No abstract available.
Capsid Proteins* ; Capsid* ; Genome*

PURPOSE: In this study a system dynamics methodology was used to identify correlation and nonlinear feedback structure among factors affecting unplanned extubation (UE) of ICU patients and to construct and verify a simulation model. METHODS: Factors affecting UE were identified through a theoretical background established by reviewing literature and preceding studies and referencing various statistical data. Related variables were decided through verification of content validity by an expert group. A causal loop diagram (CLD) was made based on the variables. Stock & Flow modeling using Vensim PLE Plus Version 6.0b was performed to establish a model for UE. RESULTS: Based on the literature review and expert verification, 18 variables associated with UE were identified and CLD was prepared. From the prepared CLD, a model was developed by converting to the Stock & Flow Diagram. Results of the simulation showed that patient stress, patient in an agitated state, restraint application, patient movability, and individual intensive nursing were variables giving the greatest effect to UE probability. To verify agreement of the UE model with real situations, simulation with 5 cases was performed. Equation check and sensitivity analysis on TIME STEP were executed to validate model integrity. CONCLUSION: Results show that identification of a proper model enables prediction of UE probability. This prediction allows for adjustment of related factors, and provides basic data do develop nursing interventions to decrease UE.
Adult ; Airway Extubation/*psychology ; Female ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Male ; Middle Aged ; *Models, Theoretical ; Nonlinear Dynamics ; Risk Factors

PURPOSE: This study was conducted to test the effect of a 12-week exercise program on body composition, blood pressure, blood glucose, blood lipid and bone mineral density for middle-aged and aged women in rural areas. METHODS: The subjects were 33 women at the age of 40-75. For statistical analysis, descriptive statistics and paired t-test were used with SPSSWIN 16.0. RESULTS: The results were summarized as follows. First, body weight, BMI, % body fat, abdominal adipose, and waist circumference of the women decreased significantly after implementing the 12-week exercise program. Second, diastolic blood pressure, serum cholesterol, triglyceride, and LDL decreased significantly, and the HDL level increased significantly after the 12-week exercise program. Third, bone mineral density did not increase significantly after the program. CONCLUSION: These results suggest that the exercise program has an effect in decreasing body composition, and improving blood pressure, blood glucose, and blood lipid in middle-aged and aged women.
Adipose Tissue ; Blood Glucose ; Blood Pressure ; Body Composition ; Body Weight ; Bone Density ; Cholesterol ; Female ; Humans ; Triglycerides ; Waist Circumference

Fifty-four adenocarcinomas of stomach were investigated to assess the expression of p21 and p53 using an immunohistochemical method. The relationship between p21 and p53 expression and the clinicopathologic parameters were analysed. The staining pattern of p21/p53 were: p21+/p53+, p21-/p53+, p21+/p53-, and p21-/p53- in 30, 12, 8, and 4 cases, respectively. Loss of p21 expression was observed in 16 of 54 tumor tissues (29%). p21 expression, however, had an inverse correlation with vascular invasion and depth of tumor invasion. The p21 and p53 protein expression showed intratumoral heterogeneity. In 63% of the adenocarcinoma, a proportional relationship was found between p21 and p53 immunostaining. The present results suggest that p53 independent induction of p21 expression may be involved in the molecular mechanism of these tumors, and expression of p21 protein may be related to a favorable prognosis in gastric adenocarcinomas.
Adenocarcinoma* ; Immunohistochemistry ; Population Characteristics ; Prognosis ; Stomach

PURPOSE: This study aimed to construct a management model for patient transfer in a multilevel healthcare system and to predict the effect of counseling with nurses on the patient transfer process. METHODS: Data were collected from the electronic medical records of 20,400 patients using the referral system in a tertiary hospital in Seoul from May 2015 to April 2017. The data were analyzed using system dynamics methodology. RESULTS: The rates of patients who were referred to a tertiary hospital, continued treatment, and were terminated treatment at a tertiary hospital were affected by the management fee and nursing staffing in a referral center that provided patient transfer counseling. Nursing staffing in a referral center had direct influence on the range of increase or decrease in the rates, whereas the management fee had direct influence on time. They were nonlinear relations that converged the value within a certain period. CONCLUSION: The management fee and nursing staffing in a referral center affect patient transfer counseling, and can improve the patient transfer process. Our findings suggest that nurses play an important role in ensuring smooth transitions between clinics and hospitals.
Continuity of Patient Care ; Counseling* ; Delivery of Health Care ; Electronic Health Records ; Fees and Charges ; Humans ; Nursing ; Patient Transfer* ; Referral and Consultation ; Seoul ; Tertiary Care Centers

