Background: Cognitive behavioral therapy for adherence and depression (CBT-AD) performed by clinical psychologists is an effective treatment for improving the depression in people living with HIV (PLWH). However, because access to clinical psychologists is limited in most clinics, CBT-AD is rarely performed for PLWH in Korea. This pilot study evaluates whether CBT-AD can be effectively performed by a nurse trained and supervised by a clinical psychologist, with a view to the wider provision of CBT-AD. Materials and Methods: One clinical psychologist developed manuals, educated and supervised one nurse. PLWH with depression or adherence to self-reported antiretroviral therapy <90% were enrolled, and CBT-AD was conducted once weekly for 12 sessions. PLWH were assessed for adherence by visual analog scale, Beck depression inventory (BDI) for depression, PozQoL for quality of life, and Berger’s 40-item stigma scale for stigma at baseline, after the 6th, 12th session, at 4-, and 8-months after CBT-AD. Acceptability for PLWH and feasibility for providers were evaluated through surveys. Results: Five male PLWH have completed the study protocols (mean age 29.2 years). All study participants showed improving depression (mean BDI at baseline 33.0 ± 7.0, and after the 12th session 13.4 ± 3.5), and the effect was maintained at the 8-month follow-up (BDI 15.4 ± 6.4). Quality of life showed a tendency to improve (mean PozQoL at baseline 28.0 ± 7.7, after 12th session 36.8 ± 4.4, and at the 8-month follow-up 38.2 ± 7.9), but stigma did not show clear improvement (Berger’s 40-item stigma scale at baseline 121.0 ± 3.9, after 12th session 107.6 ± 8.8. and at the 8-month follow-up 107.6 ± 5.0). All study participants received great help from CBT-AD and expressed their desire to continue. All providers agreed that nursedelivered CBT-AD could be implemented in routine clinical practice. Conclusion Our findings suggest that a nurse-delivered CBT-AD could be feasible and acceptable for PLWH through structured interventions. It has been shown to have the potential to help PLWH, especially for their depression and quality of life.

PURPOSE: The purpose of this study is to identify factors influencing the pregnancy rate among unexplained infertile couples who received treatments of assisted reproductive technology (ART) and intra-uterine inseminations (IUI). METHODS: The medical records of 24,201 cases of unexplained infertility among a total of 31,684 intrauterine insemination treatment cases, (which benefited by 'National Medical-aid Program for ART in 2011') were used for this analysis. RESULTS: Woman's age (OR=0.94), frequency of IUI (OR=0.86), and treatment type (OR=1.54) were significant factors on pregnancy rates in the logistic regression analysis. CONCLUSION: Factors, such as the age of the infertile woman, frequency of IUI, and treatment type used to induce ovulation were shown to positively influence pregnancy rate. However, the age of the spouse was not a significant variable. Infertile couples having unprotected sexual intercourse with unexplained infertility had priority. The results demonstrated that about 70% of infertile Korean couples had unexplained infertility. This was a higher rate of unexplained infertility than that of the clinical standard. Therefore, we should assess for causes through future studies. In addition, affective or emotional factors influencing unexplained infertility need to be researched further.
Coitus ; Family Characteristics* ; Female ; Humans ; Infertility ; Insemination* ; Insemination, Artificial ; Korea* ; Logistic Models ; Medical Records ; Ovulation* ; Pregnancy Rate* ; Pregnancy* ; Reproductive Techniques, Assisted ; Spouses

PURPOSE: The purpose of this study was to identify factors affecting prenatal care (PNC) by married immigrant women. METHODS: This study was a secondary analysis of "Reproductive Health Status of Married Immigrant Women and Policy Directions in Korea" by the Korea Institute for Health & Social Affairs. The participants were 727 married immigrant women from Asia. Data were analysed using descriptive statistics, chi2 test and logistic regression with SPSS 14.0. RESULTS: Of the 727 women interviewed, 91.7% visited prenatal clinic. However, first time for PNC was late and total number of PNC was lower (9.07) than the average of Korean women. Timing and number of PNC in rural area were later and fewer than those in urban area. PNC by these women was significantly lower in those who had lived in Korea longer and for those who the employed. However, PNC was significantly higher in those who attended health education during pregnancy and had not experienced premature delivery. Those who attended health education during pregnancy (OR=2.84, CI=1.49~5.40) or were unemployed (OR=0.51, CI=0.26~0.99) were more likely to have PNC. CONCLUSION: These findings illustrate the need to strengthen the public information and provide special services to their demands about PNC for married immigrant women.
Asia ; Emigrants and Immigrants ; Female ; Health Education ; Humans ; Korea ; Logistic Models ; Pregnancy ; Prenatal Care

BACKGROUND: We evaluated multiplex PCR for species identification and toxin typing to improve the sensitivity and turnaround time of toxigenic Clostridium difficile culture (TCDC). METHODS: We performed multiplex PCR using primers targeting the species-specific gene, tpi, and the toxin genes, tcdA and tcdB. From January to March 2008, 528 stool specimens were tested with direct toxin assay (DT) using C. difficile Tox A/B II (Techlab, Blacksburg, USA) and TCDC. For 288 specimens from early study period, toxin production by C. difficile isolates of TCDC was measured by enzyme immunoassay with culture supernatants using VIDAS C. difficile Toxin A&B (CDAB;bioMerieux, Marcy-l'Etoile, France) and multiplex PCR with isolated colonies. For 240 specimens from late period, only multiplex PCR was used to test toxin production by the isolates. RESULTS: During the early period, 29 C. difficile were isolated and their toxin-positive rates were 65.5% by PCR and 44.8% by CDAB (P<0.05). Among 528 stool specimens, the results of DT+/TCDC+, DT+/ TCDC-, and DT-/TCDC+ were 32 (6.1%), 33 (6.3%), and 10 (1.9%), respectively, when tested with PCR. 13.3% of total 75 positive specimens was detected only by TCDC. Of the 42 toxigenic C. difficile isolates, all were positive for tpi, 30 (71.4%) were tcdA+/tcdB+, and 12 (28.6%) were tcdA-/tcdB+. CONCLUSION: TCDC using multiplex PCR for species identification and toxin typing is sensitive and rapid to be used as a routine diagnostic test.
Boron Compounds ; Clostridium ; Clostridium difficile ; Diagnostic Tests, Routine ; Immunoenzyme Techniques ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction