PURPOSE: The purpose of this study was to identify the correlation of critical thinking disposition and problem solving process, and the simulation-based assessment of clinical competence based on a survey of college nursing students. METHODS: In this descriptive correlation study, data for 214 nursing students were analyzed using t-test and Pearson correlation coefficients. RESULTS: Critical thinking disposition, problem solving process, and simulation-based assessment of clinical competence averaged 3.76+/-0.46 (out of 5), 3.67+/-0.47 (5), and 1.51+/-0.17 (2), respectively. A significant difference in scores for simulation-based assessment of clinical competence was found between the high-scoring group and low-scoring group in critical thinking disposition. A significant positive correlation was found between critical thinking disposition and nursing assessment, a sub-domain of clinical competence. CONCLUSION: The results suggest that success in simulation-based learning requires critical thinking disposition in the nursing students, and their critical thinking disposition plays a positive role in nursing assessment, which evaluates the patient's status in a complex situation. Simulation-based learning programs help assess the students' levels in their clinical judgement and performance, and identify their strengths and weaknesses so that the instructor can evaluate and improve the current teaching method.
Clinical Competence* ; Humans ; Learning ; Nursing Assessment ; Pediatric Nursing* ; Problem Solving* ; Statistics as Topic ; Students, Nursing* ; Teaching ; Thinking*

PURPOSE: The purpose of this study was to identify the effects of an educational intervention by evaluating neonatal emergency airway management knowledge, critical thinking disposition, problem- solving ability, and confidence in clinical performance after developing and operating a simulation-based neonatal emergency airway management education program for nurses in a neonatal intensive care unit.METHODS: The participants were 30 nurses in a neonatal intensive care unit. Data were collected from June 6 to 15, 2018 and analyzed using IBM SPSS version 22.0.RESULTS: The results of the pretest and posttest for each educational group showed statistically significant improvements in neonatal emergency airway management knowledge, critical thinking, problem- solving ability, and confidence in clinical performance.CONCLUSION: The simulation-based neonatal emergency airway management training program was an effective educational program that enhanced neonatal emergency airway management knowledge, critical thinking disposition, problem-solving ability, and confidence in clinical performance among nurses in a neonatal intensive care unit. Therefore, it is suggested that the program described in this study can contribute to improving nursing quality by enhancing the ability of nurses to cope with emergencies in practice. It can also be used for education for new nurses and contribute to the development of nurses' practices.
Airway Management ; Education ; Emergencies ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Nursing ; Patient Simulation ; Thinking

PURPOSE: The purpose of this study was to examine the effects of a virtual reality simulation and a blended simulation on nursing care for children with asthma through an evaluation of critical thinking, problem-solving processes, and clinical performance in both education groups before and after the educational intervention.METHODS: The participants were 48 nursing students. The experimental group (n=22) received a blended simulation, combining a virtual reality simulation and a high-fidelity simulation, while the control group (n=26) received only a virtual reality simulation. Data were collected from February 25 to 28, 2019 and analyzed using SPSS version 25 for Windows.RESULTS: The pretest and posttest results of each group showed statistically significant improvements in critical thinking, problem-solving processes, and clinical performance. In a comparison of the results of the two education groups, the only statistically significant difference was found for critical thinking.CONCLUSION: Simulation-based education in child nursing has continued to involve high-fidelity simulations that are currently run in many programs. However, incorporating a new type of blended simulation, combining a virtual reality simulation and a high-fidelity simulation, into the nursing curriculum may contribute to the further development of nursing education.
Asthma ; Child ; Computer User Training ; Curriculum ; Education ; Education, Nursing ; Humans ; Nursing ; Nursing Care ; Patient Simulation ; Pediatric Nursing ; Students, Nursing ; Thinking

