Purpose: We explored emergency nurses’ experiences of coping with moral distress. Methods: A qualitative research design was used. We conducted in-depth interviews with 11 nurses working at a regional emergency medical center in South Korea. Data were analyzed using conventional content analysis. Results: The main theme of nurses’ coping with moral distress was “a passive emotion-based response.” We also extracted three categories of coping strategies: “uncritical adaptation to anguished situation,” “self-justification for not acting,” and “flight from ethical decision making.” Conclusion Nurses coped with moral distress in a passive and emotional way, possibly because of perceived incompetence and compliance to an organizational hierarchy. The findings imply that effective approaches to addressing moral distress in emergency nurses are needed at the individual and organizational levels.

BACKGROUND: This study was conducted to explore the prevalence of and the factors affecting constipation in elementary school students in urban and rural areas. METHODS: Study subjects were 585 grade 5 and 6 students. We conducted self-administered questionnaires during October, 2009. Outcome measure was the prevalence of constipation evaluated by the Rome III Diagnostic criteria for functional constipation. Independent variables were gender, grade, residence, mother's employment status, self-rated health status, number of family members, bowel movement habit, and health behavior (nutrition, exercise, and stress). RESULTS: The multiple logistic regression analysis showed that females, grade 5 students, those with working mothers, and those physically inactive reported having constipation significantly more often. CONCLUSIONS: Our study revealed that the female gender, increasing age, mother's employment status, and physical inactivity were risk factors for constipation in elementary school students. To improve bowel function in children, health education programs and school health promotion programs targeting healthy life habits should be implemented.
Child ; Constipation* ; Employment ; Female ; Health Behavior ; Health Education ; Humans ; Logistic Models ; Mothers ; Outcome Assessment (Health Care) ; Prevalence* ; Risk Factors ; School Health Services ; Surveys and Questionnaires

OBJECTIVES: Alcohol drinking, obesity, and reduced physical activity are commonly related to oxidative stress, which induces plasma membrane-bound protein damage in hepatic cells and elevates serum gamma-GTP. We have a hypothesis that a long commuting time may induce oxidative stress. This study was undertaken to investigate the relationship between commuting time and serum gamma-GTP level. METHODS: Questionnaires were administered to 717 male workers who had worked at Kimpo airport until the year 2000,and had then moved to Incheon airport and were working there in 2002. The questionnaire included items concerning commuting time, sleeping time and alcohol consumption. Physical examination and laboratory data were also collected. RESULTS: Serum gamma-GTP level was significantly and positively correlated with commuting time, body mass index, systolic blood pressure,diastolic blood pressure, hemoglobin, glucose, total cholesterol, AST, ALT and alcohol consumption. Multivariate regression analysis demonstrated that serum gamma-GTP level is significantly associated with commuting time, after considering the other covariates. CONCLUSIONS: Commuting time is one of the factors that affects serum gamma-GTP level in male workers.
Airports ; Alcohol Drinking ; Blood Pressure ; Body Mass Index ; Cholesterol ; gamma-Glutamyltransferase* ; Glucose ; Gyeonggi-do ; Hepatocytes ; Humans ; Incheon ; Male* ; Motor Activity ; Obesity ; Oxidative Stress ; Physical Examination ; Plasma ; Questionnaires ; Transportation*

A 69-year-old man presented with a black irregular patch on his left cheek. Skin biopsy revealed lentigo maligna melanoma in situ. He was treated via partial excision of the melanoma, followed by the application of 5% imiquimod cream every other night for 6 to 8 hours. The patient experienced severe local inflammation accompanied by burning, edema, and erythema, as well as oozing and crusting. The patient discontinued using the imiquimod cream after 15 applications because of the inflammation. Depigmentation was noted in the treated area 3 months after the initiation of treatment with imiquimod cream. Histological examination using Melan-A staining of the depigmented area revealed an absence of melanocytes, which is consistent with vitiligo. The depigmented lesions improved considerably after a 5-year follow-up, and there was no recurrence of melanoma.
Aged ; Biopsy ; Burns ; Cheek ; Edema ; Erythema ; Follow-Up Studies ; Humans ; Hutchinson's Melanotic Freckle* ; Inflammation ; Lentigo* ; MART-1 Antigen ; Melanocytes ; Melanoma* ; Recurrence ; Skin ; Toll-Like Receptors ; Vitiligo

Angiodysplasia is an important vascular lesion of the gastointestinal tract , located at the site of ectasia of intestinal submucosal veins and overlying mucosal capillaries. It is a major cause of morbidity from gastrointestinal bleeding in old age, but rather rare in children. Its cause is still unknown, though is mostly considered to be acquired as a result of a degenerative process associated with aging. We experienced a case of colonic angiodysplasia in 14-year old boy, diagnosed by colonoscopy. The patient had a history of repeated hematochezia for a year. This report summarized our case and reviewed the literature.
Aging ; Angiodysplasia ; Capillaries ; Child ; Colon ; Colonoscopy ; Dilatation, Pathologic ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Male ; Veins

