PURPOSE: This study was conducted to identify effects of self-esteem, empathy and existential well-being on spiritual care competence in nursing students. METHODS: Participants were 357 nursing students from three colleges in G metropolitan city. The survey was conducted from March 11 to April 3, 2015, with a self-report questionnaire. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffe test, Pearson correlation coefficient and stepwise multiple regression analysis with SPSS version 21.0. RESULTS: Differences in spiritual care competence were statistically significant according to experience in providing spiritual care and recognition of need for spiritual care. There were significant differences in self-esteem, empathy and existential well-being according to satisfaction with major, satisfaction with life and recognition of the need for spiritual care. Spiritual care competence of nursing students showed a significantly positive correlation to self-esteem, empathy and existential well-being. Factors influencing spiritual care competence were recognition of need for spiritual care, self-esteem, empathy and experience in providing spiritual care, which explained about 16% of spiritual care competence. CONCLUSION: Results indicate the importance of developing an intervention program for nursing students to strengthen spiritual care competence through improved recognition of needs for spiritual care, self-esteem, empathy and experience in providing spiritual care.
Empathy* ; Humans ; Mental Competency* ; Nursing* ; Students, Nursing*

PURPOSE: The World Health Organization identifies spiritual care as a component of health and thus nursing care. There is a need to identify how self-esteem, communication and existential well-being affects spiritual care competence in nurses. METHODS: The participants were 189 nurses in G metropolitan city. The survey was conducted from March 21 to April 8, 2016, with a self-report questionnaire. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson correlation coefficient and stepwise multiple regression analysis using SPSS version 21.0. RESULTS: Differences in spiritual care competence were statistically significant according to education level, work department, position, having received spiritual care education, experience of providing spiritual care, experience of asking religionist to provide spiritual care for a patient and recognition of need for spiritual care. The spiritual care competence of nurses showed a significantly positive correlation with self-esteem, communication and existential well-being. Factors influencing spiritual care competence were communication, experience of providing spiritual care and existential well-being which explained about 37.5% of spiritual care competence. CONCLUSION: It's necessary for nurses to develop intervention programs to strengthen spiritual care competence through improving communication, providing opportunities for spiritual care and existential well-being.
Clinical Competence ; Education ; Humans ; Mental Competency* ; Nursing Care ; Self Concept ; World Health Organization

In this study, we developed MobileNurseTM; a prototype of mobile nursing information system using PDA. MobileNurseTM is designed to communicate with hospital information system(HIS) via mobile support station(MSS) which interchanges and stores clinical data. MobileNurseTM consists of 3 components. The first component is medical order checking module. It enables nurses to retrieve patients' information such as physicians' orders and test results at anywhere or anytime. The second component is nursing recording module which helps nurses to record the results of their practices at bedside. On the autosynchronization of MSS and PDA, the data in PDA and MSS can be interchanged and updated respectively. The last component is nursing unit care planing module. It is helpful for retrieving the nursing care plans of patients that are expected to be done, such as patients' discharge, consultation, or transfer. With use of PDA in clinical environment, nurses can spend more time on caring for patients by reducing time-consuming, redundant paperwork. It is promising that this 'point-of-care system enables nurses to improve the quality of nursing care.
Humans ; Information Systems* ; Nursing Care ; Nursing Records ; Nursing* ; Patient Care Planning

The Combitube is an emergency airway-maintaining device, which can supply oxygen to dyspneic patients in emergency situations following two-jaw surgery. These patients experience difficulty in opening the mouth or have a partially obstructed airway caused by edema or hematoma in the oral cavity. As such, they cannot maintain the normal airway. The use of a Combitube may be favorable compared to the laryngeal mask airway because it is a thin and relatively resilient tube. A healthy 24-year-old man was dyspneic after extubation. Oxygen saturation fell below 90% despite untying the bimaxillary fixation and ambubagging. The opening of the mouth was narrow; thus, emergency airway maintenance was gained by insertion of a Combitube. The following day, a facial computer tomography revealed that the airway space narrowing was severe compared to its pre-operational state. After the swelling subsided, the patient was successfully extubated without complications.
Airway Obstruction* ; Edema ; Emergencies ; Hematoma ; Humans ; Laryngeal Masks ; Mouth ; Oxygen ; Young Adult

