PURPOSE: The aim of this study was to analyze Neonatal Intensive Care Unit nurses' behaviors while soothing newborns with bronchopulmonary dysplasia. METHODS: An observational study was used to assess nurses'soothing behaviors. Data were collected from September, 2012 to March, 2013 using an audio-video recording system. Participants were eight babies and 12 nurses caring for those babies. After obtaining parental permission, the overall process of each episode from nurses'engagement in soothing to the end of soothing was recorded. Then a researcher interviewed each participating nurse. Data from 18 episodes were transcribed as verbal and nonverbal nursing behaviors and then categorized by two researchers. RESULTS: There were 177 observed soothing behaviors which were classified with the five sensory-based categories (tactile, oral, visual, auditory, vestibular). Most frequently observed soothing behavior was ‘Gently talking’ followed by ‘Removing irritant’, and ‘Providing non-nutritive sucking’. Nurses' perceived soothing behaviors were similar to the observed soothing behaviors except for ‘Gently talking’. CONCLUSION: Nurses used diverse and mixed soothing behaviors as well as recognizing those behaviors as essential nursing skills. Nurses' soothing behaviors identified in this study can be used to comfort babies and to enhance their developmental potential in accordance with individual characterstics or cues.
Bronchopulmonary Dysplasia* ; Cues ; Humans ; Infant ; Infant Care ; Infant, Newborn ; Intensive Care, Neonatal* ; Nursing ; Nursing Care ; Observational Study ; Parents

PURPOSE: Children in migrant villages in Kyrgyzstan have a high incidence of anemia and need effective health promotion programs. The purpose of this study was to evaluate a pilot study of a health promotion project for infants and toddlers based on community participation.METHODS: This was a retrospective study conducted to evaluate the effectiveness of the project. The project was carried out by nurses at a public health center, community health workers, and local residents in a migrant village. After the operational system of the project was established, health assessments, child-care education, provision of vouchers for iron supplements, and activities to improve residents' awareness were conducted during 6 months among 100 children, of whom 85 were finally analyzed.RESULTS: In international health projects, close cooperation of the project team with community residents and health workers is important. Access to the community-based program was feasible in the socially and economically poor migrant village, and improvements were shown in children's anemia and awareness of health care.CONCLUSION: By focusing on the effective aspects of this preliminary project, plans to utilize community health workers and promotion strategies can be added to the main project to improve health promotion among children in this area.
Anemia ; Child Health ; Child ; Community Health Centers ; Community Health Workers ; Community-Based Participatory Research ; Consumer Participation ; Delivery of Health Care ; Education ; Health Promotion ; Humans ; Incidence ; Infant ; Iron ; Kyrgyzstan ; Pilot Projects ; Program Evaluation ; Public Health ; Retrospective Studies ; Transients and Migrants

PURPOSE: The purpose of this study was to identify trends in intervention studies on childhood obesity in Korea. METHODS: From 1996, when the first research paper on childhood obesity intervention was published, to 2015, 192 published papers were analyzed using descriptive statistics. RESULTS: The number of studies increased sharply between 1996 and 2007, but declined slightly from then. The majority of studies involved only children as intervention participants. Most were elementary students, and overweight and obese children. Exercise therapy was the most common type of intervention. Parental participation was found in 35 studies, while teacher's participation was found in only one study. In many studies physiological indicators were used as measurement variables, but follow-up was done in only 10 studies. Finally, only a few studies applied a conceptual framework, while a quasi-experimental research design was used for most studies. CONCLUSION: Examination of trends in intervention studies on childhood obesity in Korea, shows there has been a quantitative increase but not enough improvement in terms of the quality of interventions. Findings in the present study suggest that it is necessary to seek diversity in terms of study participants, interventions and evaluation method along with quality improvement in research methodology.
Child ; Exercise Therapy ; Follow-Up Studies ; Humans ; Korea* ; Methods ; Only Child ; Overweight ; Parents ; Pediatric Obesity* ; Quality Improvement ; Research Design

PURPOSE: This study was done to develop and evaluate an algorithm-based simulation scenario for emergency measures for high-risk newborns presenting with apnea. METHODS: A one shot case study design was used to evaluate the algorithm-based simulation scenario. Effects of the developed simulation scenario were evaluated using the Simulation Effectiveness Tool (SET) and the Lasater Clinical Judgement Rubric (LCJR). From March to November 137 senior nursing students completed the simulation using this scenario. RESULTS: The eight-frame simulation scenario was developed based on the Neonatal Resuscitation Program (NRP) and the nursing clinical judgment process. After use of the scenario, overall scores for SET and LCJR were 21.0 out of 26.0 and 32.4 out of 44.0 respectively. There were no significant differences in scores according to general characteristics. Positive correlation coefficients were identified among overall and subcategories of SET and LCJR. In addition, students provided positive feedback on the simulation experience. CONCLUSION: Considering that nursing students have limited access to high-risk newborns during their clinical experience and that newborns presenting apnea are common in the neonatal intensive care unit, the simulation scenario developed in this study is expected to provide nursing students with more opportunities to practice emergency measures for high-risk newborns.
Apnea* ; Education, Nursing ; Emergencies* ; Humans ; Infant, Newborn* ; Intensive Care, Neonatal ; Judgment ; Nursing ; Pediatric Nursing ; Resuscitation ; Students, Nursing

