BACKGROUND: The 48/6 Model of Care is an integrative care initiative for improving the health outcomes of hospitalized older patients; however, its applicability in community-dwelling older adults as a health screening tool has not been investigated. The present study aimed to examine the applicability of this model, prevalence of dysfunction in 6 care areas, and its relationship with self-reported mobility in community-dwelling older adults. METHODS: This was a cross-sectional survey study of community-dwelling adults aged 65 or older. Participants were screened for problems using 9 items corresponding to the 6 care areas of the 48/6 Model of Care (cognitive functioning, functional mobility, pain management, nutrition and hydration, bladder and bowel management, and medication management). Mobility was assessed via the Life-Space Assessment (LSA). We examined the correlation between each screening item and the LSA. RESULTS: A total of 444 older adults (260 women, 58.6%) participated. The mean number of health problems was 2.3 ± 2.1, with the most common being pain, cognitive impairment, and urinary incontinence. These problems and LSA scores were significantly different by age groups. A multiple regression analysis showed that polypharmacy (β = −10.567, P < 0.001), dysphagia (β = −9.610, P = 0.021), and pain (β = −7.369, P = 0.004) were significantly associated with life-space mobility after controlling for age. CONCLUSION The 48/6 Model of Care is applicable to community-dwelling older adults, who show high prevalence of dysfunction in the 6 care areas. This study supports the role of the model in screening for the health status of older adults living in the community, and in estimating mobility.

BACKGROUND: The 48/6 Model of Care is an integrative care initiative for improving the health outcomes of hospitalized older patients; however, its applicability in community-dwelling older adults as a health screening tool has not been investigated. The present study aimed to examine the applicability of this model, prevalence of dysfunction in 6 care areas, and its relationship with self-reported mobility in community-dwelling older adults.METHODS: This was a cross-sectional survey study of community-dwelling adults aged 65 or older. Participants were screened for problems using 9 items corresponding to the 6 care areas of the 48/6 Model of Care (cognitive functioning, functional mobility, pain management, nutrition and hydration, bladder and bowel management, and medication management). Mobility was assessed via the Life-Space Assessment (LSA). We examined the correlation between each screening item and the LSA.RESULTS: A total of 444 older adults (260 women, 58.6%) participated. The mean number of health problems was 2.3 ± 2.1, with the most common being pain, cognitive impairment, and urinary incontinence. These problems and LSA scores were significantly different by age groups. A multiple regression analysis showed that polypharmacy (β = −10.567, P < 0.001), dysphagia (β = −9.610, P = 0.021), and pain (β = −7.369, P = 0.004) were significantly associated with life-space mobility after controlling for age.CONCLUSION: The 48/6 Model of Care is applicable to community-dwelling older adults, who show high prevalence of dysfunction in the 6 care areas. This study supports the role of the model in screening for the health status of older adults living in the community, and in estimating mobility.
Adult ; Cognition Disorders ; Cross-Sectional Studies ; Deglutition Disorders ; Female ; Humans ; Mass Screening ; Pain Management ; Polypharmacy ; Prevalence ; Urinary Bladder ; Urinary Incontinence

PURPOSE: The purpose of this study was to provide data for development of the Journal of Fundamentals of Nursing through reviewing classification of sectional editorship. METHODS: Descriptive statistical analysis was used, to identify content then, the classifications of sectional editorship were reviewed. RESULTS: The categories, "Basic concepts of nursing" (30.2%:17.9%), "Needs for comfort" (15.9%:13.1%), "Nursing education" (12.7%:12.7%), and "Needs for activity and exercise" (7.1%:7.1%) were most frequent through both the 1st and 2nd sectional editorship. CONCLUSION: Classification of sectional editorship was developed to clarify the educational purpose of fundamentals of nursing, and was modified through reflections by researchers. The current classification of sectional editorship is not a permanent formula, so using various viewpoints in further examination is needed.
Nursing Research