Xylitol is well-known to have an anti-caries effect by inhibiting the replication of cariogenic bacteria. In addition, xylitol enhances saliva secretion. However, the precise molecular mechanism of xylitol on saliva secretion is yet to be elucidated. Thus, in this study, we aimed to investigate the stimulatory effect of xylitol on saliva secretion and to further evaluate the involvement of xylitol in muscarinic type 3 receptor (M3R) signaling. For determining these effects, we measured the saliva flow rate following xylitol treatment in healthy individuals and patients with dry mouth. We further tested the effects of xylitol on M3R signaling in human salivary gland (HSG) cells using real-time quantitative reverse-transcriptase polymerase chain reaction, immunoblotting, and immunostaining. Xylitol candy significantly increased the salivary flow rate and intracellular calcium release in HSG cells via the M3R signaling pathway. In addition, the expressions of M3R and aquaporin 5 were induced by xylitol treatment. Lastly, we investigated the distribution of M3R and aquaporin 5 in HSG cells. Xylitol was found to activate M3R, thereby inducing increases in Ca²⁺ concentration. Stimulation of the muscarinic receptor induced by xylitol activated the internalization of M3R and subsequent trafficking of aquaporin 5. Taken together, these findings suggest a molecular mechanism for secretory effects of xylitol on salivary epithelial cells.
Aquaporin 5 ; Bacteria ; Calcium ; Calcium Signaling ; Candy ; Epithelial Cells ; Humans ; Immunoblotting ; Mouth ; Polymerase Chain Reaction ; Receptors, Muscarinic ; Saliva ; Salivary Glands ; Xylitol

Topical epinephrine is useful to reduce bleeding during skin grafting. However, even though a clear operative field is obtained, systemic absorption of topical epinephrine can occur and this may cause severe hypertension, arrhythmias, ventricular tachycardia, myocardial ischemia, pulmonary edema, or cardiac arrest. We managed a case of cardiac arrhythmia during general anesthesia, which was induced by gauze soaked in topical epinephrine used for skin grafting of burn wounds. A 26-year-old woman developed premature ventricular complexes and ventricular tachycardia during surgery when epinephrine-soaked gauze was applied to the skin donor and burn wound sites to control oozing. The patient was resuscitated immediately and within 10 minutes the vital signs had normalized. It is recommended that caution is exercised when epinephrine-soaked gauze is applied to a large area of skin.
Absorption ; Adult ; Anesthesia, General ; Arrhythmias, Cardiac ; Burns ; Epinephrine ; Female ; Heart Arrest ; Hemorrhage ; Humans ; Hypertension ; Myocardial Ischemia ; Pulmonary Edema ; Skin ; Skin Transplantation ; Tachycardia, Ventricular ; Tissue Donors ; Ventricular Premature Complexes ; Vital Signs

PURPOSE: This descriptive study was performed to explore trends in child health nursing research by analyzing the themes, contents and structure of articles published in 2014 in Child Health Nursing Research, the official journal of the Korean Academy of Child Health Nursing. METHODS: Thirty-eight articles were reviewed using keywords, author (s), subjects, ethical considerations, designs, statistics involved, funding resources, and others. RESULTS: Ten domains from 160 keywords were identified as follows, child related, psycho-social variable related, parents and family related, nursing and health related, and others. A mean of 2.9 authors per article was identified and 71% of the authors were academic- affiliated. Twenty-eight articles were human-participant related while 21 articles addressed both Institutional Review Board and written consent. Non-experimental design was the most commonly used method followed by experimental design, and qualitative design. The duration for acceptance was a mean of 89.1 days from submission with most articles requiring a second round of article review. Half of the articles were supported by grant organizations such as Korean National Research Foundation. CONCLUSION: The findings of the analysis show an improvement in the scientific quality with a diversity of articles in Child Health Nursing Research.
Child ; Child Welfare* ; Child* ; Ethics Committees, Research ; Financial Management ; Financing, Organized ; Humans ; Nursing Research* ; Nursing* ; Parents ; Publications ; Research Design

