Nurses’ job performance is defined as the effectiveness of a person in carrying out his or her duties related to patient care. Aim of this study is to measure job performance among nurses in a tertiary hospital and its associated factors. A cross-sectional study was conducted among nurses selected from four departments, which were Obstetrics & Gynecology (O&G), medical, surgical and Cardiac Care Unit (CCU)/High Dependency Unit (HDU). A Malay validated Six-Dimension Scale of Nursing Performance (6-DSNP) questionnaire was used to measure job performance. Nurses who have one child more compared to other nurses had significantly lower total mean score of job performance by -0.06 (95% CI 0.11, 0.01). Nurses working in medical department [adj.β=0.16 (95% CI 0.01, 0.30)] and CCU/HDU [adj.β= 0.33(95% CI: 0.17, 0.50)] had significantly higher total mean scores of jobs performance compared to O&G department. Effective strategies and re-examining work conditions are imperative for better job performance.
job performance ; associated factors ; nurses ; tertiary hospital

Nurses’ job performance is defined as the effectiveness of a person in carrying out his or her duties related to patient care. Aim of this study is to measure job performance among nurses in a tertiary hospital and its associated factors. A cross-sectional study was conducted among nurses selected from four departments, which were Obstetrics & Gynecology (O&G), medical, surgical and Cardiac Care Unit (CCU)/High Dependency Unit (HDU). A Malay validated Six-Dimension Scale of Nursing Performance (6-DSNP) questionnaire was used to measure job performance. Nurses who have one child more compared to other nurses had significantly lower total mean score of job performance by -0.06 (95% CI 0.11, 0.01). Nurses working in medical department [adj.β=0.16 (95% CI 0.01, 0.30)] and CCU/HDU [adj.β= 0.33(95% CI: 0.17, 0.50)] had significantly higher total mean scores of jobs performance compared to O&G department. Effective strategies and re-examining work conditions are imperative for better job performance.
job performance ; associated factors ; nurses ; tertiary hospital

Pneumonia is the cause of significant morbidity and mortality, despite advances in diagnosis and antibacterial treatment. Pneumonia is often misdiagnosed and mistreated up until recently. Recent classification of pneumonia consists of community-acquired pneumonia, health care-associated pneumonia, hospital-acquired pneumonia, and ventilator-associated pneumonia. The etiology, risk factors, and treatment are different among them. This article briefly introduces new concepts and ideas in biomarkers, diagnosis, treatment, prognosis, and prevention of pneumonia during the past 2 years. One of the most frequent subjects of recent papers was those about pandemic H1N1 in 2009.
Biomarkers ; Pandemics ; Pneumonia ; Pneumonia, Ventilator-Associated ; Prognosis ; Risk Factors

BACKGROUND: Pneumonia continues to be the most common major infection in trauma patients. Despite the advances in prevention, diagnosis, and treatment for pneumonia, it remains a major cause of morbidity and mortality. The aim of this retrospective study is to identify the risk factors and clinical features of ventilator-associated pneumonia among chest trauma patients. MATERIAL AND METHOD: The study population consisted of 78 mechanically ventilated patients admitted to the ICU of Chonnam National University Hospital between January, 2001, and December, 2006. The patients were divided into two groups: those with pneumonia (Group I) and without pneumonia (Group II). Clinical predictors of the occurrence and mortality for ventilator associated pneumonia were analyzed. RESULT: There were 57 men and 21 women, with a mean age of 48.3+/-19.9 years. Almost half of the patients, 48.7% (38 of 78), had pneumonia. The mortality rate was 21.0% (8 of 38) in Group I and 2.5% (1 of 40) in Group II. The predictors of ventilator-associated pneumonia were the duration of mechanical ventilation (17.4 days vs 6.5 days, p<0.001), the mean stay in the ICU (21.7 days vs 9.7 days, p<0.001), the use of inotropics due to hemodynamic instability (63.1% vs 25.0%, p=0.001), and the serum level of CRP (11.3+/-7.8 vs 6.4+/-7.3, p= 0.006). CONCLUSION: Posttraumatic ventilator-associated pneumonia was significantly related with the duration of mechanical ventilation, the mean stay in ICU, and the use of inotropics due to hemodynamic instability. The serum level of CRP at admission was higher in the pneumonia group. Morbidity and mortality can be reduced by early identification of predictive factors for developing pneumonia in chest trauma patients.
Female ; Hemodynamics ; Humans ; Male ; Pneumonia ; Pneumonia, Ventilator-Associated ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Thorax

Bisphosphonate-Associated Osteonecrosis of the Jaw ; diagnosis ; etiology ; prevention & control ; therapy ; Diphosphonates ; chemistry ; pharmacokinetics ; pharmacology ; Humans ; Risk Factors

Middle Aged ; Humans ; Siblings ; Mutation ; TATA-Binding Protein Associated Factors/genetics*

OBJECTIVETo explore the molecular mechanism of Waardenburg syndrome type II (WS2) resulting from SOX10 gene mutation E248fs through in vitro experiment.

