Hypertrophic osteoarthropathy (HOA) is a rare clinical condition including an abnormal periosteal reaction in the long bones that causes painful swelling and tenderness of the extremities, digital clubbing, arthritis, synovitis, and joint effusions. Most cases are associated with tumorous conditions and most commonly with lung cancer. HOA has been rarely reported in association with other cancers. A patient with a history of recurrent renal cell carcinoma was referred to our clinic with bilateral leg pain, knee joint effusion, and arthritis. Simple radiography and bone scintigraphy confirmed a diagnosis of HOA. Oral non-steroidal anti-inflammatory drugs, joint fluid aspiration, and intra-articular injection of pain medications were found to be effective in the management of HOA pain. HOA prognosis depends on the underlying disease, therefore, cancer treatment is critical. This case demonstrates the need to consider HOA in patients with various malignancies who present with bone or joint pain of the extremities.

PURPOSE: This study was done to examine the effect of direct practice of newborn health assessment on nursing student's clinical competence and self-efficacy and to propose effective strategies for clinical education on newborn care. METHODS: Design was a nonequivalent control group quasi-experimental study. The direct practice program was composed of a lecture, demonstration, drill and feedback using a manikin, and repeated direct practice regarding newborn health assessment. Participants were 65 student nurses taking the pediatric nursing practicum in the nursery room at M hospital. The experimental group (n=33) participated in the direct practice program for newborn health assessment and the control group (n=32) received the traditional practice method. Nursing clinical competence was assessed by two nurse investigators and structured questionnaires were used to measure self-efficacy. RESULTS: The experimental group's clinical competence was significantly higher than that of the control group (t=-4.82, p=.000). However no significant difference was found between the two groups for self-efficacy (t=1.264, p=.211). CONCLUSION: These findings indicate that the direct practice program is effective in improving nursing student's clinical competence, but it was not effective in increasing self-efficacy. Direct practice in various clinical education settings is recommended and longitudinal effects be evaluated.
Clinical Competence* ; Education ; Humans ; Infant, Newborn* ; Manikins ; Nurseries ; Nursing* ; Pediatric Nursing ; Research Personnel

PURPOSE: This study aimed to confirm the utility of the European Organization for Research and Treatment of Cancer (EORTC) and the Spanish Urological Club for Oncological Treatment (CUETO) scoring systems and to determine which model is preferred as a prognostic model in Korean patients with non-muscle-invasive bladder cancer. MATERIALS AND METHODS: Between 1985 and 2011, 531 patients who were treated by transurethral resection of bladder cancer were retrospectively analyzed by use of the EORTC and CUETO models. Statistically, we performed Kaplan-Meier survival analysis; calculated Harrell's concordance index, receiver operating characteristic (ROC) curve, and cutoff values; and performed univariate and multivariate Cox proportional hazards regression analyses. RESULTS: For risk of recurrence, with the use of the EORTC model, all groups had statistically significant differences except between the group with a score of 0 and the group with a score of 1-4. With the use of the CUETO model, all groups differed significantly. For risk of progression, with the use of the EORTC model, significant differences were observed between all groups except between the group with a score of 2-6 and the group with a score of 7-13. With the use of the CUETO model, a significant difference was observed between the group with a score of 0 and the other groups. The concordance index of the EORTC and CUETO models was 0.759 and 0.836 for recurrence and 0.704 and 0.745 for progression, respectively. The area under the ROC curve for the EORTC and CUETO models was 0.832 and 0.894 for recurrence and 0.722 and 0.724 for progression, respectively. CONCLUSIONS: Both scoring systems, especially the CUETO model, showed value in predicting recurrence and progression in Korean patients, which will help in individualizing treatment and follow-up schedules.
Adult ; Aged ; Aged, 80 and over ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Models, Statistical ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local/pathology ; Retrospective Studies ; Risk Assessment/methods ; *Severity of Illness Index ; Urinary Bladder Neoplasms/*pathology/surgery ; Young Adult

