BACKGROUND: Hemodialysis patients are increasing every year and bloodstream infections (BSIs) are a major cause of morbidity and mortality in patients receiving hemodialysis. As the domestic studies have not explored the incidence of BSIs, the distribution and current situation of microorganism and so on this study was carried out to determine the incidence and epidemiological risk factors of the BSIs in hemodialysis patients. A distribution of pathogenic organism of the BSIs was investigated. METHODS: This study was carried out for those 275 patients with hemodialysis for 12 months the patients who underwent hemodialysis in the hemodialysis center within the university hospital. Data was collected by structural questionnaire, medical record review. The definition for BSIs was based on that of CDC. RESULTS: A total of 59 BSIs occurred during 123,502 dialysis sessions. The bloodstream infection rate per 1,000 dialysis sessions was 0.48 overall and varied markedly by the type of vascular access: 0.1 for arteriovenous fistulas, 0.54 for arteriovenous grafts. 2.57 for permanent catheters and 5.39 for temporary catheters. The most common pathogen isolated from the BSIs was MSSA and MRSA 18.0%, Streptococcus species 11.5%. In a logistic regression analysis, immunosuppressive therapy (OR=8.081, p=0.001), case of starting hemodialysis in the intensive care unit (OR=4.855, p=0.043) were associated independently with BSIs. CONCLUSION: Based on this study, continuous study and effort together with interest in BSIs, and the study on BSIs in hemodialysis patients should be further continued in the years to come. Surveillance for BSIs is recommended as a routine activity in hemodialysis center.
Arteriovenous Fistula ; Bacteremia ; Catheters ; Centers for Disease Control and Prevention (U.S.) ; Cross Infection ; Dialysis ; Humans ; Incidence ; Intensive Care Units ; Logistic Models ; Medical Records ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Renal Dialysis* ; Risk Factors ; Streptococcus ; Transplants ; Surveys and Questionnaires

PURPOSE: The purpose of study was to examine effects of aromatherapy on stress, sleep, nausea and vomiting of women after laparoscopic hysterectomy. METHODS: The participants were 60 women who had laparoscopic hysterectomy: experiment group for aromatherapy (n=30) and control group for routine care (n=30). The experimental group received inhalation aromatherapy for 5 minutes, twice; the first was done right after the operation, the second was at 9 pm before sleep on the same day--while the control group had no inhalation. Data were collected from July to September, 2012 at G hospital. RESULTS: The degree of psychological stress was not significantly different between two groups (t=-1.96, p= .054). Yet, there were significant differences between two groups for degree of physiological stress (t=-3.20, p= .002), the level of cortisol (t=-2.01, p= .049), the score of sleep status (t=2.47, p= .016), the score of sleep satisfaction (t=2.43, p= .018), and the score for nausea and vomiting (t=-2.58, p= .012). CONCLUSION: Inhalation aromatherapy using the mixed oil of lavender, mandarin, and marjoram was effective in decreasing the level of physiological stress, cortisol, and the score for nausea and vomiting, and also allowed the participants to have a better sleep. Therefore, inhalation aromatherapy could be effective in improving the quality of life of these women during recovery.
Analgesia, Patient-Controlled* ; Aromatherapy* ; Female ; Humans ; Hydrocortisone ; Hysterectomy* ; Inhalation ; Lavandula ; Nausea* ; Origanum ; Quality of Life ; Stress, Physiological ; Stress, Psychological ; Vomiting*

