PURPOSE: The purpose of this study was to explore perioperative nurses' communication experience within the surgical team with regard to patient safety. METHODS: Data were collected from December 2015 to September 2016, through in-depth individual interviews with 14 perioperative nurses. Individual interviews, once or twice, lasted from 40 minutes to one hour for each session. The main interview question was “How do you describe your communication experience with surgical team members as a perioperative nurse?” Collected data were analyzed using a conventional content analysis. RESULTS: Two categories of the perioperative nurses' experience of communication were identified: communication contributing to patient safety, communication hindering patient safety. Communication in the surgical team reflected on the unique features of the operating room, such as urgency and a hierarchical organizational culture. However, the nurses recognized ineffective communication could impact on patient safety, and endeavored to overcome communication failures. CONCLUSION: The results indicate that sharing responsibility, open communication, assertiveness on safety issues, and interprofessional collaboration in the operating room are necessary to ensure effective communication. Thus, respectful culture and an open communication climate based on interprofessional understanding are required to improve communication. Training programs to enhance communication skills should be implemented.
Assertiveness ; Climate ; Cooperative Behavior ; Education ; Humans ; Operating Rooms ; Organizational Culture ; Patient Safety ; Qualitative Research

Purpose: This study was done to examine the effects of auricular acupressure (AA) on blood pressure (BP) and stress responses in adults with prehypertension. Methods: This single-blind, randomized, placebo-controlled study was conducted from September 2019 to February 2020. Participants were recruited through bulletin board notices in D city. The experimental group (n=27) received 8 weeks of AA intervention on specific acupoints (shenmen, kidney, heart, occiput, adrenal gland) to reduce blood pressure and stress, whereas the control group (n=25) received AA unspecific acupoints (helix 1-5). The outcomes were measured using BP, perceived stress scale (PSS), cortisol, and heart rate variability (HRV). Collected data were analyzed using Fisher’s exact test, chi-square, Shapiro-Wilk normality test, paired t-test, independent t-test, Mann-Whitney U test, repeated measures ANOVA and Friedman test with the SPSS/WIN 24.0. Results: Statistical differences were found between the groups for systolic BP (x2=85.64, p<.001), diastolic BP (x2=27.76, p=.001), PSS (F=9.439, p=.003), low frequency (F=5.22, p=.027), heart rate (F=3.208, p=.045), and HRV index (F=3.579, p=.035). Cortisol did not differ significantly between the experimental group and control group. Conclusion The findings show that AA leads to improvements in BP and stress responses in adults with prehypertension. Therefore, AA can be used as an alternative nursing intervention for hypertension prevention and stress management.

Purpose: This study aimed to develop an educational informatics system for nursing faculty to improve their competencies in teaching patient safety and to evaluate the effectiveness of the system. Methods: We developed a system called, ‘Resource to Enhance Safety Competency and Utilize for Education’ (RESCUE) based on the World Health Organization Multi-professional Patient Safety Curriculum Guide, and it was implemented with full-time nursing faculty in 4-year nursing schools. A one-group pretest-posttest design was used for evaluation. A total of 46 nursing faculty members used the system during a 3-month period. The effects of the RESCUE were measured using a survey including patient safety teaching competency, system usability and user satisfaction. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. Results: After using the RESCUE, participants showed a significant increase in self-confidence in teaching patient safety during lectures (Z=-3.61, p<.001) and practica (Z=-3.14, p=.002). Conclusion The developed informatics system was shown to be effective in improving the self-confidence of nursing faculty in teaching patient safety. To effectively integrate patient safety topics into the curriculum, it can be helpful to utilize the educational materials provided in this study with various clinical cases.