PURPOSE: Effective literature searching is essential to support evidence-based nursing. The aim of this study was to present our recent systematic search experience to identify guidelines in PubMed for prevention of catheter-associated urinary tract infections. METHODS: Five approaches to the literature search via PubMed were employed. The searches were restricted to items published from 1980 to 2010, for patients admitted to hospital, and in the English language. The search results were compared using the number of records and relevant items, and the sensitivity and precision of each search strategy. RESULTS: The individual approaches retrieved 19-141 of records and 3-6 of relevant items. Sensitivity ranged from 37.5% to 75.0% with the highest values for simple searches and a search combining MeSH terms and free textwords with a methodological search filter. Precision varied from 4.3% to 21.7% and the highest precision was found for MeSH terms with limits feature. CONCLUSION: The simple search in PubMed is an appropriate way for nurses in a busy clinical practice to search the literature for evidence. However, several approaches using MeSH terms, free textwords, limits feature or methodological search filters are also required to have more efficient and better informed search results.
Evidence-Based Nursing ; Humans ; Methods ; Urinary Catheterization ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: The purpose of this study was to describe current status in management of children with atopic dermatitis and to examine knowledge and care practices of preschool teachers. METHODS: A survey using a self-administered questionnaire was conducted. Knowledge and practice were measured with the questionnaire by Park (2011). Data were analysed using SPSS.WIN 20.0. RESULTS: Of the teachers, 81.3% managed children with atopic dermatitis depending on parents' needs and 58.9% reported difficulties due to limited knowledge and expressed a need for continuing education and provision of educational guidelines. Preschool teachers had a mean score for knowledge about atopic dermatitis of .75 out of 1 point. Among three domains of knowledge, signs & symptoms had the highest score and management, the lowest. The mean score for care practices for children with atopic dermatitis was 3.4 out of 4 points. Among the four domains of care practices, food had the highest score and dress & bedclothes, the lowest. Knowledge and practice of the teachers were different according to responsibility in management and educational need. The correlation between knowledge and practice was not significant. CONCLUSION: These results suggest that educational programs and strategies should be developed to increase preschool teachers' knowledge and improve care practice for children with atopic dermatitis.
Child ; Dermatitis, Atopic ; Education, Continuing ; Humans ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to identify perception of recovery, self-esteem, role performance, job satisfaction and factors influencing job satisfaction of psychiatric mental heath nurses. METHODS: Data were collected from 161 psychiatric nurses from G city & J province who understood the purpose of the study and agreed to participate. Data were analyzed using descriptive statistics, t-test, Pearson correlation coefficient, and multiple regression with SPSS 18.0. RESULTS: There were significant differences in job satisfaction between upper 25% and lower 25% group for perception of recovery, self-esteem, and role performance. Results from the multiple regression analysis revealed difference in the related factors and in the magnitude of the relationship evaluated by standardized beta coefficients. Significant factors, listed by the magnitude of beta coefficients, were role performance, self esteem, roles and responsibilities in recovery, expectations regarding recovery in perception of recovery. These variables accounted for 16% of job satisfaction. CONCLUSION: Results indicate that to improve psychiatric nurses' job satisfaction, there is a need to develop programs including personal qualities and perception of recovery. Further research is necessary in order to establish consensus on roles of the related factors of job satisfaction.
Consensus ; Humans ; Job Satisfaction ; Self Concept

PURPOSE: This study was conducted to investigate the degree of dry mouth and oral health-related quality of life and to identify factors contributing to oral health-related quality of life for community-dwelling elders. METHODS: A descriptive correlational study design was used. Participants were 156 older adults from two senior welfare centers. Data were collected on February 21, 22 and 29, 30, 2009 using structured questionnaires. Enter type multiple regression analysis was used to identify factors influencing oral health-related quality of life according to general and oral health characteristics. RESULTS: There were significant differences in oral health-related quality of life according to living arrangement, insurance, smoking, number of natural teeth, and denture type. The oral health-related quality of life had significant correlations with the number of chronic disease, number of medications, and dry mouth. Factors influencing oral health-related quality of life for community-dwelling older adults were dry mouth, number of chronic disease, and medical aid, which explained about 47.9% of total variance. CONCLUSION: These results indicate that in order to promote oral health-related quality of life for older adults, prevention or management of chronic diseases as well as oral health and dry mouth are needed for this population, and especially economically poor elders.
Aged ; Aged, 80 and over ; Dentures ; Female ; Humans ; Male ; Oral Health ; Personal Satisfaction ; *Quality of Life ; Questionnaires ; Regression Analysis ; Smoking ; Xerostomia/*psychology