This study aimed to investigate the effect of repeated oral health education on the oral health of preschool children. This study classified the control group of children of 5~6 years of age where the oral health education was conducted one time, and the experiment group where the oral health education was conducted 4 times. The oral health conditions of each group and their risk of developing dental caries were also assessed. No significant difference was observed in the participants in terms of general characteristics, oral health conditions, risk of developing dental caries, and oral health behavior after oral health education. The two groups did not show a significant difference (p<0.001) in dental plaque index before and after oral health education, and showed a significant difference (p<0.001) according to the number of education sessions. Before oral health education, the participants in both groups were brushing their teeth incorrectly. However, after the third session, 56.7% of the participants in the experimental group and 9.4% in the control group used the correct method of tooth brushing. A significant difference was observed between the two groups (p<0.05). In addition, when the tooth-brushing time was compared, the two groups showed a significant difference (p<0.001), and a significant difference was observed in terms of the number of education sessions (p<0.05). In summary, repeated oral health education had significant influences on the dental plaque index, tooth-brushing method, brushing occlusal surfaces, and tooth-brushing time. Therefore, when oral health education is carried out, repeated oral health education in children is more effective than one-time oral health education as reflected in the changes in dental plaque index and oral health behavior. Moreover, oral health education is considered effective in changing the oral health behavior of children when conducted at least 3 times.
Child ; Child, Preschool* ; Dental Caries ; Dental Caries Activity Tests ; Dental Plaque Index ; Education* ; Humans ; Methods ; Oral Health* ; Tooth ; Toothbrushing

Holt-Oram Syndrome is an autosomal dominant disorder characterized by the association of upper-limb abnormalities and congenital heart disease. A woman with no family history of genetic disease underwent antenatal sonography at 27 weeks' menstrual age to screen for fetal anomalies. Ultrasonography revealed abnormalities in the upper limbs. The limb abnormalities included abscence of bilateral thumbs and radius: the left humus was short. Pregnancy termination was performed. The postnatal chromosomal analysis revealed a normal 46XX karyotype and the autopsy finding confirmed the Holt-Oram syndrome. We report a case of Holt-Oram Syndrome in fetus with unaffected parents with brief of the literatures.
Autopsy ; Extremities ; Female ; Fetus ; Heart Defects, Congenital ; Humans ; Karyotype ; Parents* ; Pregnancy ; Radius ; Soil ; Thumb ; Ultrasonography* ; Upper Extremity

PURPOSE: Leigh syndrome (LS) is a rare, progressive neurodegenerative disorder with characteristic abnormalities in the central nervous system. Such patients present with heterogeneous clinical symptoms and genetic abnormalities; thus, prognosis is difficult to anticipate. The present study investigates whether distinct patient characteristics are associated with mitochondrial DNA (mtDNA) mutation in LS patients. METHODS: We retrospectively analyzed data from patients diagnosed with LS at our hospital who were assessed using genomic sequencing of mtDNA. A subgroup analysis was performed to divide patients according to the mtDNA sequencing results. RESULTS: Among the 85 patients enrolled, 18 had mtDNA mutations. Most patients had lactic acidosis and a lactate/pyruvate ratio above 20, indicating respiratory chain abnormalities. In the subgroup analysis, the mutation group had a significantly higher female-to-male ratio, alanine level, ocular involvement, and midbrain and medulla abnormalities on magnetic resonance imaging (MRI). CONCLUSION: The subgroup analysis indicates that mtDNA sequencing is recommended for female patients, or those who exhibit ocular involvement, high alanine levels, or MRI findings with lesions in the midbrain and medulla.
Acidosis, Lactic ; Alanine ; Brain Stem ; Central Nervous System ; DNA, Mitochondrial* ; Electron Transport ; Female ; Humans ; Leigh Disease* ; Magnetic Resonance Imaging ; Mesencephalon ; Mitochondria ; Neurodegenerative Diseases ; Prognosis ; Retrospective Studies

OBJECTIVES: The purpose of this study was to identify the risk factors of metabolic syndrome (MS) and to analyze the relationship between the risk factors of MS and medical cost of major diseases related to MS in Korean workers, according to the scale of the enterprise. METHODS: Data was obtained from annual physical examinations, health insurance qualification and premiums, and health insurance benefits of 4,094,217 male and female workers who underwent medical examinations provided by the National Health Insurance Corporation in 2009. Logistic regression analyses were used to the identify risk factors of MS and multiple regression was used to find factors associated with medical expenditures due to major diseases related to MS. RESULT: The study found that low-income workers were more likely to work in small-scale enterprises. The prevalence rate of MS in males and females, respectively, was 17.2% and 9.4% in small-scale enterprises, 15.9% and 8.9% in medium-scale enterprises, and 15.9% and 5.5% in large-scale enterprises. The risks of MS increased with age, lower income status, and smoking in small-scale enterprise workers. The medical costs increased in workers with old age and past smoking history. There was also a gender difference in the pattern of medical expenditures related to MS. CONCLUSIONS: Health promotion programs to manage metabolic syndrome should be developed to focus on workers who smoke, drink, and do little exercise in small scale enterprises.
Female ; Health Expenditures ; Health Promotion ; Humans ; Insurance, Health ; Korea* ; Logistic Models ; Male ; National Health Programs ; Physical Examination ; Prevalence ; Risk Factors ; Smoke ; Smoking