PURPOSE: This study was performed to identify the effects of self-leadership and job involvement on clinical competence in general hospital nurses. METHODS: The participants in this study were 443 staff nurses working in general hospitals and having more than 6 months of nursing experience. Data were collected using self-administered questionnaires. RESULTS: There were significant positive correlations between nurses' self-leadership and job involvement, and between nurses' self-leadership and clinical competence. In the multiple regression analysis, clinical career, type of department and self-leadership were significant predictors in explaining nurses' clinical competence and accounted for 28% of the variance in nurses' clinical competence. CONCLUSION: Study findings suggest that nurses' self-leadership is defined as having an important influence on nurses' clinical competence. In order to strengthen nurses' clinical competence, there is a need to develop education programs to increase nurses' self-leadership.
Clinical Competence ; Hospitals, General

Background and Objectives: Although the digit-in-noise (DIN) test is simple and quick, little is known about its key factors. This study explored the considerable components of the DIN test through a systematic review and meta-analysis. Materials and Methods: After six electronic journal databases were screened, 14 studies were selected. For the meta-analysis, standardized mean difference was used to calculate effect sizes and 95% confidence intervals. Results: The overall result of the meta-analysis showed an effect size of 2.224. In a subgroup analysis, the patient’s hearing status was found to have the highest effect size, meaning that the DIN test was significantly sensitive to screen for hearing loss. In terms of the length of the presenting digits, triple digits had lower speech recognition thresholds (SRTs) than single or pairs of digits. Among the types of background noise, speech-spectrum noise provided lower SRTs than multi-talker babbling. Regarding language variance, the DIN test showed better performance in the patient’s native language(s) than in other languages. Conclusions When uniformly developed and well validated, the DIN test can be a universal tool for hearing screening.

BACKGROUND: Recent studies have suggested that implantation site intermediate trophoblasts (ISITs) and chorionic type intermediate trophoblasts (CTITs) show different immunohistochemical findings, and that each type has specific location in placentas. However, we observed that both subtypes are intimately admixed in many areas of the placentas and both types are proliferated around the infarcts. METHODS: In order to examine the site specificity in their distribution and the changes of intermediate trophoblasts (ITs), if any, in the pre-eclamptic placentas, quantitative analyses of ISITs and CTITs using p63, CD146, placental alkaline phosphatase, human placental lactogen, and alpha-inhibin were performed in normal and pre-eclamptic placentas containing infarcts. RESULTS: In the fetal membranes of both normal and pre-eclamptic placentas, CTITs and ISITs were equally identified, forming distinct layers. ISITs were predominant in the intervillous septum and basal plate, while CTITs were predominant in the subchorionic area. At the margin of infarcts in pre-eclamptic placentas, both subtypes were increased in number, forming distinct layers. CONCLUSIONS: The subtypes of ITs do not have site specificity in placentas. Increased number of ITs and zonal distribution around infarcts suggest that CTITs and ISITs have differentiation associated relationship, and the differentiation might be related to the microenvironment of placenta, such as intraplacental oxygen concentration.
Alkaline Phosphatase ; Chorion ; Extraembryonic Membranes ; Fluconazole ; Immunohistochemistry ; Inhibins ; Oxygen ; Placenta ; Placental Lactogen ; Pre-Eclampsia ; Sensitivity and Specificity ; Trophoblasts

PURPOSE: Clinical competence among nurses is an essential requirement for the provision of safe and effective patient care. This study aims to classify types of professional quality of life experienced by Korean nurses, and examine the relationship between demographic and professional characteristics and clinical competence among nurses experiencing each type. METHODS: A total of 335 nurses completed questionnaires assessing professional quality of life, clinical competence, and demographic and professional characteristics. Following identification of the underlying factors of professional quality of life, we classified participants into three clusters. RESULTS: There were significant differences in age, marital status, religion, educational status, and position between clusters. Results also revealed that nurses with high compassion satisfaction and low compassion fatigue (burnout, secondary traumatic stress) tended to have higher clinical competence. CONCLUSIONS: This study demonstrated that it is possible to directly examine the relationship between professional quality of life level and clinical competence among nurses. Thus, interventions to increase nurses' compassion satisfaction and relieve compassion fatigue are needed, as professional quality of life may affect clinical competence.
Adult ; *Attitude of Health Personnel ; *Clinical Competence ; Cross-Sectional Studies ; Female ; Humans ; Job Satisfaction ; Male ; Middle Aged ; Nurses/*psychology ; *Quality of Life ; Republic of Korea ; *Stress, Psychological ; Young Adult