PURPOSE: The purpose of this study was to investigate patient safety teaching competency of nursing faculty and the extent of teaching patient safety topics in the nursing curriculum. METHODS: A national survey was conducted with full-time nursing faculty in 4-year nursing schools. Regional quota sampling method was used. An online survey was sent to 1,028 nursing faculty and 207 of them were completed. Among the 207, we analyzed data from 184 participants. The revised Health Professional Education in Patient Safety Survey was used. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation analysis, and multiple linear regression analyses. RESULTS: The faculty's self-confidence was lower than their perceived importance of patient safety education. The mean score of teaching patient safety was 3.52±0.67 out of 5, and the contents were mostly delivered through lectures. The extent of faculty's teaching varied depending on faculty's clinical career, teaching subjects, participation in practicum courses, and previous experience of patient safety education. The significant predictors of the extent of teaching patient safety were the faculty's self-confidence in teaching patient safety (β=.39) during clinical practicum, their perceived importance of patient safety education during lectures (β=.23), and the teaching subject (β=.15). CONCLUSION: To enhance the competency of nursing faculty for effective patient safety education, a patient safety education program tailored to faculty characteristics should be developed and continuously provided for faculty. In addition, it is necessary to improve patient safety curriculum, strengthen clinical and school linkages, and utilize various education methods in patient safety education.
Curriculum ; Education ; Education, Nursing ; Faculty, Nursing* ; Health Occupations ; Humans ; Lectures ; Linear Models ; Methods ; Nursing* ; Patient Safety* ; Preceptorship ; Professional Competence ; Schools, Nursing

No abstract available.
Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group/*genetics ; Child ; Chromosomes, Human, Pair 6 ; Female ; Humans ; Infant ; Leukemia, Myeloid, Acute/*genetics/pathology ; Male ; Middle Aged ; Republic of Korea ; *Trisomy ; Young Adult

Cyberlindnera fabianii (previously known as Hansenula fabianii, Pichia fabianii, and Lindnera fabianii) is a yeast species that forms a biofilm, allowing it to resist azole drugs. In this study, we report a case of fungemia with C. fabianii that was successfully treated with anidulafungin. In this case, the organism was initially misidentified as Candida utilis (with a high probability of 93%, suggesting good identification) using the VITEK 2 yeast identification card (YST ID; bio-Merieux, USA). The species responsible for the patient's fungemia was correctly identified after sequencing the internally transcribed spacer region and the D1/D2 domain of the large subunit (26S) rDNA gene. The CLSI M27-A3 broth microdilution method was used to determine the in vitro antifungal activity of anidulafungin and fluconazole against C. fabianii. The MICs of anidulafungin and fluconazole were found to be 0.03 microg/mL and 2 microg/mL, respectively. The patient recovered after 14 days of anidulafungin treatment.
Biofilms ; Candida ; Danazol ; DNA, Ribosomal ; Fluconazole ; Fungemia* ; Humans ; Pichia ; Yeasts

Present study was performed to delineate the inter-relationship among neuronal death, mossy fiber sprouting (MFS) and neurogenesis in hippocampal formation of pilocarpine-treated mice. Status epilepticus was induced by intraperitoneal administration of 300 mg/kg pilocarpine in male ICR and C57BL/6 mouse. The severity of seizure was evaluated using 5 grades of Racine scales for first 4 hr after pilocarpine injection. Fluro-Jade C (FJC) staing, NeoTimm's staining and immunohistochemistry for BrdU were employed to evaluate neuronal cell death, MFS and neurogenesis, respectively. All animals in the present study induced seizures over grade 3 of Racine scale by pilocarpine injection. ICR mice show higher seizure severity (mean Racine scale; 4.37) than C57BL/6 mice do (mean Racine scale; 3.22), while the latency times for the first seizure over Racine scale grade 3 are from 15 min to 20 min and showed no difference between the 2 strains. In ICR mouse, numerous FJC-positive cells in hilus of hippocampus were detected at 4 h after pilocarpine injection, while they were not detected at that time in C57BL/6 mouse. The number of FJC-positive neuronal cells, which were densely found in the pyramidal layer of CA1, CA3 and hilus polymorphic regions of hippocampus, reached peak at 3 days after injection and then few cells were found at 7 days after injection in both strains. In control animals, BrdU positive cells in dentate subgranular layer which represent the hippocampal neurogenesis were more numerous in C57BL/6 than in ICR. The number of BrdU positive cells significantly increased at 2 days after pilocarpine injection and reached the peak at 8 days after injection and returned to control level at 15 day after injection in both strains. The percent increase of the BrdU positive cell was more prominent in ICR mouse. MFS was found at 2 weeks after the injection and the intensity of MFS was getting strong at 4 weeks after injection. There was no differences in MFS grading between 2 strains. These results suggest that there are some inter-relationships among the seizure severity, hippocampal neuronal cell death and hippocampal neurogenesis, but they don't have any significant relationships with the mossy fiber sprouting from dentate granule cells.
Animals ; Bromodeoxyuridine ; Cell Death ; Hippocampus ; Humans ; Immunohistochemistry ; Male ; Mice ; Mice, Inbred ICR ; Neurogenesis ; Neurons ; Pilocarpine ; Seizures ; Status Epilepticus ; Weights and Measures

