The purpose of this study was to build a substantive theory about the experience of the maternal uncertainty in childhood chronic illness. The qualitative research method used was grounded theory. The interviewees were 12 mothers who have cared for a child who had chronic illness. The data were collected through in-depth interviews with audiotape recording done by the investigator over a period of nine months. The data were analyzed simultaneously by a constant comparative method in which new data were continuously coded into categories and properties according to Strauss and Corbin's methodology. The 34 concepts were identified as a result of analyzing the grounded data. Ten categories were lack of clarity, unpredictability, unfamiliarity, negative change, anxiety, devotion, normalization and burn-out. Causal conditions included : lack of clarity, unpredictability, unfamiliarity and change ; central phenomena : anxiety, being perplexed ; context : seriousness of illness, support ; intervening condition : belief ; action/interaction strategies : devotion, overprotection ; consequences : normalization, burn-out. These categories were synthesized into the core concept-anxiety. The process of experiencing uncertainty was 1) Entering the world of uncertainty, 2) Struggling in the tunnel of uncertainty, 3) Reconstruction of the situation of uncertainty. Four hypotheses were derived from the analysis : (1) The higher the lack of clarity, unpredictability, unfamiliarity, change, the higher the level of uncertainty (2) The more serious the illness and the less the support, the higher the level of uncertainty. (3) The positive believes will influence the devoted care and normalization of the family life. Through this substantive theory, pediatric nurses can understand the process of experiencing maternal uncertainty in childhood chronic illness. Further research to build substantive theories to explain other uncertainties may contribute to a formal theory of how normalization is achieved in the family with chronically ill child.
Anxiety ; Child ; Chronic Disease* ; Humans ; Mothers ; Qualitative Research ; Research Personnel ; Tape Recording ; Uncertainty* ; Child Health

No abstract available.
Kidney Transplantation* ; Muromonab-CD3*

Objective: To evaluate effects of docosahexaenoic acid-enriched phosphatidylcholine (DHA-PC) on cytokine production induced by lipopolysaccharide (LPS). Methods: The culture supernatants of splenocytes exposed to DHA-PC along with LPS were harvested to determine the production of Th 1 (IFN-γ and IL-2) and Th2 [IL-4, IL-5, IL-6 and IL-12/IL-23(p40)] cytokines. Cytokines were measured using ELISA. Results: Co-administration of DHA-PC with LPS resulted in significantly lower IL-2 expression compared to that observed with administration of only LPS (P<0.01). Treatment with DHA-PC and LPS significantly increased IL-5 expression (P<0.01). Moreover, co-administration of DHA-PC with LPS significantly decreased IL-6 and IL-12/IL-23(p40) expressions compared to that observed with administration of only LPS (P<0.01). Conclusions: Our results suggest that DHA-PC inhibits pro-inflammatory cytokines [IL-2, IL-6 and IL-12/IL-23(p40)] expression on induction of inflammation.

OBJECTIVE: There is a large and increasing body of experimental and clinical data supporting the existence of variable estrogen receptors in both normal and neoplastic estrogen target tissue. Recently, exon 5 deleted estrogen receptor(D5-ER) has been identified in many estrogen dependent tumors. The purpose of this study is to assess the relationship between uterine myoma and D5-ER. METHODS: The relative amount of wild type estrogen receptor mRNA and D5-ER mRNA were examined in human myometrium and myoma tissue obtained from 12 myoma patients and 12 control subjects by RT-PCR. The correlation between WT/D5-ER ratio and age was also evaluated. RESULTS: There was no difference in expression of D5-ER mRNA not only between myoma and myometrim of the myoma patients, but also between myometrium of myoma patients and normal subjects. No significant correlation was found between D5-ER expression and age of the subjects in myometrial tissue. However, we could find negative correlation between WT/D5-ER ratio and age in myoma tissue. CONCLUSION: Upon these data, we conclude that D5-ER is a common variant mutation of estrogen receptor, which is not related with development of myoma. However, in myoma tissue, there is possibility that D5-ER may act some role in the growth of tumor.
Animals ; Estrogens* ; Exons* ; Female ; Humans* ; Leiomyoma* ; Mice ; Myoma ; Myometrium* ; Receptors, Estrogen ; RNA, Messenger*

