiatric diagnoses of survivors of traumatic stress, i.e. torture, as a part of a large research project of a human rights survey of torture survivors. METHODS: Participants were 24 torture survivors who consented to participate, who had experienced torture during the period of 1970 through the 2000's. Participants were recruited from human rights support groups and government agencies using the snowballing technique. Data was collected by a psychiatrist and two psychologists using the MINI-International Neuropsychiatric Interview PLUS. RESULTS: The prevalence of past psychiatric diagnoses which occurred during a post-victimization period included post-traumatic stress disorder (PTSD, 37.5%), depressive disorders (45.8%), panic disorder (16.6%), substance related disorders (24.9%), psychotic disorder (4.1%), and adjustment disorder (16.6%). The prevalence of current diagnoses at interview period included PTSD (33.3%), depressive disorders (41.6%), panic disorder (8.2%), generalized anxiety disorder (4.1%), substance related disorders (20.8%), psychotic disorder (4.1%), adjustment disorder (12.5%), and suicidal tendency of above mid-level (16.6%). The co-morbidity rate was 37.5% in the past, and 33.3% at present. CONCLUSION: It was revealed that torture survivors were suffering from high rates of chronic psychiatric disorders. Appropriate psychiatric treatment may be in need to support the sufferings of the survivors.
Adjustment Disorders ; Anxiety Disorders ; Depressive Disorder ; Government Agencies ; Human Rights ; Humans ; Mental Disorders ; Panic Disorder ; Prevalence ; Psychiatry ; Psychotic Disorders ; Self-Help Groups ; Stress Disorders, Post-Traumatic ; Stress, Psychological ; Survivors ; Torture

Purpose: Tinnitus, which is often described as the conscious awareness of a sound without an external auditory stimulus, is one of the most common symptoms in the general population. This study aimed to explore the experiences of individuals living with tinnitus. Methods: In this qualitative exploratory study, data were collected from November 2017 to January 2018 through in-depth individual interviews with 11 tinnitus patients. Verbatim transcripts and field notes were analyzed using content analysis. Results: The extracted content was classified into three core categories of tinnitus experiences: “suffering from constant sound,” “being imprisoned surrounded by persistent noise,” and “efforts to overcome.” Conclusion This study shows that tinnitus had a severe negative impact on patients’ lives. The finding will help healthcare providers understand their patients more deeply.

PURPOSE: This study was done to test a structural equation modeling of case management outcomes in order to identify parameters affecting case management outcomes for the community-dwelling vulnerable elders. METHODS: Data were collected from 309 nurses (case managers) and community-dwelling vulnerable elders (clients) from public health centers. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and covariance structure analysis were performed using SPSS Version 18.0 for Windows and Amos 16.0. RESULTS: The hypothetical model had an acceptable fit: GFI=.97, CFI=.95, RMSEA=.02, SRMR=.05. The factor "case managers' singularity" had the greatest impact on case management outcomes in this model. In addition, the factor "case management practice" influenced case management outcomes; however, client characteristics did not. Case managers' singularity affected case management outcomes directly and indirectly, with case management practice mediating the latter effect. CONCLUSION: These results suggest that the causal relationship between case management outcomes and factors influencing these outcomes should be clarified through longitudinal research including a variety of client characteristics. In addition, in future studies, analysis of the effects of programs to improve manpower quality and examine the relationships among case management outcomes should be done.
Adult ; Aged ; Aged, 80 and over ; Case Management ; Community Health Centers ; Female ; Humans ; Job Satisfaction ; Male ; Middle Aged ; *Models, Nursing ; Nurses/*psychology ; Personal Satisfaction ; Poverty ; Questionnaires ; Time Factors

Reinforced endotracheal tubes (ETTs) are designed to resist kinking or compression. However, these have a potential risk of being obstructed or severed by a patient's bite. We report a case in which a reinforced ETT was severed by tube-bite while the patient was in the prone position during an intensive care unit stay. Bronchoscopic evaluation showed that the severed distal part of the tube had lodged in the patient's right main bronchus, and it had to be surgically removed. The patency of reinforced ETTs should be carefully monitored in patients intubated in the prone position.
Airway Obstruction ; Bronchi* ; Bronchoscopy ; Humans ; Intensive Care Units ; Intubation ; Patient Rights ; Prone Position

Nurses play a crucial role in providing high-quality care in intensive care units (ICU). Previous studies have shown an association between nurse staffing levels and outcome of critically ill patients. Increasing nurse staffing levels in ICU has been recommended to improve the outcome of critically ill patients. However, nursing staff shortages associated with decreased budgets may prevent adequate nurse-to-patient ratios although there lies increasing needs for critical care. Several studies have suggested that higher nurse staffing level is associated with favorable patient outcome, including mortality, length of stay, and infections, but some of studies did not find an association between nurse staffing and patient outcome. Although there are some controversies in the associations between nurse staffing levels and patient outcome, it is difficult to apply such effect as compared with other developed countries in North American and Europe as the nurse-to-patient ratio in Korea's ICU is relatively low. By studying the nurse staffing effects for patient outcome from the Korea ICU, it is found that higher nurse staffing level is associated with improved patient mortality. This finding may suggest that a shortage of nursing staff is currently a serious issue for caring of critically ill patients in Korea.
Budgets ; Critical Care ; Critical Illness ; Developed Countries ; Europe ; Humans ; Critical Care ; Intensive Care Units ; Korea ; Length of Stay ; Nursing Staff

