• Journal of Korean Clinical Nursing Research
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• v.26 no.2
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• pp.217-231
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• 2020

Purpose: To identify the clinical role of Advanced Practice Nurses (APN), and evaluate how other medical personnel perceive their work(difficulty, importance). Methods: A questionnaire survey was performed with 277 health care providers (APN 52, nurses 88, and medical doctors 137 [professors 51, fellows 44, & residents 42]) in a single, tertiary hospital. The questionnaire was categorized into 6 domains (total 40 tasks): 6 tasks on identifying health issues (A); 3 tasks on prescribing and conducting diagnostic tests (D); 18 tasks on disease treatment (T); 4 tasks regarding prescribing medicine (M); 3 tasks regarding medical collaboration (C); 6 tasks regarding patient education (E). The survey measured the frequency, difficulty, and importance of APN's clinical tasks, and evaluated the willingness of authorizing clinical tasks to APN. Results: The most frequent tasks for APN were A domain, lowest were T domain. The scores for perceived job difficulty were lower than those for job importance in all groups. The proportion of willingness to legally delegate clinical practices to APN was higher in A and E domains, but lower in D and T domains. However, professors, who spent the most time with APN, showed a higher willingness to legally delegate clinical practice. The participants favored medical doctors as substitutes for tasks which were not legislated for delegated job performance. Conclusion: In this study identified clinical roles that medical doctors considered possible for legal delegation to APN were identified. The results can be used as evidence for the legalization of the practice of APN.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.6
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• pp.293-298
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• 2015

Objectives: Infection involving the orbit, zygomatic space, lateral pharyngeal space, or hemifacial and oral floor phlegmon is referred to as cervicofacial infection (CFI). When diagnosis and/or adequate treatment are delayed, these infections can be life-threatening. Most cases are the result of odontogenic infections. We highlight our experiences in the management of this life-threatening condition. Materials and Methods: This was a retrospective study of patients who presented with CFI from December 2005 to June 2012 at the Oral and Maxillofacial Surgery Clinic or the Accident and Emergency Unit of Ahmadu Bello University Teaching Hospital (Zaria, Nigeria). The medical records of all patients who presented with either localized or diffuse infection of the maxillofacial soft tissue spaces were retrospectively collected. Data collected was analyzed using SPSS version 13.0 and are expressed as descriptive and inferential statistics. Results: Of the 77 patients, 49 patients (63.6%) were males, a male to female ratio of 1:7.5. The ages ranged from two years to 75 years with a mean of $35.0{\pm}19.3$ years, although most patients were older than 40 years. The duration of symptoms prior to presentation ranged from 6 to 60 days, with a mean of $11.0{\pm}9.4$ days. More than 90% of the patients presented to the clinic within the first 10 days. The most commonly involved anatomical space was the submandibular space (n=29, 37.7%), followed by hemifacial space (n=22, 28.6%) and buccal space (n=7, 9.1%). Ludwig angina accounted for about 7.8% of the cases. Conclusion: CFI most commonly involves the submandibular space, typically affects individuals with a low level of education, and is influenced by traditional medical practices. Despite improved health care delivery, CFI remains a significant problem in developing countries.

• Bulletin of the Korean Chemical Society
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• v.15 no.10
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• pp.873-881
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• 1994

The approximate rate and stoichiometry of the reaction of excess diisobutylaluminum hydride-dimethyl sulfide complex($DIBAH-SMe_2$) with organic compounds containing representative functional group under standardized conditions (toluene, $0{\circ}C$) were examined in order to define the reducing characterstics of the reagent and to compare the reducing power with DIBAH itself. In general, the reducing action of the complex is similar to that of DIBAH. However, the reducing power of the complex is weaker than that of DIBAH. All of the active hydrogen compounds including alcohols, amines, and thiols evolve hydrogen slowly. Aldehydes and ketones are reduced readily and quantitatively to give the corresponding alcohols. However, $DIBAH-SMe_2$ reduces carboxylic acids at a faster rate than DIBAH alone to the corresponding alcohols with a partial evolution of hydrogen. Similarly, acid chlorides, esters, and epoxides are readily reduced to the corresponding alcohols, but the reduction rate is much slower than that of DIBAH alone. Both primary aliphatic and aromatic amides examined evolve 1 equiv of hydrogen rapidly and are reduced slowly to the amines. Tertiary amides readily utilize 2 equiv of hydride for reduction. Nitriles consume 1 equiv of hydride rapidly but further hydride uptake is quite slow. Nitro compounds, azobenzene, and azoxybenzene are reduced moderately. Cyclohexanone oxime liberates ca. 0.8 equiv of hydrogen rapidly and is reduced to the N-hydroxylamine stage. Phenyl isocyanate is rapidly reduced to the imine stage, but further hydride uptake is quite sluggish. Pyridine reacts at a moderate rate with an uptake of one hydride in 48 h, while pyridine N-oxide reacts rapidly with consumption of 2 equiv of hydride for reduction in 6h. Similarly, disulfides and sulfoxide are readily reduced, whereas sulfide, sulfone, and sulfonic acid are inert to this reagent under these reaction conditions.