PURPOSE: This study was done to develop and evaluate an algorithm-based simulation scenario for emergency measures for high-risk newborns presenting with apnea. METHODS: A one shot case study design was used to evaluate the algorithm-based simulation scenario. Effects of the developed simulation scenario were evaluated using the Simulation Effectiveness Tool (SET) and the Lasater Clinical Judgement Rubric (LCJR). From March to November 137 senior nursing students completed the simulation using this scenario. RESULTS: The eight-frame simulation scenario was developed based on the Neonatal Resuscitation Program (NRP) and the nursing clinical judgment process. After use of the scenario, overall scores for SET and LCJR were 21.0 out of 26.0 and 32.4 out of 44.0 respectively. There were no significant differences in scores according to general characteristics. Positive correlation coefficients were identified among overall and subcategories of SET and LCJR. In addition, students provided positive feedback on the simulation experience. CONCLUSION: Considering that nursing students have limited access to high-risk newborns during their clinical experience and that newborns presenting apnea are common in the neonatal intensive care unit, the simulation scenario developed in this study is expected to provide nursing students with more opportunities to practice emergency measures for high-risk newborns.
Apnea* ; Education, Nursing ; Emergencies* ; Humans ; Infant, Newborn* ; Intensive Care, Neonatal ; Judgment ; Nursing ; Pediatric Nursing ; Resuscitation ; Students, Nursing

BACKGROUNDS/AIMS: Growth of tumors and their metastases is dependent on factors that stimulate vessel formation (angiogenesis). Vascular endothelial growth factor (VEGF) is closely related to angiogenesis in various human cancers. The aim of this study was to determine the value of serum VEGF levels in hepatocellular carcinomas as a tumor marker. METHODS: We measured serum VEGF levels, by enzyme immunoassay, and platelet counts in healthy controls (n=22), liver cirrhosis (LC; n=4) and hepatocellular carcinomas (HCC; n=14). RESULTS: The mean serum VEGF levels in controls and the patients with LC and HCC were 251.8+/-121.5 (mean+/-SD), 163.4+/-82.1 and 557.8+/-520.3pg/ml, respectively. The levels were significantly elevated in the HCC group, compared with the control group (p<0.05). Serum VEGF levels in the HCC group were highly correlated with platelet counts (r=0.915, p<0.05). Conclusions : We consider that serum VEGF is a possible tumor marker for HCC. Serum VEGF may be partly derived from platelets.
Carcinoma, Hepatocellular* ; Humans ; Immunoenzyme Techniques ; Liver Cirrhosis ; Neoplasm Metastasis ; Platelet Count ; Vascular Endothelial Growth Factor A*

BACKGROUND/AIMS: The most appropriate treatment for acute gastric variceal bleeding (GVB) is currently endoscopic gastric variceal obturation (GVO) using Histoacryl(R). However, the secondary prophylactic efficacy of beta-blocker (BB) after GVO for the first acute episode of GVB has not yet been established. The secondary prophylactic efficacy of BB after GVO for the first acute episode of GVB was evaluated in this study. METHODS: Ninety-three patients at Soonchunhyang University Hospital with acute GVB who received GVO using Histoacryl(R) were enrolled between June 2001 and March 2010. Among these, 42 patients underwent GVO alone (GVO group) and 51 patients underwent GVO with adjuvant BB therapy (GVO+BB group). This study was intended for patients in whom a desired heart rate was reached. The rates of rebleeding-free survival and overall survival were calculated for the two study groups using Kaplan-Meyer analysis and Cox's proportional-hazards model. RESULTS: The follow-up period after the initial eradication of gastric varices was 18.14+/-25.22 months (mean+/-SD). During the follow-up period, rebleeding occurred in 10 (23.8%) and 21 (41.2%) GVO and GVO+BB patients, respectively, and 39 patients died [23 (54.8%) in the GVO group and 16 (31.4%) in the GVO+BB group]. The mean rebleeding-free survival time did not differ significantly between the GVO and GVO+BB groups (65.40 and 37.40 months, respectively; P=0.774), whereas the mean overall survival time did differ (52.54 and 72.65 months, respectively; P=0.036). CONCLUSIONS: Adjuvant BB therapy after GVO using Histoacryl(R) for the first acute episode of GVB could decrease the mortality rate relative to GVO alone. However, adjuvant BB therapy afforded no benefit for the secondary prevention of rebleeding in GV.
Adrenergic beta-Antagonists/*therapeutic use ; Adult ; Aged ; Enbucrilate/therapeutic use ; Endoscopy, Digestive System ; Esophageal and Gastric Varices/*drug therapy ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage/mortality/*therapy ; Heart Rate ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Proportional Hazards Models ; Propranolol/therapeutic use ; Risk Factors ; Severity of Illness Index