No abstract available.
Lip

PURPOSE: The purpose of this study was to examine nurses' emotional responses and ethical attitudes towards elderly patients' Do-Not-Resuscitate (DNR) decision. METHODS: Data were collected using a questionnaire which was filled out by 153 nurses who worked in nursing homes and general hospitals. Data were analyzed using real numbers, percentages, means, standard deviations and Pearson's correlation coefficients with SPSS 19.0 program. RESULTS: The average score for ethical attitudes towards the DNR decision was 2.68 out of 4. Under the ethical attitudes category, the highest score was found with a statement that said 'Although they will not perform cardiopulmonary resuscitate (CPR), it is right to do their best with other treatments for DNR Patients'. Items regarding emotional responses to the DNR decision, the average score was 2.36 out of 4. Among them, the highest score was achieved on 'I understand and sympathize'. No significant correlation was found between ethical attitudes and emotional responses in relation to patients' DNR decision (r=-0.12, P=0.13). CONCLUSION: Regarding elderly patients' DNR decision, nurses showed somewhat highly ethical attitudes and slightly positive emotional response. A follow-up study is needed to investigate variables that affect our results.
Aged* ; Ethics ; Hospitals, General ; Humans ; Nursing Homes ; Resuscitation Orders ; Surveys and Questionnaires

PURPOSE: This study investigated attitudes toward general elders and elders with dementia among nursing students before beginning the clinical practicum. In addition, students' characteristics differentiating the attitudes were examined. METHODS: Attitudes were measured with questionnaires developed for Asian culture at the beginning week of the first semester of the junior year in two baccalaureate programs. Responses from 120 out of 121 students were analyzed using Pearson correlation coefficient, paired t-test, ANOVA, and Scheffe test. RESULTS: Students held negative attitudes toward both types of elders except for generosity dimension toward general elders showing a neutral attitude. Elders with dementia were evaluated more negatively than general elders in all the dimensions of vitality, generosity and flexibility. Vitality and generosity toward general elders were different according to intimacy and the degree of communication with elders. Generosity toward general elders was also different according to students' religious beliefs. Students with interest in elders/issues showed more negative attitudes of vitality and flexibility toward elders with dementia. CONCLUSIONS: Students in general had negative attitudes toward elders and more negative attitudes toward elders with dementia. We need to put more efforts into the entire nursing curriculum in order to improve attitudes toward elders with particular concern over attitudes toward elders with dementia.
Asian Continental Ancestry Group ; Curriculum ; Dementia* ; Humans ; Nursing ; Pliability ; Religion ; Students, Nursing* ; Surveys and Questionnaires

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disorder that leads to a progressive muscle wasting and paralysis. The pathological phenotypes are featured by severe motor neuron death and glial activation in the lumbar spinal cord. Proposed ALS pathogenic mechanisms include glutamate cytotoxicity, inflammatory pathway, oxidative stress, and protein aggregation. However, the exact mechanisms of ALS pathogenesis are not fully understood yet. Recently, a growing body of evidence provides a novel insight on the importance of glial cells in relation to the motor neuronal damage via the non-cell autonomous pathway. Accordingly, the aim of the current paper is to overview the role of astrocytes and microglia in the pathogenesis of ALS and to better understand the disease mechanism of ALS.
Amyotrophic Lateral Sclerosis ; Astrocytes* ; Glutamic Acid ; Microglia* ; Motor Neurons ; Neurodegenerative Diseases ; Neuroglia ; Oxidative Stress ; Paralysis ; Phenotype ; Spinal Cord

PURPOSE: This study investigated changes in attitudes toward elders in general and elders with dementia after students finished a gerontological nursing practicum. METHODS: Questionnaires developed for Asian cultures were administered pre practicum, immediately post practicum, and at 8-months follow up to 31 senior students in a baccalaureate nursing program. The 1-week practicum occurred at two adult day care centers: a center for elders with dementia and a center for elders with stroke. Repeated measures ANOVA and Bonferroni correction procedures were used to analyze data. RESULTS: Students' evaluation of elder vitality and flexibility increased significantly at post practicum, however this increase was not sustained at follow up. Score of generosity of elders, the only positively evaluated dimension for elders in general, improved partly at post practicum. Students evaluated flexibility and generosity of elders with dementia more negatively than general elders. All of the decreased attitudes at follow up were not significantly different from those at pre practicum. CONCLUSIONS: Students had more negative attitudes toward elders with dementia. Attitudes of students in direct contact with elders with dementia were improved through the practicum regarding generosity and flexibility. However the sustainability of the immediate effect was not observed at follow up.
Adult ; Aged ; Analysis of Variance ; *Attitude of Health Personnel ; Day Care ; Dementia/*nursing ; *Education, Nursing, Baccalaureate ; Female ; Geriatric Nursing/*education ; Humans ; Korea ; Male ; Stroke/*nursing ; Students, Nursing