We investigated the cutoff values of surrogate of insulin resistance for diagnosing metabolic syndrome in Korean adults. The data from 976 non-diabetic individuals (484 men and 492 women) aged 30-79 yr were analyzed. We determined the odds ratios for the prevalence of metabolic syndrome according to the quartiles of fasting insulin, homeostasis model for insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) as independent variables, while adjusting for age, sex, and body mass index. The cutoff values of fasting insulin, HOMA-IR, and QUICKI were estimated by the areas under the receiver-operating characteristic (ROC) curves. The cutoff points for defining insulin resistance are a fasting insulin level of 12.94 micro U/mL, HOMA-IR=3.04 as the 75th percentile value, and QUICKI=0.32 as the 25th percentile value. Compared with the lowest quartile, the adjusted odds ratios for the prevalence of metabolic syndrome in the highest quartiles of fasting insulin, HOMA-IR, and QUICKI were 1.95 (1.26-3.01), 2.27 (1.45-3.56), and 2.27 (1.45-3.56), respectively. The respective cutoff values for fasting serum insulin, HOMA-IR, and QUIC-KI by ROC analysis were 10.57 micro U/mL (sensitivity 58.5%, specificity 66.8%), 2.34 (sensitivity 62.8%, specificity 65.7%), and 0.33 (sensitivity 61.2%, specificity 66.8%). Fasting insulin, HOMA-IR, and QUICKI can be used as surrogate measures of insulin resistance in Korean non-diabetic adults.
Triglycerides/blood ; Predictive Value of Tests ; Multivariate Analysis ; Middle Aged ; Metabolic Syndrome X/*blood/diagnosis/physiopathology ; Male ; Korea ; *Insulin Resistance ; Insulin/*blood ; Humans ; Female ; Fasting/blood ; Diabetes Mellitus/blood/physiopathology ; Cholesterol, HDL/blood ; Cholesterol/blood ; Blood Pressure/physiology ; Blood Glucose/analysis ; Aged ; Adult

Multisystem inflammatory disease in children is a Kawasaki disease like illness occurring after severe acute respiratory syndrome coronavirus 2 infection in children. As the pandemic progresses, similar syndromes were also reported in adult with a decreased incidence.Multisystem inflammatory syndrome in adults (MIS-A) can be characterized with shock, heart failure, and gastrointestinal symptoms with elevated inflammatory markers after coronavirus disease 2019 (COVID-19) infection. Herein, we describe the first case of MIS-A in South Korea. A 38-year-old man presented to our hospital with a 5-day history of abdominal pain and fever. He had been treated with antibiotics for 5 days at the previous hospital, but symptoms had worsened and he had developed orthopnea on the day of presentation.He suffered COVID-19 six weeks ago. Laboratory data revealed elevated white blood cell counts with neutrophil dominance, C-reactive protein, and B-type natriuretic peptide. Chest X-ray showed normal lung parenchyme and echocardiography showed severe biventricular failure with normal chamber size. We diagnosed him as MIS-A and treated with intravenous immunoglobulin and steroid.

Multisystem inflammatory disease in children is a Kawasaki disease like illness occurring after severe acute respiratory syndrome coronavirus 2 infection in children. As the pandemic progresses, similar syndromes were also reported in adult with a decreased incidence.Multisystem inflammatory syndrome in adults (MIS-A) can be characterized with shock, heart failure, and gastrointestinal symptoms with elevated inflammatory markers after coronavirus disease 2019 (COVID-19) infection. Herein, we describe the first case of MIS-A in South Korea. A 38-year-old man presented to our hospital with a 5-day history of abdominal pain and fever. He had been treated with antibiotics for 5 days at the previous hospital, but symptoms had worsened and he had developed orthopnea on the day of presentation.He suffered COVID-19 six weeks ago. Laboratory data revealed elevated white blood cell counts with neutrophil dominance, C-reactive protein, and B-type natriuretic peptide. Chest X-ray showed normal lung parenchyme and echocardiography showed severe biventricular failure with normal chamber size. We diagnosed him as MIS-A and treated with intravenous immunoglobulin and steroid.