PURPOSE: This study was a systematic review and meta-analysis designed to evaluate the effects of breastfeeding intervention on breastfeeding rates. METHODS: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a systematic search was conducted using eight core electronic databases and other sources including gray literature from January 9 to 19, 2017. Two reviewers independently select the studies and assessed methodological risk of bias of studies using the Cochrane criteria. The topics of breastfeeding interventions were analyzed using descriptive analysis and the effects of intervention were meta-analyzed using the Review Manager 5.2 software. RESULTS: A total of 16 studies were included in the review and 15 were included for meta-analysis. The most frequently used intervention topics were the importance of good latch-on and frequency of feeding and determining adequate intake followed. The pooled total effect of breastfeeding intervention was 1.08 (95% CI 1.03~1.13). In the subgroup analysis, neither pre-nor post-childbirth intervention was effective on the breastfeeding rates at 1, 3, and 6 months, and neither group nor individual interventions had an effect. Only the 1 month breastfeeding rate was found to be affected by the individual intervention with the persistent strategies 1.21 (95% CI 1.04~1.40). CONCLUSION: Effective breastfeeding interventions are needed to help the mother to start breastfeeding after childbirth and continue for at least six months. It should be programmed such that individuals can acquire information and specific breastfeeding skills. After returning home, there should be continuous support strategies for breastfeeding as well as managing various difficulties related to childcare.
Bias (Epidemiology) ; Breast Feeding* ; Humans ; Mothers ; Parturition ; Postpartum Period*

PURPOSE: The purposes of this study were to investigate daycare teachers'knowledge, anxiety and management of childhood fever and to identify factors affecting their management of childhood fever. METHODS: A descriptive correlation study was conducted. Participants were 109 daycare center teachers from G metropolitan city. A self-administered questionnaire was used for data collection. RESULTS: The mean percent of correct answers for knowledge about childhood fever was 42.9%. Levels of anxiety related to children's fever were high among day care teachers in this study. Many daycare center teachers used management practices which were not recommended for childhood fever management. There was a statistically significant difference in participants' knowledge about childhood fever by marital status and having a child. Moreover, there were statistically significant positive correlation between daycare center teachers' knowledge and management and negative correlation between daycare center teachers' anxiety and management of childhood fever. Knowledge and anxiety related to childhood fever accounted for 15.2% of variance for fever management. CONCLUSION: Results show that day care teachers' knowledge and anxiety related to fever are important factors in predicting their fever management. Development and evaluation of educational interventions to improve daycare teachers' childhood fever management are recommended.
Anxiety ; Child ; Child Day Care Centers ; Data Collection ; Day Care, Medical ; Evidence-Based Practice ; Fever* ; Humans ; Marital Status ; Statistics as Topic

BACKGROUND: Men with chronic obstructive pulmonary disease, have reduced endogenous testosterone levels, but the relationship between pulmonary function and endogenous testosterone levels, is inconsistent. Testicular volume is a known indicator of endogenous testosterone levels, male fertility, and male potency. In the present study, the authors investigated the relationship, between testicular volume and lung function. METHODS: One hundred and eighty-one South Korean men age 40-70, hospitalized for urological surgery, were retrospectively enrolled, irrespective of the presence of respiratory disease. Study subjects underwent pulmonary function testing, prior to procedures, and testicular volumes were measured by orchidometry. Testosterone levels of patients in blood samples collected between 7 AM and 11 AM, were measured by a direct chemiluminescent immunoassay. RESULTS: The 181 study subjects were divided into two groups, by testicular volume (≥35 mL vs. <35 mL), the larger testes group, had better lung functions (forced vital capacity [FVC]: 3.87±0.65 L vs. 3.66±0.65 L, p=0.037; forced expiratory volume in 1 second [FEV1]: 2.92±0.57 L vs. 2.65±0.61 L, p=0.002; FVC % predicted: 98.2±15.2% vs. 93.8±13.1%, p=0.040; FEV1 % predicted: 105.4±19.5% vs. 95.9±21.2%, p=0.002). In addition, the proportion of patients with a FEV1/FVC of <70%, was lower in the larger testes group. Univariate analysis conducted using linear regression models, revealed that testicular volume was correlated with FVC (r=0.162, p=0.029), FEV1 (r=0.218, p=0.003), FEV1/FVC (r=0.149, p=0.046), and FEV1 % predicted (r=0.178, p=0.017), and multivariate analysis using linear regression models, revealed that testicular volume was a significant predictive factor for FEV1 % predicted (β=0.159, p=0.041). CONCLUSION: Larger testicular volume was independently associated, with favorable indices of lung function. These results suggest that androgens, may contribute to better lung function.
Androgens ; Fertility ; Forced Expiratory Volume ; Humans ; Immunoassay ; Linear Models ; Lung* ; Male ; Multivariate Analysis ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Respiratory Physiological Phenomena ; Retrospective Studies ; Testis ; Testosterone ; Vital Capacity