This study analyzed the longevity of preformed metal crowns (PMCs) in first permanent molars and evaluated factors influencing their survival during a long-term follow-up period. In all, 115 first permanent molars treated with PMCs between June 2008 and June 2018 were retrospectively analyzed. The overall combined success rate for the study group was 84.3%. The 5-year survival rate was 82.8%. Multivariate Cox regression analyses identified distal cavities and mandibular PMC placement as risk factors for restoration failure. Careful placement of PMCs at the final try-in stage augments the longevity of the crown.

This retrospective study assessed the effectiveness and side effects of conscious sedation using chloral hydrate, hydroxyzine, and N2O/O2 in the sedation of 149 pediatric patients over 188 sedation sessions, and to identify associated variables.
The effectiveness of the sedation was evaluated using the Houpt scale, and was considered effective for scale categories of excellent or good. Effectiveness and side effects were assessed every 15 minutes. The effectiveness decreased and side effects increased over time. The effectiveness of sedation during 60 minutes was 57.4%, and one or more side effects occurred in 18.1% of sessions. Effectiveness of sedation increased with body mass index (BMI). When patients were sedated at the beginning of the procedure, the effectiveness was greater. Side effects increased with patient age. When sedation was divided into two sessions, the number of sedation did not affect the effectiveness or side effects.
It can be suggested that sedation should be performed over two separate sessions, as a single prolonged session may lead to reduced effectiveness and increased side effects. To maximize effectiveness and minimize side effects, several variables such as BMI, whether to sedate at the beginning of the procedure and age should be considered thoroughly before sedation.

Dilacerations generally involve central incisors; most often maxillary incisors rather than their mandibular counterparts. The clinical features of dilaceration include non-eruption of the responsible tooth or prolonged retention of the deciduous predecessor tooth. In Case 1, the tooth showed a dilaceration at the boundary between the crown and the root, more laterally rather than labiolingually. In Case 2, the dilacerated tooth showed a crown dilaceration with a relatively normal orientation of the dental root. In both cases, no significant space losses for eruption were observed. Moreover, it seems that unlike the maxilla with the palate, the mandibular anterior teeth are limited to show severe displacement.
From these cases, it is suggested that if a mandibular permanent incisor shows a crown dilaceration or lateral dilaceration at the boundary between the crown and the root, there is a relatively high probability of spontaneous eruption of the dilacerated tooth.

The purpose of this study was to investigate the characteristics related to the musculoskeletal disorders in pediatric dentists and general dentists. This study was conducted based on the survey results of a total of 109 dentists who have been working for the last year. Forty - three pediatric dentists and 66 general dentists were surveyed through online survey tool. Both pediatric dentists and general dentists mainly complained of musculoskeletal disorders in the neck, shoulders, wrists, and back. Most pediatric dentists usually suffered from back pain due to their unbalanced posture while giving dental treatments. Pediatric dentists in sedative treatment felt more pain in particular part of their body, such as neck and shoulder. Regular exercise and stretching for the prevention of musculoskeletal disorder have been shown to mainly relieve pain in the back but no other parts in their body.

Purpose: This study aimed to identify the colonization rate of carbapenem-resistant Enterobacteriaceae (CRE), the characteristics of CRE isolates, and risk factors for CRE colonization in patients transferred to the general wards of a small/medium-sized hospital. Methods: This retrospective study was conducted on patients who underwent CRE culture tests within 24 hours of admission among patients transferred to a small/medium-sized hospital. Forty-seven patients confirmed as positive for CRE were classified as belonging to the patient group. For the control group, 235 patients (five times the number of the patient group) were matched by sex, age, and diagnosis, and then selected at random. Data were analyzed using descriptive analysis and multiple logistic regression analysis. Results: The CRE colonization rate was 5% (47 out of 933 patients), and Klebsiella pneumoniae (68.0%) was the most common isolate of CRE. The positivity rate of carbapenemase-producing Enterobacteriaceae was 61.7%. The risk factors for CRE colonization included renal disease (odds ratio [OR]=4.93; 95% confidence interval [CI], 1.49-16.31), heart disease (OR=3.86; 95% CI, 1.35-11.01), indwelling urinary catheters (OR=4.43; 95% CI, 1.59-12.36), and cephalosporin antibiotic use (OR=8.57; 95% CI, 1.23-59.60). Conclusion Having a comorbid renal or cardiac disease, an indwelling urinary catheter, or a history of exposure to cephalosporin antibiotics could be classified as risk factors for CRE colonization in patients transferred to small and medium-size hospitals. It is necessary to perform active infection control through proactive CRE culture testing of patients with risk factors.