PURPOSE: This study was conducted to identify the factors contributing to sleep disorders in patients on hemodialysis. Methods: A descriptive correlational study design was used. The participants were 135 patients on hemodialysis in hemodialysis clinics. Data were collected from March to May 2007 using structured questionnaires and hematologic sample. Stepwise multiple regression was used to identify factors influencing sleep disorders among the demographic-clinical factors, depression and fatigue. RESULTS: About 69% of the patients had a sleep disorders. There were significant differences in sleep disorders according to marital status, caregiver, religion, economic level, insurance, erythropoietin, somnifacient, and antihypertensive agents. But there were no differences according to age, gender, dialysis period, or antidepressants. Their sleep disorders had significant correlations with depression, and fatigue, and a significant negative correlation with Protein, Albumin, Phosphate and BUN. But there were no correlations with hematocrit, hemoglobin, creatinine, sodium, potassium, or calcium. Depression and fatigue were factors influencing sleep disorders. They accounted for 43.8% of the variance in sleep disorders in these patients. CONCLUSION: Findings provide an understanding of sleep disorders and the factors that are an influence in patients on hemodialysis. To promote sleep in these patients, nursing interventions to manage depression and fatigue are needed.
Antidepressive Agents ; Antihypertensive Agents ; Calcium ; Caregivers ; Creatinine ; Depression ; Dialysis ; Erythropoietin ; Fatigue ; Hematocrit ; Hemoglobins ; Humans ; Insurance ; Marital Status ; Potassium ; Surveys and Questionnaires ; Renal Dialysis ; Sleep Wake Disorders ; Sodium

PURPOSE: The purpose of this study was to identify nursing activities and to analyze patient outcomes related to indwelling urinary catheterization. METHOD: A review was done of 628 medical records from five units for patients admitted between January 1 and June 30, 2006. Twelve nurses who worked in the same units were interviewed. RESULTS: In the interviews, nurses reported considering several non-invasive interventions prior to catheterization but there were no medical records of this activity. Results from the in-depth interviews showed that infection control activities such as urinary bag management were conducted but again there were no medical records. Seventy-five percent of the catheters were removed without prescription. In the medical records there were no notes for approximately 15%, on the time of first voiding and 80%, on volume of first voiding after removal of catheter. There was a significant difference in hospitalization days between the group catheterized for 5 days or less and the group catheterized for 6 days or more. CONCLUSION: Results indicate a need to close the gap between recorded and described activities and between current and best evidence based practice. Further study is needed to develop a standard recording system and guidelines related indwelling catheterization to decrease the gaps identified in this research.
Catheterization ; Catheters ; Catheters, Indwelling ; Evidence-Based Practice ; Hospitalization ; Humans ; Infection Control ; Medical Records ; Prescriptions ; Professional Practice ; Urinary Catheterization ; Urinary Catheters

Ceramide has emerged as a novel second messenger for intracellular signalling. It is produced from sphingomyelin and is involved in the control of cell differntiation, proliferation, and apoptosis. C2- ceramide, short chain ceramide, plays a role in mediating contraction of cat esophageal smooth muscle cells. We examined the effect of synthesized ceramide analogues on the C2-ceramide and ACh-induced contraction in esophageal smooth muscle cells isolated with collagenase. CY3523, CY3525, or CY3723 inhibited C2-ceramide induced contraction, in a time dependent manne. Each analogue also inhibited the contraction in concentration dependent manners. CY 3523, CY 3525, and CY 3723 had no effect to the contraction induced by PMA. The inhibition with CY3523, CY3525 and CY3723 on the C2- ceramide induced contraction was recovered by PMA. These analogues decreased the density of MAPK bands (p44/42 or p38) in the western blot. These results suggest that ceramide analogues can inhibit C2-ceramide induced contraction via PKC and MAPK dependent pathway.
Animals ; Apoptosis ; Blotting, Western ; Cats ; Collagenases ; Contracts ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Negotiating ; Protein Kinase C ; Relaxation ; Second Messenger Systems ; Sphingosine