PURPOSE: This study was done to examine the effect of direct practice of newborn health assessment on nursing student's clinical competence and self-efficacy and to propose effective strategies for clinical education on newborn care. METHODS: Design was a nonequivalent control group quasi-experimental study. The direct practice program was composed of a lecture, demonstration, drill and feedback using a manikin, and repeated direct practice regarding newborn health assessment. Participants were 65 student nurses taking the pediatric nursing practicum in the nursery room at M hospital. The experimental group (n=33) participated in the direct practice program for newborn health assessment and the control group (n=32) received the traditional practice method. Nursing clinical competence was assessed by two nurse investigators and structured questionnaires were used to measure self-efficacy. RESULTS: The experimental group's clinical competence was significantly higher than that of the control group (t=-4.82, p=.000). However no significant difference was found between the two groups for self-efficacy (t=1.264, p=.211). CONCLUSION: These findings indicate that the direct practice program is effective in improving nursing student's clinical competence, but it was not effective in increasing self-efficacy. Direct practice in various clinical education settings is recommended and longitudinal effects be evaluated.
Clinical Competence* ; Education ; Humans ; Infant, Newborn* ; Manikins ; Nurseries ; Nursing* ; Pediatric Nursing ; Research Personnel

Purpose: This study aimed to develop a structural model to explain breastfeeding behavior of primipara based on information-motivation-behavioral skills. Variables were breastfeeding knowledge, breastfeeding motivation, breastfeeding self-efficacy, and parenting stress. Methods: Participants were first-time mothers who were breastfeeding infants from birth to 6 months. Data were collected from 5 pediatric hospitals and 1 public health center in Jeollanam-do from December 24, 2018 to February 28, 2019. A total of 285 questionnaires were included in the analysis. Data were analyzed using IBM SPSS Statistics ver. 20.0 and AMOS 20.0 programs. Results: Fitness statistics for the hypothetical model were appropriate (χ2=48.30 [degrees of freedom= 14, p<0.001], goodness of fit index=0.96, normed fit index=0.89, comparative fit index=0.92, standardized root mean square residual=0.06). Breastfeeding self-efficacy had the most direct and total impact on breastfeeding behaviors (β=0.38, p=0.01). Breastfeeding self-efficacy was directly and totally influenced by breastfeeding knowledge (β=-0.18, p=0.01), breastfeeding motivation (β=0.26, p=0.01). Parenting stress showed a direct effect on breastfeeding self-efficacy (β=-0.14, p=0.02) and breastfeeding behavior (β=0.20, p=0.01), confirming its modulating effect on both variables. Conclusion Since breastfeeding self-efficacy was the most important variable for the breastfeeding behavior in first-time mothers, nursing interventions should be developed to promote breastfeeding selfefficacy including accurate breastfeeding information and enhanced breastfeeding motivation. Strategies that could relieve or adjust parenting stress should be considered since parenting stress had a causal relationship with breastfeeding self-efficacy and breastfeeding behavior.

Purpose: This study aimed to develop a structural model to explain breastfeeding behavior of primipara based on information-motivation-behavioral skills. Variables were breastfeeding knowledge, breastfeeding motivation, breastfeeding self-efficacy, and parenting stress. Methods: Participants were first-time mothers who were breastfeeding infants from birth to 6 months. Data were collected from 5 pediatric hospitals and 1 public health center in Jeollanam-do from December 24, 2018 to February 28, 2019. A total of 285 questionnaires were included in the analysis. Data were analyzed using IBM SPSS Statistics ver. 20.0 and AMOS 20.0 programs. Results: Fitness statistics for the hypothetical model were appropriate (χ2=48.30 [degrees of freedom= 14, p<0.001], goodness of fit index=0.96, normed fit index=0.89, comparative fit index=0.92, standardized root mean square residual=0.06). Breastfeeding self-efficacy had the most direct and total impact on breastfeeding behaviors (β=0.38, p=0.01). Breastfeeding self-efficacy was directly and totally influenced by breastfeeding knowledge (β=-0.18, p=0.01), breastfeeding motivation (β=0.26, p=0.01). Parenting stress showed a direct effect on breastfeeding self-efficacy (β=-0.14, p=0.02) and breastfeeding behavior (β=0.20, p=0.01), confirming its modulating effect on both variables. Conclusion Since breastfeeding self-efficacy was the most important variable for the breastfeeding behavior in first-time mothers, nursing interventions should be developed to promote breastfeeding selfefficacy including accurate breastfeeding information and enhanced breastfeeding motivation. Strategies that could relieve or adjust parenting stress should be considered since parenting stress had a causal relationship with breastfeeding self-efficacy and breastfeeding behavior.