BACKGROUND: Compared to an equivalent sized polyvinyl chloride (PVC) double-lumen tube (DLT), a silicone DLT has a shorter endobronchial segment. The aim of this study was to compare the incidence of clinically significant displacement of left-sided PVC and silicone DLTs after a positional change to a lateral position from a supine position and determine its effect on the need for DLT repositioning for successful lung separation in patients undergoing thoracic surgery. METHODS: One hundred eight adult patients requiring one-lung ventilation were randomly divided into group P (PVC DLT, n = 54) and group S (Silicone DLT, n = 54). The position of the DLT was observed before and after lateral positioning to assess the effect of the position change. The incidence of clinically significant displacement (>10 mm) of DLT was compared between the groups. RESULTS: DLTs were clinically significantly displaced in group P (17/48, 35.4%) and group S (18/52, 34.6%) after lateral positioning (p = 0.933). A proximal displacement (31.3% [group P] and 25.0% [group S]) was more common than distal displacement (4.2% [group P] and 9.6% [group S]), with no significant intergroup difference (p = 0.494). After lateral positioning, critical malposition of DLT with bronchial herniation to the right main bronchus was 8.3% (group P) and 7.9% (group S, p = 0.906). CONCLUSION: Left-sided PVC and silicone DLTs produced comparable incidences of clinically significant displacement and, consequently, required similar rates of repositioning for successful lung separation after lateral positioning.
Adult ; Bronchi ; Bronchoscopy ; Humans ; Incidence ; Intubation, Intratracheal ; Lung ; One-Lung Ventilation ; Polyvinyl Chloride ; Polyvinyls ; Posture ; Silicon ; Silicones ; Supine Position ; Thoracic Surgery ; Thoracic Surgical Procedures

BACKGROUND: Compared to an equivalent sized polyvinyl chloride (PVC) double-lumen tube (DLT), a silicone DLT has a shorter endobronchial segment. The aim of this study was to compare the incidence of clinically significant displacement of left-sided PVC and silicone DLTs after a positional change to a lateral position from a supine position and determine its effect on the need for DLT repositioning for successful lung separation in patients undergoing thoracic surgery. METHODS: One hundred eight adult patients requiring one-lung ventilation were randomly divided into group P (PVC DLT, n = 54) and group S (Silicone DLT, n = 54). The position of the DLT was observed before and after lateral positioning to assess the effect of the position change. The incidence of clinically significant displacement (>10 mm) of DLT was compared between the groups. RESULTS: DLTs were clinically significantly displaced in group P (17/48, 35.4%) and group S (18/52, 34.6%) after lateral positioning (p = 0.933). A proximal displacement (31.3% [group P] and 25.0% [group S]) was more common than distal displacement (4.2% [group P] and 9.6% [group S]), with no significant intergroup difference (p = 0.494). After lateral positioning, critical malposition of DLT with bronchial herniation to the right main bronchus was 8.3% (group P) and 7.9% (group S, p = 0.906). CONCLUSION Left-sided PVC and silicone DLTs produced comparable incidences of clinically significant displacement and, consequently, required similar rates of repositioning for successful lung separation after lateral positioning.