This retrospective study included 222 dogs suspected to have tracheal collapse (TC) and examined between 1 January 2012 and 31 December 2015. Fluoroscopic and radiographic images and medical records were evaluated to investigate the fluoroscopic characteristics of TC and cervical lung herniation (CLH), and to determine their relationships to various influencing. Grade of TC, existence of tracheal kinking, location of CLH (right or left side), and grade of CLH were evaluated fluoroscopically. One hundred ninety-nine dogs (89.6%) were diagnosed with TC. Presence of TC was not associated with the patients' cough history; however, CLH was positively correlated with cough history (odds ratio [OR], 2.896; 95% confidence interval [CI], 1.556 to 5.390) and was affected by tracheal kinking (OR, 3.841; 95% CI, 1.884 to 7.831). Chronic cough was not related with CLH. Since TC can be observed in patients without a history of cough, presence of TC should be ruled out by using physical examination and diagnostic imaging. Although CLH is associated with a history of cough, it is a common appearance in dogs, and transient coughing can elicit CLH in patients without a history of cough.
Animals ; Cough ; Diagnostic Imaging ; Dogs* ; Fluoroscopy ; Humans ; Lung* ; Medical Records ; Physical Examination ; Retrospective Studies

Objectives: Artificial intelligence (AI) technologies are developing very rapidly in the medical field, but have yet to be actively used in actual clinical settings. Ensuring reliability is essential to disseminating technologies, necessitating a wide range of research and subsequent social consensus on requirements for trustworthy AI. Methods: This review divided the requirements for trustworthy medical AI into explainability, fairness, privacy protection, and robustness, investigated research trends in the literature on AI in healthcare, and explored the criteria for trustworthy AI in the medical field. Results: Explainability provides a basis for determining whether healthcare providers would refer to the output of an AI model, which requires the further development of explainable AI technology, evaluation methods, and user interfaces. For AI fairness, the primary task is to identify evaluation metrics optimized for the medical field. As for privacy and robustness, further development of technologies is needed, especially in defending training data or AI algorithms against adversarial attacks. Conclusions In the future, detailed standards need to be established according to the issues that medical AI would solve or the clinical field where medical AI would be used. Furthermore, these criteria should be reflected in AI-related regulations, such as AI development guidelines and approval processes for medical devices.

BACKGROUND: Postoperative nausea and vomiting (PONV) frequently occurs following bimaxillary orthognathic surgeries. Compared to opioids, Nefopam is associated with lower incidences of PONV, and does not induce gastrointestinal tract injury, coagulopathy, nephrotoxicity, or fracture healing dysfunction, which are common side effects of Nonsteroidal anti-inflammatory drugs. We compared nefopam- and fentanyl-induced incidence of PONV in patients with access to patient-controlled analgesia (PCA) following bimaxillary orthognathic surgeries. METHODS: Patients undergoing bimaxillary orthognathic surgeries were randomly divided into nefopam and fentanyl groups. Nefopam 120 mg or fentanyl 700 µg was mixed with normal saline to a final volume of 120 mL. Patients were given access to nefopam or fentanyl via PCA. Postoperative pain intensity and PONV were measured at 30 minutes and 1 hour after surgery in the recovery room and at 8, 24, 48, and 72 hours after surgery in the ward. The frequency of bolus delivery was compared at each time point. RESULTS: Eighty-nine patients were enrolled in this study, with 48 in the nefopam (N) group and 41 in the fentanyl (F) group. PONV occurred in 13 patients (27.7%) in the N group and 7 patients (17.1%) in the F group at 8 hours post-surgery (P = 0.568), and there were no significant differences between the two groups at any of the time points. VAS scores were 4.4 ± 2.0 and 3.7 ± 1.9 in the N and F groups, respectively, at 8 hours after surgery (P = 0.122), and cumulative bolus delivery was 10.7 ± 13.7 and 8.6 ± 8.5, respectively (P = 0.408). There were no significant differences in pain or bolus delivery at any of the remaining time points. CONCLUSION: Patients who underwent bimaxillary orthognathic surgery and were given nefopam via PCA did not experience a lower rate of PONV compared to those that received fentanyl via PCA. Furthermore, nefopam and fentanyl did not provide significantly different postoperative pain control.
Analgesia, Patient-Controlled ; Analgesics, Opioid ; Fentanyl ; Fracture Healing ; Gastrointestinal Tract ; Humans ; Incidence ; Nefopam ; Orthognathic Surgery ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Prospective Studies ; Recovery Room