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.2
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• pp.104-109
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• 2008

Purpose: Unrefined tablets prepared from Aconitum tubers are occasionally used in Korean folk medicine. This study defines the potential sources, clinical toxicology, and treatment of aconitine poisoning. Methods: A retrospective survey was conducted in 63 patients in the ED of a tertiary University Hospital with suspected toxicity from an unrefined tablet prepared from Aconitum tubers from 1999 to 2007. Results: A total of 63 cases enrolled included 26 men and 37 women, aged 30 to 86 years. Forty-eight patients ingested aconitine tablets as digestives, 26 tablets on average. After a latent period of 30 to 450 minutes, patients developed a combination of neurologic (87.3%), gastrointestinal (82.5%), cardiopulmonary (41.3%), and other (28.6%) features typical of aconitine poisoning. Initial ECG abnormalities revealed dysrhythmia (61.9%), conduction disturbance (42.9%), and abnormal waveforms (39.7%), with 28.6% of patients having normal ECGs. All patients received supportive treatment or close observation regardless of ingestion amounts. Patients with hypotension or ventricular arrhythmia were treated with inotropic agents or amiodarone. Conclusion: Toxicologic signs and symptoms can occur after the consumption of aconitine tablets, regardless of ingestion amount. The risk occurs because of inadequately processed aconitine roots. This study will provide important data for public education and distribution regulations for Aconitum sp. in Korea.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.1
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• pp.43-49
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• 2021

Objective: Exercise is a risk factor for infertility in women. However, research on the effects of different intensities of exercise on folliculogenesis has not yielded clear results. This study was conducted to analyze the effects of differences in the intensity of exercise on folliculogenesis in mice. Methods: Nineteen female BALB/c mice (age, 3-4 months; weight, 13-25 g) were randomly divided into four groups: control, mild exercise, moderate exercise, and high-intensity exercise. The mice in the exercise groups engaged in swimming, with additional loads of 3%, 6%, or 9% of body weight, respectively. There were five swimming sessions per week for 4 weeks, with a gradually increasing duration every week. At the end of the treatment, ovarian extraction was carried out and hematoxylin and eosin staining was performed to identify folliculogenesis. Results: There were significant differences in the number of total follicles between the control and moderate-exercise groups (p=0.036) and between the mild- and moderate-exercise groups (p=0.005). The mean number of primary follicles was higher in the moderate-exercise group than in the mild-exercise group (p=0.006). The mean number of secondary, tertiary, and Graafian follicles did not differ significantly among groups (p≥0.05). However, the number of total follicles and follicles in each phase tended to increase after exercise, especially moderate-intensity exercise. Conclusion: Exercise of different intensities affected the total number of follicles and primary follicles. The number of follicles of each phase tended to increase after exercise. Moderate-intensity exercise had better effects than other intensities of exercise.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.4
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• pp.79-92
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• 2020

Purpose : The purpose of this study was to evaluate the prescription pattern of NSAIDs and GPAs in the arthritis patients over 65 years old to prevent the GI adverse events. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used agents to treat arthritis, can cause gastrointestinal (GI) adverse effects. Recent guidelines recommend that moderate risk patients who have one or two risk factors, should be prescribed either combination of non-selective NSAID (nsNSAIDs) and gastroprotective agent (GPAs) or selective NSAID alone. Methods : Study population was National Patient Sample of 2011. Number of drugs used were 138 for NSAIDs and 21 for GPAs. Chi-square test was used to compare prescribing patterns. Results : The appropriate prescription rate follows the guideline was 11.2%: co-prescription with nsNSAID and proton pump inhibitor (PPI) or misoprostol was 1.6% and selective NSAID alone was 9.6%. Inappropriate prescription rates were as follows: co-prescription with nsNSAID and Histamine-2 receptor antagonist (H2RA) or antiacid was 53.8% and nsNSAID alone was 35.0%. The appropriate prescription rate among the types of medical institute was 54.4% in tertiary hospital, 31.2% in secondary hospital, and 6.0% in primary hospital. The appropriate prescription rate among the regions was 19.4%, highest in Seoul and 4.2%, lowest in Jeju. The appropriate prescription rate among the medical departments was as follow: 12.2% in orthopaedic surgery, 11.0% in internal medicine, and 7.7% in other departments. Conclusion : This finding suggests the needs to revise the national medical insurance imbursement policy, provide continuing medical education about the guideline of medical doctors.