Background and Objectives: The purpose of the present study was to validate the performance and diagnostic efficacy of the Korean digits-in-noise (K-DIN) test in comparison to the Korean speech perception-in-noise (K-SPIN) test, which is the representative speech-in-noise test in clinical practice. Subjects and Methods: Twenty-seven subjects (15 normal-hearing and 12 hearing-impaired listeners) participated. The recorded Korean 0-9 digits were used to form quasirandom digit triplets; 50 target digit triplets were presented at the most comfortable level of each subject while presenting speech-shaped background noise at various levels of signal-to-noise ratios (-12.5, -10, -5, or +5 dB). Subjects were then instructed to listen to both target and noise masker unilaterally and bilaterally through a headphone. K-SPIN test was also conducted using the same procedure as the K-DIN. After calculating their percent correct responses, K-DIN and K-SPIN results were compared using a Pearson-correlation test. Results: Results showed a statistically significant correlation between K-DIN and K-SPIN in all hearing conditions (left: r=0.814, p<0.001; right: r=0.788, p<0.001; bilateral: r=0.727, p<0.001). Moreover, the K-DIN test achieved better testing efficacy, shorter average listening time (5 min vs. 30 min), and easier performance of task according to participants’ qualitative reports than the K-SPIN test. Conclusions In this study, the Korean version of digit triplet test was validated in both normal-hearing and hearing-impaired listeners. The findings suggest that the K-DIN test can be used as a simple and time-efficient hearing-in-noise test in audiology clinics in Korea.

Background and Objectives: The digits-in-noise (DIN) test was developed as a simple and time-efficient hearing-in-noise test worldwide. The Korean version of the DIN (K-DIN) test was previously validated for both normal-hearing and hearing-impaired listeners. This study aimed to explore the factors influencing the outcomes of the K-DIN test further by analyzing the threshold (representing detection ability) and slope (representing test difficulty) parameters for the psychometric curve fit. Subjects and Methods: In total, 35 young adults with normal hearing participated in the K-DIN test under the following four experimental conditions: 1) background noise (digit-shaped vs. pink noise); 2) gender of the speaker (male vs. female); 3) ear side (right vs. left); and 4) digit presentation levels (55, 65, 75, and 85 dB). The digits were presented using the method of constant stimuli procedure. Participant responses to the stimulus trials were used to fit a psychometric function, and the threshold and slope parameters were estimated according to pre-determined criteria. The accuracy of fit performance was determined using the root-mean-square error calculation. Results: The listener’s digit detection ability (threshold) was slightly better with pink noise than with digit-shaped noise, with similar test difficulties (slopes) across the digits. Gender and the tested ear side influenced neither the detection ability nor the task difficulty. Additionally, lower presentation levels (55 and 65 dB) elicited better thresholds than the higher presentation levels (75 and 85 dB); however, the test difficulty varied slightly across the presentation levels. Conclusions The K-DIN test can be influenced by stimulus factors. Continued research is warranted to understand the accuracy and reliability of the test better, especially for its use as a promising clinical measure.

Purpose: Loss of heterozygosity (LOH) at chromosomes 1p and 16q is a poor prognostic factor infavorable histology Wilms tumor (FHWT). This study investigated the prevalence of LOH at1p and 16q and evaluated its prognostic value in Korean children with FHWT. Materials and Methods: We analyzed 101 FHWT patients who were diagnosed between 1996 and 2016 in KoreanSociety of Pediatric Hematology Oncology Group hospitals. Using paraffin-embedded kidneytissue samples sent from each center, we reviewed LOH at 1p and 16q in each patient andassessed the prognostic value of LOH status for clinical parameters affecting event-freesurvival (EFS). Results: Of the 101 patients, 12 (11.9%) experienced recurrence; the 3-year EFS was 87.6%. LOHat 1p or 16q was detected in 19 patients (18.8%), with five having LOH at both 1q and 16q.The frequency of LOH at 1p was higher among younger patients (p=0.049), but there wasno difference in LOH prevalence according to tumor stage. In the multivariate analysis, LOHat 16q was a significant negative prognostic factor affecting EFS (3-year EFS, 73.7% vs.91.1%; hazard ratio, 3.95; p=0.037), whereas LOH at 1p was not (p=0.786). Conclusion LOH at 16q was a significant negative prognostic factor affecting outcome in Korean pediatricFHWT patients. Due to the small sample size of this study, large-scale multicenter trialsare warranted to investigate the prognostic value of LOH at 1p and 16q in Korean childrenwith FHWT.