PURPOSE: This study aimed to investigate the effects of Korean hand acupressure on pain and abdominal bloating of patients receiving laparoscopic surgery. METHODS: This study was a quasi-experimental design using a non-equivalent control group pre-post test. The experimental group and the control group were 39 patients each who were hospitalized at gynecology ward of a hospital located in Gyeonggi-do. The experimental group received Korean hand acupressure therapy on the meridian point: A5, A6, H3, H7, I38 for 48 hours immediately after the surgery. Pain and abdominal bloating were measured at 5 times. Data were analyzed using SPSS/Win 18.0. RESULTS: The experimental group showed lower pain score than the control group (p<.001). While there was no significant difference in abdominal bloating (p=.528), the time effect was significantly different (p<.001). CONCLUSION: The findings indicate that Korean hand acupressure reduces pain and abdominal bloating of laparoscopic surgery patients.
Acupressure* ; Evaluation Studies as Topic ; Gyeonggi-do ; Gynecology ; Hand* ; Humans ; Hysterectomy* ; Laparoscopy

PURPOSE: This cross-sectional study was done to compare factors influencing young adolescents' aggression according to family structure. METHODS: Participants were 680 young adolescents aged 11 to 15 years (113 in single father families, 136 in single mother families, 49 in grandparent families, and 382 in both-parent families). All measures were self-administered. Data were analyzed using SPSS 18.0 program and factors affecting young adolescents' aggression were analyzed by stepwise multiple regression. RESULTS: Levels of young adolescents' aggression and all variables were significantly different among the four family structure groups. Factors influencing young adolescents' aggression were also different according to these 4 groups. For single father families, depression-anxiety and family hardiness significantly predicted the level of young adolescents' aggression (adjusted R square=.37, p<.001). For single mother families, depression-anxiety, gender, and friends' support significantly predicted the level of young adolescents' aggression (adjusted R square=.58, p<.001). For grandparent families, depression-anxiety and family support significantly predicted the level of young adolescents' aggression (adjusted R square=.58, p<.001). For both-parent families, depression-anxiety, family hardiness, and friends' support significantly predicted the level of young adolescents' aggression (adjusted R square=.48, p<.001). CONCLUSION: Nurses working with young adolescents should consider family structure-specific factors influencing aggression in this population.
Adolescent ; *Adolescent Psychology ; *Aggression ; Anxiety ; Child ; Cross-Sectional Studies ; Depression ; Family ; Family Relations ; Female ; Humans ; Male ; Questionnaires ; Sex Factors ; Single-Parent Family ; Social Support

Cantrell's syndrome is a rare congenital anomaly, consists of five malformations. There are the midline abdominal wall defect, the defect of sterna lower part, an agenesis of the anterior part of the diaphragm, an absence of the diaphragmatic pericardium, and the congenital intracardiac problem. We diagnosed Cantrell's syndrome with left ventricular diverticulum in a female neonate with no perinatal problems. She experienced an one-staged operation and discharged with no complications. We report a case with brief review of the literature.
Abdominal Wall ; Diaphragm ; Diverticulum* ; Female ; Humans ; Infant, Newborn* ; Pericardium

PURPOSE: This study was done to identify correlations between fatigue and quality of life in clinical nurses. METHOD: A sample of 294 nurses working in 3 general hospitals answered a questionnaire containing Yoshitake's fatigue scale and WHOQOL-BREF. Data were analyzed using t-test, ANOVA and Pearson correlation coefficients. The SPSS/WIN 11.0 version program was used. RESULTS: The score for level of fatigue was 2.11 (52.7%) and quality of life, 2.89 (57.8%). The level of fatigue was highest in the physical domain followed by psychical and nervous-sensual domain in that order. There were statistically significant differences in scores of fatigue depending on the nurse's age, marital status, career, position, health status and present illness. Quality of life had the highest score in the social domain followed by physical, overall, psychological, and environmental domain in that order. There were statistically significant differences in scores on quality of life depending on nurse's age, marital status, career, position, health status and present illness. CONCLUSION: The relationship between fatigue and quality of life revealed a significant negative correlation. Based on this study, nursing administrators need to reduce the level of nurse fatigue by providing various programs, which improve quality of life.
Administrative Personnel ; Fatigue* ; Hospitals, General ; Humans ; Marital Status ; Nursing ; Quality of Life* ; Surveys and Questionnaires

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*