• Journal of Korean Biological Nursing Science
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• v.23 no.2
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• pp.91-99
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• 2021

Purpose: This study aimed to identify occupational stress and health problems as well as turnover reasons among leavers in novice nurses and to estimate factors which might affect turnover by comparing them to stayers. Methods: In this study, secondary analysis of data gathered from the Shift Work Nurse's Health and Turnover studies, was carried out. The data were collected from 204 stayers who have been working for 18 months since 2018 and 48 leavers who left within the same period at two tertiary hospitals in Seoul. The reasons for turnover, occupational stress, and 8 types of health problems were recorded. The data were analyzed using SAS 9.4 to obtain descriptive statistics. In parallel, Pearson's chi-squared test, Fisher's exact test, and independent t-test were also conducted. Results: The main reasons for turnover were job stress and difficult interpersonal relationships in the workplace. Occupational stress of leavers was higher than stayers, especially in the subscales of interpersonal conflict, organizational system, lack of reward, and occupational climate. Among the 8 types of health problems, the depression prevalence of leavers was higher compared to stayers and showed marginal significance. Unexpectedly, the sleep disturbance prevalence of stayers was significantly higher compared to leavers. Conclusion: To reduce the turnover rate of novice nurses, education on how to cope with occupational stress is needed. A customized program for novice nurses to overcome the difficulties of interpersonal relations would be helpful.

• Journal of Korean Clinical Nursing Research
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• v.27 no.3
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• pp.233-244
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• 2021

Purpose: The purpose of this study was to investigate the actual utilization of clinical practice guidelines developed by Hospital Nurses Association. Methods: The subjects were 70 nurses who were in charge of guideline distributions in 70 advanced general hospital and general hospitals with 500 beds or more nationwide. Data were collected between June and August, 2020 by mail (return rate: 88.6%). Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS/WIN 24.0. Results: Among the clinical practice guidelines developed by Hospital Nurses Association, 72.9~90.1% were placed with book and electronic file in nursing department and 24.3~35.8% were placed with book and electronic file in each nursing unit at hospital. The average number of utilized clinical practice guidelines were 3.96±3.88, and average score of guideline utilization was score 2.85±0.79 which means 'use sometimes'. Conclusion: To improve the distribution and utilization of the clinical practice guidelines, it is necessary to enhance the recognition of values of evidence based nursing practice targeting head of nursing department and to stimulate the distribution and utilization of the clinical practice guidelines using diverse education programs for staff nurses.

• Journal of Hospice and Palliative Care
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• v.24 no.4
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• pp.235-244
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• 2021

Purpose: This study aimed to provide basic data for developing interventions to relieve the end-of-life care stress experienced by pediatric nurses by examining the relationships of end-of-life care stress with compassionate competence and attitudes toward end-of-life care. Methods: Data were collected via a survey that was conducted from September 10 to September 30, 2018 and administered to 113 nurses who had worked for more than 6 months in a pediatric unit at a tertiary hospital in Seoul, South Korea. The data were analyzed for frequency, percentage, mean, and standard deviation, and the independent t-test, one-way analysis of variance, and Pearson correlation analysis were conducted using SPSS version 25.0. Results: End-of-life care stress among pediatric nurses had a weak positive correlation (r=0.216, P<0.05) with compassionate competence and had no significant correlation with attitudes toward end-of-life care. Among the sub-factors of end-of-life care stress, psychological difficulties had a weak positive correlation with sensitivity (r=0.309, P<0.01) and communication (r=0.230, P<0.05), which are aspects of compassionate competence. Lack of knowledge about end-of-life care had a weak positive correlation with communication (r=0.209, P<0.05) as an aspect of compassionate competence. Conclusion: To improve the quality of end-of-life care provided by pediatric nurses, it is necessary to improve their compassionate competence and reduce their end-of-life care stress by developing education and support programs tailored to the characteristics of children and specific communication methods.

• Journal of Korean Critical Care Nursing
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• v.15 no.3
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• pp.51-61
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• 2022

Purpose : This study aimed to verify the effectiveness of the clinical ladder system (CLS) by identifying the perception of the CLS, professional self-concept, self-efficacy, and organizational commitment among intensive care unit (ICU) nurses. Methods : Data were collected through a questionnaire survey of 173 nurses working in 11 ICUs at a tertiary hospital in Seoul. Results : The perception of the CLS, self-efficacy, and organizational commitment showed significant difference according to the CLS level. As a result of the partial Spearman correlation analysis after adjusting for demographic difference according to CLS (age, marital status, education, and clinical career), CLS positively correlated with the perception of the CLS (r=.16, p=.045), professional self-concept (r=.24, p=.001), and self-efficacy (r=.21, p=.007). On the contrary, organizational commitment negatively correlated with the perception of the CLS (r=-.43, p<.001) and self-efficacy (r=-.32, p<.001). Conclusion : The CLS is effective for professional self-concept and self-efficacy. However, specialists 2 nurses, who had high professional self-concept and self-efficacy, showed low level of organizational commitment. Thus, it is necessary to examine the factors of work burden and career plateau that are imposed after promotion and improve experience and planning according to the growth needs. Moreover, regular evaluation of the CLS will require hospital support to ensure that ICU nurses appreciate and actively participate in the support.