Background/Aims: To analyze the incidence and risk factors of outcomes after liver transplantation (LT) in the Korean population. Methods: This study analyzed data from the liver cohort of Korean Organ Transplantation Registry (KOTRY) who had LT between May 2014 and December 2017. Study measures included the incidence of post-LT outcomes in recipients of living donor LT (LDLT) and deceased donor LT (DDLT). Cox multivariate proportional hazards model was used to determine the potential risk factors predicting the outcomes. Results: A total of 2,563 adult recipients with LT (LDLT, n=1,956; DDLT, n=607) were included, with mean±standard deviation age of 53.9±8.9 years, and 72.2% were male. The post-LT outcomes observed in each LDLT and DDLT recipients were death (4.0% and 14.7%), graft loss (5.0% and 16.1%), rejection (7.0% and 12.0%), renal failure (2.7% and 13.8%), new onset of diabetes (12.5% and 15.4%), and hepatocellular carcinoma (HCC) recurrence (both 6.7%). In both LDLT and DDLT recipients, the most common post-LT complications were renal dysfunction (33.6% and 51.4%), infection (26.7% and 48.4%), and surgical complication (22.5% and 23.9%). Incidence of these outcomes were generally higher among recipients of DDLT than LDLT. Multivariate analysis indicated recipient age and DDLT as significant risk factors associated with death and graft loss. DDLT and ABO incompatible transplant were prognostic factors for rejection, and HCC beyond Milan criteria at pre-transplant was a strong predictor of HCC recurrence. Conclusions This study is a good indicator of the post-LT prognosis in the Korean population and suggests a significant burden of post-LT complications.

Background/Aims: To analyze the incidence and risk factors of outcomes after liver transplantation (LT) in the Korean population. Methods: This study analyzed data from the liver cohort of Korean Organ Transplantation Registry (KOTRY) who had LT between May 2014 and December 2017. Study measures included the incidence of post-LT outcomes in recipients of living donor LT (LDLT) and deceased donor LT (DDLT). Cox multivariate proportional hazards model was used to determine the potential risk factors predicting the outcomes. Results: A total of 2,563 adult recipients with LT (LDLT, n=1,956; DDLT, n=607) were included, with mean±standard deviation age of 53.9±8.9 years, and 72.2% were male. The post-LT outcomes observed in each LDLT and DDLT recipients were death (4.0% and 14.7%), graft loss (5.0% and 16.1%), rejection (7.0% and 12.0%), renal failure (2.7% and 13.8%), new onset of diabetes (12.5% and 15.4%), and hepatocellular carcinoma (HCC) recurrence (both 6.7%). In both LDLT and DDLT recipients, the most common post-LT complications were renal dysfunction (33.6% and 51.4%), infection (26.7% and 48.4%), and surgical complication (22.5% and 23.9%). Incidence of these outcomes were generally higher among recipients of DDLT than LDLT. Multivariate analysis indicated recipient age and DDLT as significant risk factors associated with death and graft loss. DDLT and ABO incompatible transplant were prognostic factors for rejection, and HCC beyond Milan criteria at pre-transplant was a strong predictor of HCC recurrence. Conclusions This study is a good indicator of the post-LT prognosis in the Korean population and suggests a significant burden of post-LT complications.

Despite a remarkable increase of deceased donors, organ shortage is the main hurdle of organ transplantation in Korea. Therefore, liver transplantation priority is a major issue of liver allocation. We confront a situation that needs to change in order to achieve more adequate and objective allocation of the system. We considered the MELD system as an alternative to the CTP score and Status system. For application of the MELD system, comparison between two systems is required; and a national-based retrospective review of liver transplantation candidates (waiting list) was conducted as a multi-center collaborative study. Eleven transplant centers participated in this national study. From 2009 to 2012, 2,702 waiting lists were enrolled. After mean 349+/-412 days follow-up, 967 patients (35.8%) of liver transplantation, 750 patients (27.8%) of drop-out/mortality, and 719 patients (26.6%) on waiting were identified. In analysis of patient mortality during waiting time, status system showed significant difference of waiting mortality by status at registration. However, differences of waiting mortality by MELD system were more prominent and discriminate. In comparisons by MELD score in exclusive Status 2A waiting patients, there was a significant difference of waiting mortality by MELD score. This means that the MELD system is a good predictor of short-term survival after listing compared with status system with CTP score. Korean national-based retrospective study showed the superiority of the MELD system in prediction of short-term mortality and usefulness as a determinant for allocation priority.
Cytidine Triphosphate ; Emergencies* ; End Stage Liver Disease ; Follow-Up Studies ; Humans ; Korea ; Liver Transplantation* ; Liver* ; Mortality ; Organ Transplantation ; Resource Allocation ; Retrospective Studies ; Survival Analysis* ; Tissue Donors* ; Transplants ; Waiting Lists