This study evaluated pulsed TDI variables including the isovolumic time interval and duration of the major wave in a population of large healthy dogs. Longitudinal myocardial motion at the septal mitral annulus was evaluated with pulsed TDI in 45 healthy adult dogs. Maximal myocardial velocities, isovolumic time intervals, and duration of the myocardial waves were measured. The correlation between time intervals and velocity variables was also investigated. The mean maximal systolic velocity was 6.92 +/- 1.78 cm/sec, the mean early diastolic velocity (Em) was 6.58 +/- 1.81 cm/sec, the mean late diastolic velocity (Am) was 5.10 +/- 2.00 cm/sec, the mean isovolumic contraction time (IVCT) was 53.61 +/- 95.13 msec, and the mean isovolumic relaxation time (IVRT) was 26.74 +/- 57.24 msec. The early diastolic mitral inflow velocity (E)/Em ratio was 10.94 +/- 3.27 while the Em/Am ratio was 1.40 +/- 0.40. There was a negative correlation between Am duration and Am amplitude, and a positive correlation between the IVRT and Em/Am ratio (p < 0.05). The normal LV parameter using pulsed TDI method could be used as the reference range for identifying myocardial dysfunction in dogs.
Animals ; Dogs/*anatomy & histology ; Female ; Heart Ventricles/*ultrasonography ; Male ; Mitral Valve/*ultrasonography ; Ultrasonography, Doppler, Pulsed/methods/*veterinary

PURPOSE: The purpose of this study was to examine the social determinants of health (SDH) associated with health-related quality of life (HQOL) among the community-dwelling elderly, based on the conceptual framework of the Commission on Social Determinants of Health (CSDH). METHODS: A survey was conducted with 199 elders aged 65 years or older sampled through convenient sampling. Data were collected through face to face interviews by trained interviewers using a structured questionnaire, which included scales of the residential area, social support, sense of community, social network, health behaviors, and HQOL. Data were analyzed by ANOVA and stepwise multivariate regression. RESULTS: Major SDH affecting HQOL included the participants' residential area, sense of community, and health behavior. The HQOL of the elderly residing in the B area with a low rate of basic livelihood security recipients was higher than that of those residing in other areas. CONCLUSION: CSDH framework was useful to determine the factors associated with HQOL among the community-dwelling elderly. In addition to their health behavior, their sense of community was found to be a SDH of HQOL, indicating the need of health promotion programs tailored to the characteristics of residential areas and strategies to enhance involvement in community activities.
Aged* ; Health Behavior ; Health Promotion ; Humans ; Quality of Life* ; Social Determinants of Health* ; Weights and Measures ; Surveys and Questionnaires

Guillain-Barre syndrome is an acute inflammatory demyelinating polyradiculopathy characterized by progressive motor weakness, areflexia, and ascending paralysis. Guillain-Barre syndrome is extremely rare in pregnant patients, and there are no established guidelines for delivery or safest anesthetic methods. We report a Cesarean delivery in the case of a 32-year old woman who was diagnosed with Guillain-Barre syndrome 18 weeks into gestation. Tracheostomy was performed due to progressive respiratory muscle weakness and respiratory failure, and ventilator support was required in the intensive care unit. The respiratory difficulty was exacerbated by the growth of the fetus, necessitating emergency Cesarean delivery. The delivery was successfully performed under general anesthesia, and the patient recovered without neurological sequelae.
Anesthesia, General ; Cesarean Section ; Emergencies ; Female ; Fetus ; Guillain-Barre Syndrome ; Humans ; Intensive Care Units ; Paralysis ; Polyradiculopathy ; Pregnancy ; Respiratory Insufficiency ; Respiratory Muscles ; Tracheostomy ; Ventilators, Mechanical