Valproic acid (VPA) is a well-known anti-epileptic and mood stabilizing drug. A growing number of reports demonstrate that VPA is neuroprotective against various insults. Despite intensive efforts to develop new therapeutics for stroke over the past two decades, all treatments have thus far failed to show clinical effect because of treatment-limiting side effects of the drugs. Therefore, a safety-validated drug like VPA would be an attractive candidate if it has neuroprotective effects against ischemic insults. The present study was undertaken to examine whether pre- and post-insult treatments with VPA protect against brain infarct and neurological deficits in mouse transient (tMCAO) and permanent middle cerebral artery occlusion (pMCAO) models. In the tMCAO (2 hr MCAO and 22 hr reperfusion) model, intraperitoneal injection of VPA (300 mg/kg, i.p.) 30 min prior to MCAO significantly reduced the infarct size and the neurological deficit. VPA treatment immediately after reperfusion significantly reduced the infarct size. The administration of VPA at 4 hr after reperfusion failed to reduce the infarct size and the neurological deficit. In the pMCAO model, treatment with VPA (300 mg/kg, i.p.) 30 min prior to MCAO significantly attenuated the infarct size, but did not affect the neurological deficit. Western blot analysis of acetylated H3 and H4 protein levels in extracts from the ischemic cortical area showed that treatment with VPA increased the expression of acetylated H3 and H4 at 2 hrs after MCAO. These results demonstrated that treatment with VPA prior to ischemia attenuated ischemic brain damage in both mice tMCAO and pMCAO models and treatment with VPA immediately after reperfusion reduced the infarct area in the tMCAO model. VPA could therefore be evaluated for clinical use in stroke patients.
Animals ; Blotting, Western ; Brain ; Brain Ischemia ; Histone Deacetylase Inhibitors ; Humans ; Infarction, Middle Cerebral Artery ; Injections, Intraperitoneal ; Ischemia ; Mice ; Neuroprotective Agents ; Reperfusion ; Stroke ; Valproic Acid

30 mg/g), the concordance rate, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of UACR, analyzed using MEDITAPE UC-11A, were 80.5, 97.5, 67.0, 70.3, and 97.1%, respectively. Using UPCR, analyzed via quantitative assay, as a reference to estimate proteinuria (UPCR >0.15 g/g), the concordance rate, sensitivity, specificity, PPV, and NPV of UPCR, analyzed using MEDITAPE UC-11A, were 86.7, 94.4, 81.5, 77.6, and 95.6%, respectively.CONCLUSIONS: UACR and UPCR, analyzed using MEDITAPE UC-11A, exhibited relatively high sensitivity and NPV, which is beneficial for laboratory screening for both albuminuria and proteinuria.]]>
Albuminuria ; Chronic Disease ; Humans ; Hypertension ; Kidney Diseases ; Mass Screening ; Proteinuria ; Renal Insufficiency, Chronic ; Sensitivity and Specificity

Primary thyroid cancers including papillary, follicular, poorly differentiated, and anaplastic carcinomas show substantial differences in biological and clinical behaviors. Even in the same pathological type, there is wide variability in the clinical course of disease progression. The molecular carcinogenesis of thyroid cancer has advanced tremendously in the last decade. However, specific inhibition of oncogenic pathways did not provide a significant survival benefit in advanced progressive thyroid cancer that is resistant to radioactive iodine therapy. Accumulating evidence clearly shows that cellular energy metabolism, which is controlled by oncogenes and other tumor-related factors, is a critical factor determining the clinical phenotypes of cancer. However, the role and nature of energy metabolism in thyroid cancer remain unclear. In this article, we discuss the role of cellular energy metabolism, particularly mitochondrial energy metabolism, in thyroid cancer. Determining the molecular nature of metabolic remodeling in thyroid cancer may provide new biomarkers and therapeutic targets that may be useful in the management of refractory thyroid cancers.
Carcinogenesis ; Carcinoma ; Disease Progression ; Energy Metabolism* ; Iodine ; Mitochondria ; Oncogenes ; Phenotype ; Thyroid Gland* ; Thyroid Neoplasms ; Biomarkers