METHODS293T cells were transiently transfected with wild type (WT) SOX10 and mutant type (MT) E248fs plasmids. The regulatory effect of WT/MT SOX10 on the transcriptional activity of MITF gene and influence of E248fs on WT SOX10 function were determined with a luciferase activity assay. The DNA binding capacity of the WT/MT SOX10 with the promoter of the MITF gene was determined with a biotinylated double-stranded oligonucleotide probe containing the SOX10 binding sequence cattgtc to precipitate MITF and E248fs, respectively. The stability of SOX10 and E248fs were also analyzed.

RESULTSAs a loss-of-function mutation, the E248fs mutant failed to transactivate the MITF promoter as compared with the WT SOX10 (P<0.01), which also showed a dominant-negative effect on WT SOX10. The WT SOX10 and E248fs mutant were also able to bind specifically to the cattgtc motif in the MITF promoter, whereas E248fs had degraded faster than WT SOX10.

CONCLUSIONDespite the fact that the E248fs has a dominant-negative effect on SOX10, its reduced stability may down-regulate the transcription of MITF and decrease the synthesis of melanin, which may result in haploinsufficiency of SOX10 protein and cause the milder WS2 phenotype.

Humans ; Microphthalmia-Associated Transcription Factor ; genetics ; Promoter Regions, Genetic ; SOXE Transcription Factors ; genetics ; Waardenburg Syndrome ; etiology ; genetics

OBJECTIVETo investigate the prognostic value of ultra-sensitive pregnancy associated plasma protein-A (PAPP-A) level in the early phase of acute coronary syndrome (ACS) attack.

METHODSPatients diagnosed as ACS were enrolled and the level of circulatory PAPP-A was measured within 12 hours after ACS attack. The patients were followed at the time of 1st, 6th, and 12th months post-ACS attack in order to observe the incidence of the cardiovascular adverse events. According to the highest quintile, the patients were divided into 2 groups: high level (≥26.08 μg/L) group and low level (<26.08 μg/L) group, to evaluate the association between the level of PAPP-A and the incidence of the cardiovascular events.

RESULTSCompared with the low level group, the incidence of the composite outcome is significantly increased in the high level group, and the values of OR are 4.76, 4.38, 3.75 for 1st, 6th, 12th months respectively (P=0.000). For myocardial infarction (MI) + cardiac death (CD) the values of OR were 9.81, 6.08, 4.12 (P<0.01). Multivariate logistic regression analysis demonstrates that PAPP-A was an independent risk factor for the cardiovascular adverse events in the early, median, and late phase of ACS (P<0.05).

CONCLUSIONIn the early phase of ACS attack, the elevation of PAPP-A is an independent risk factor for the occurrence of cardiovascular adverse events.

Acute Coronary Syndrome ; blood ; diagnosis ; Aged ; Female ; Humans ; Male ; Middle Aged ; Pregnancy-Associated Plasma Protein-A ; metabolism ; Prognosis ; Risk Factors

Respiratory distress syndrome (RDS) among preterm infants is typically due to a quantitative deficiency of pulmonary surfactant. Aside from the degree of prematurity, diverse environmental and genetic factors can affect the development of RDS. The variance of the risk of RDS in various races/ethnicities or monozygotic/dizygotic twins has suggested genetic influences on this disorder. So far, several specific mutations in genes encoding surfactant-associated molecules have confirmed this. Specific genetic variants contributing to the regulation of pulmonary development, its structure and function, or the inflammatory response could be candidate risk factors for the development of RDS. This review summarizes the background that suggests the genetic predisposition of RDS, the identified mutations, and candidate genetic polymorphisms of pulmonary surfactant proteins associated with RDS.
Genetic Predisposition to Disease ; Humans ; Infant, Newborn ; Infant, Premature ; Polymorphism, Genetic ; Pulmonary Surfactant-Associated Proteins ; Pulmonary Surfactants ; Risk Factors* ; Twins

PURPOSE: The aim of this study was to investigate the incidence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) after tooth extraction in patients with osteoporosis on oral bisphosphonates in Korea and to evaluate local factors affecting the development of BRONJ. MATERIALS AND METHODS: The clinical records of 320 patients who underwent dental extraction while receiving oral bisphosphonates were reviewed. All patients had a healing period of more than 6 months following the extractions. Each patient's clinical record was used to assess the incidence of BRONJ; if BRONJ occurred, a further radiographic investigation was carried out to obtain a more definitive diagnosis. Various local factors including age, gender, extraction site, drug type, duration of administration, and C-terminal telopeptide (CTx) level were retrieved from the patients' clinical records for evaluating their effect on the incidence of BRONJ. RESULTS: Among the 320 osteoporotic patients who underwent tooth extraction, 11 developed BRONJ, reflecting an incidence rate of 3.44%. Out of the local factors that may affect the incidence of BRONJ, gender, drug type, and CTx level showed no statistically significant effects, while statistically significant associations were found for age, extraction site, and duration of administration. The incidence of BRONJ increased with age, was greater in the mandible than the maxilla, and was associated with a duration of administration of more than 3 years. CONCLUSION: Tooth extraction in patients on oral bisphosphonates requires careful consideration of their age, the extraction site, and the duration of administration, and close postoperative follow-up should be carried out to facilitate effective early management.
Bisphosphonate-Associated Osteonecrosis of the Jaw ; Diagnosis ; Diphosphonates* ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Mandible ; Maxilla ; Osteoporosis ; Risk Factors* ; Tooth Extraction* ; Tooth*