PURPOSE: In this study the present status of the practicum in Fundamentals of Nursing and test for student competency in nursing skills were surveyed. METHOD: Participants included 72 nursing schools. A structured questionnaire was used for data collection and SPSS 17.0 for data analysis. RESULTS: Credits for Fundamentals of Nursing, credits for practicum and hours per credit were 2.93, 7.34, and 2.14 respectively. Number of students per practice unit, full time assistants and students per assistant were 28.6, 0.6, and 20.2 respectively. Utilization of CPX room and OSCE room for practice was 5.6%, and 9.7% respectively. Of the school, 32.0% included clinical practice in the practicum. 90.3% provided an open lab but only 48.4% had full-time assistants for these clinical practice areas. Testing for nursing skill competency was performed twice a semester in most schools. Utilization of standard patients and high fidelity models for testing was 8.3%, and 23.6% respectively. The test was thought to be inappropriate in 33.4% of the schools. CONCLUSIONS: The results suggest that to improve the outcomes, the practicum for Fundamentals of Nursing needs to be changed to include expansion of facilities and human resources, utilization of standard patients and high fidelity models and development of appropriate test methods.
Surveys and Questionnaires ; Humans ; Pyridines ; Schools, Nursing ; Statistics as Topic ; Thiazoles

PURPOSE: Breast-conserving therapy (BCT) is a practical alternative to mastectomy for treating ductal carcinoma in situ (DCIS). We reviewed our experience for treating patients with DCIS of the breast to evaluate the outcome after performing breast-conserving surgery plus radiotherapy (BCS-RT). MATERIALS AND METHODS: Between January 1983 and December 2002, 25 patients with clinically or mammographically detected DCIS were treated by BCS-RT. One patient was diagnosed with bilateral DCIS. Thirteen cases (50%) had symptomatic lesions at presentation. All 26 cases of 25 patients underwent BCS such as lumpectomy, partial mastectomy or quadrantectomy. All of them received whole breast irradiation to a median dose of 50.4 Gy. Twenty-four cases (92.3%) received a boost to the tumor bed for a median total dose of 59.4 Gy. The median follow up period was 67 months (range: 38 to 149 months). RESULTS: Two cases (7.7%) experienced ipsilateral breast tumor recurrence (IBTR) after BCS-RT. The histology results at the time of IBTR showed invasive ductal carcinoma (IDC), and the median time to IBTR was 25.5 months. On the univariate analysis, there were no significant factors associated with IBTR in the DCIS patients. The three-year local recurrence free survival rate was 96.0% and the overall survival rate was 96.3%. CONCLUSION: After the treatment for DCIS, the IBTR rate in our study was similar to other previous studies. Considering that we included patients who had many symptomatic lesions, close or positive margins and less that complete early data, our result is comparable to the previous studies. We could not find the prognostic significant factors associated with IBTR after BCS-RT. A longer follow up period with more patients would be required to evaluate the role of any predictive factors and to confirm these short-term results.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Follow-Up Studies ; Humans ; Mastectomy ; Mastectomy, Segmental* ; Radiotherapy* ; Recurrence ; Survival Rate

BACKGROUND: It is well known that Korea is one of the endemic areas for viral hepatitis B and those who are positive for HBsAg has been reported to be about 5-10% in Korea. Since the 1980s, research and population education for prevention and vaccination for hepatitis B were implemented in Korea. Therefore, we predicted that the positive rates of HBsAg and Anti-HBs have changed since then. Young adults are considered to be the main candidates for hepatitis B vaccination, and the change in the rate of prevalence of HBsAg and Anti-HBs has been investigated in this study. METHODS: We surveyed 3760 freshmen who were positive for HBsAg and Anti-HBs who were in 1998. HBsAg and Anti-HBs was tested by RPHA/PHA. RESULTS: 3760 students included 2780 males and 980 females(mean age 19.44 years). Among them, 128(3.4%) was positive for HBsAg and 2488(66.2%) was positive for Anti-HBs. The positive rate of HBsAg was 105(3.8%) and that of Anti-HBs was 179(64.7%) among 2780 male students. The positive rate of HBsAg was 23(2.3%) and that of Anti-HBs was 691(70.5%) among 980 female students. CONCLUSIONS: As compared with previous prevalence studies of HBsAg and Anti-HBs, the positive rate of HBsAg was decreased and that of Anti-HBs was increased. The researchers hope that farther study is necessary using wider range of subjects.
Cross-Sectional Studies ; Education ; Female ; Hepatitis B ; Hepatitis B Surface Antigens* ; Hope ; Humans ; Korea ; Male ; Prevalence ; Vaccination ; Young Adult*