Ureteral jets are the result of a forceful ejection of urine from the vesicoureteral junction into the urinary bladder. By using color Doppler ultrasonography (US), we aimed to identify distinct ureteral jets in dogs, provide insight into ureteral obstruction, and facilitate study of urodynamics and vesicoureteric sphincter function via pulsed Doppler US. Color Doppler US was applied to detect urinary flow from the right ureteral orifices in eight healthy beagles. Under anesthesia, 0.9% saline (2.5 mL/kg/h) and furosemide (0.5 mg/kg) were administered intravenously to assist in detection of distinct ureteral jets and examine their frequency, velocity, duration, and waveform. In all dogs, ureteral jets were visualized under diuresis and anesthesia within 2 to 5 min (mean 3.57 ± 0.90 min) of the furosemide injection. Mean frequency, peak velocity, and duration of right ureteral jets in seven dogs in whom six ureteral jet waveform patterns were identified were 9.86 ± 3.09 jets/min, 34.07 ± 10.02 cm/sec, and 2.82 ± 1.08 sec, respectively. During the 10 min period starting 10 min after the initial jet appeared, only three waveforms were identified. Color Doppler US of ureteral jets may aid in assessing vesicoureteric sphincter function and ureteral abnormalities, such as ureteral obstruction, in dogs.
Anesthesia ; Animals ; Diuresis ; Dogs* ; Furosemide ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Color* ; Ureter* ; Ureteral Obstruction ; Urinary Bladder ; Urodynamics

BACKGROUND: Periodic lateralized epileptiform discharges (PLEDs) are the main electroencephalograph (EEG) findings that imply the existence of acute or subacute structural lesions. The purpose of this study was to investigate the electrophysiologic characteristics of PLEDs by identifying the relationship between the current-source distribution (CSD) of PLEDs and the high signal intensity of diffusion-weighted magnetic resonance imaging (MRI; HSI-DWI) in viral encephalitis. METHODS: Six patients were enrolled. Twenty typical EEG, 1-s epochs, including the negative peak of the PLEDs, were averaged into an averaged-PLED (a-PLED). The CSD at the negative peak point of the a-PLED was located on the Talairach human brain map in each patient. The CSDs of the patients were compared with the anatomic locations of encephalitic lesions observed on diffusion-weighted MRI. RESULTS: In all patients, the locations with HSI-DWI were observed in the cortical areas. In two out of the six patients the locations of CSD and those of HSI-DWI were matched. In the other patients, they were partly matched. The matched areas were observed in the frontal, temporal, and parietal areas. The additional areas of CSD were in both insular areas, and those of HSI-DWI were in the frontal, temporal, parietal, and occipital areas. CONCLUSIONS: This study showed that the CSDs of PLEDs in viral encephalitis were mostly matched with the HSI-DWI in the cortical area of the frontal, temporal, and parietal areas. The cortical lesion itself in viral encephalitis may be part of the neural generator of PLEDs.
Brain ; Electroencephalography ; Encephalitis, Viral ; Humans ; Magnetic Resonance Imaging

BACKGROUND: The voltage topography of temporal spikes has two distinct patterns, designated type I and type II; the orientation of the current-dipole source (O-CDS) of type I spikes tends to be oblique, while that of type II spikes tends to be horizontal. The purpose of this study was to identify the effects of the O-CDS of anterior temporal spikes on clinical factors including onset age, seizure frequency, secondary generalization, disease duration, intractability, polytherapy, febrile seizure, hippocampal sclerosis, and neocortical-temporal aura. METHODS: We examined the scalp electroencephalograms of 24 patients with temporal lobe epilepsy (TLE) and anterior temporal spikes. A spatiotemporal dipole model was applied to determine the O-CDS of the averaged spikes in each patient. We performed current-source analysis of multiple spatiotemporal dipole models using Brain Electrical Source Analysis software. The patients were divided into two subgroups according to their O-CDS pattern: oblique and horizontal. Clinical factors were compared between the two groups. RESULTS: Sixteen patients were classified into the oblique group, and 8 patients into the horizontal group. A neocortical-temporal aura was more commonly observed in the horizontal group (p<0.05), while drug-resistance tendencies were more commonly observed in the oblique group (p<0.1). CONCLUSIONS: The horizontal O-CDS of anterior temporal spikes may be more frequently associated with a neocortical-temporal aura than the oblique O-CDS in TLE. In addition, the oblique O-CDS pattern suggests a tendency toward drug resistance. The findings of this study imply that the oblique O-CDS pattern of anterior temporal spikes may provide additional electrophysiologic information regarding drug-resistant mesial TLE.
Age of Onset ; Brain ; Drug Resistance ; Electroencephalography ; Epilepsy ; Epilepsy, Temporal Lobe ; Generalization (Psychology) ; Humans ; Orientation ; Scalp ; Sclerosis ; Seizures ; Seizures, Febrile