Myopericarditis is an uncommon manifestation, but can be reaely a lethal complication of infectious mononucleosis. We experienced a case of infectious mononucleosis complicated by myopericarditis in which the clinical pictur was confused as acute myocarddial infarction. A 25-year-old male who presented with syncope and chest pain. The diagnosis of infectious mononucleosis was comfirmed by both a positive heterophil antibody test and a high titer of Epstein-Barr virus antibody. He was found to have completely normal findings at cardiac catheterization, including coronary arteriography. Pathologic specimen from right ventricular endomyocardial biopsy demonstrated extensive lymphocytic and eosinophilic infiltration of the myocardium.
Adult ; Angiography ; Biopsy ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Diagnosis ; Eosinophils ; Herpesvirus 4, Human ; Humans ; Infarction ; Infectious Mononucleosis* ; Male ; Myocardium ; Syncope

It was already reported in else where that a standard linear accelerator, with only slight modification can function in a manner similar to Leksell's Gamma unit device in the treatment of inoperable deep seated intracranial lesions. Using collimated narrow beams, a localization system and special computer programs for precise patient positioning and a high concentration of irradiation dose within the lesions, eleven patients with AVMs and brain tumor have now been treated since 1988. The 6 MeV linear accelerator and Hitchcock stereotactic frame was used of the all procedures. In 10 of the 11 patients, no side effects occurred. The first 7 patients, who could be observed 3 months or longer have been studied radiologically and clinically. In 6 patients marked decrease in contrast enhancement and sometimes dramatic clinical improvement was achieved. In one case a marked increase of the surrounding brain edema occurred 7days after radiosurgery, who was operated on. The radiantion dose was based on the volume, location and radiosensitivity of the lesion which ranged 15-40 Gy.
Brain Edema ; Brain Neoplasms ; Humans ; Particle Accelerators* ; Patient Positioning ; Radiation Tolerance ; Radiosurgery*

Fifty patients with residual, unresectable or recurrent rectal cancer were treated with external irradiation using a 6-MV linear accelerator at the Division of Therapeutic Radiology, Department of Radiology, Kangnam St. Mart's Hospital, Catholic University Medical College during the period of April 1983 to December 1987. This paper describes the results of a retrospective analysis of the results of external irradiation for the residual, unresectabel and recurrent rectal cancer in 46 patients. Four patients were lost to follow-up. Of the 46 patients, 18(39%) presented with unresectable primary lesions and 28 (61%) with residual or recurrent rectal cancer. In 93%, the pathologic diagnosis was adenocarcinoma. Resonse to irradiation was observed in 22 (73%) out of 30 patients who were treated for pain, 12 (86%) out of 14 patients who were treated for mass, and 17 (77%) out of 22 patients who were treated for bloody discharge. The actuarial postoperative 2-year and 3-year survival rates in recurrent and unresectable patients were 43% and 22%, respectively. However, the post-RT 2-year survival rate was 13% (6/46).
Adenocarcinoma ; Diagnosis ; Humans ; Lost to Follow-Up ; Particle Accelerators ; Radiation Oncology ; Rectal Neoplasms* ; Retrospective Studies ; Survival Rate

From March, 1983 to March, 1987, 16 patients with esophageal steno-obstruction due to nonesophageal tumors were treated in the Division of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. The patient characteristics, effect of radiotherapy (XRT) on esophageal steno-obstruction and survival were evaluated. The most common primary tumor was lung cancer (14/16) and the middle third of the esophagus was most frequently involved (14/16). Improved clinical response was observed in 80% of the patients who finished the planned courses of XRT. The mean radiation dose evoking the improvement of dysphagia was 2,993 cGy given over a period of 3 to 4 weeks. The Kaplan-Meier estimates of survival at 15 and 30 weeks of follow-up were 60% and 46%, respectively. In the completed group who finished the whole planned courses of XRT, survival rates were 77% and 51%, respectively. Four patients were alive over 90 weeks with normal passage of food.
Deglutition Disorders ; Esophagus ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Radiation Oncology ; Radiotherapy ; Survival Rate