Indoor air pollutants and atopic dermatitis in socioeconomically disadvantaged children

PURPOSE: The aims of this study were to examine indoor concentrations of air pollutants in socioeconomically disadvantaged houses and to investigate relationships between indoor air pollutant levels and the severity of atopic dermatitis (AD). METHODS: A total of 54 children who had a past history or current symptoms of AD were enrolled in the study. To evaluate the levels of indoor air pollutants, we measured concentrations of CO2, total volatile organic compounds (TVOC), formaldehyde, particulate matter with diameter less than 10 microm (PM10), airborne mold and numbers of house dust mite (HDM) in dust of the children's houses. All studied subjects completed physical examination for the severity of AD and blood tests. RESULTS: Although the mean (+/-standard deviation [SD]) concentration of indoor CO2 (600.6+/-179.4 ppm) was lower than the standard recommended levels of multiplex buildings in Korea, there was a significant correlation between CO2 concentrations and the severity of AD (r=0.302, P=0.030). The geometric means (range of 1 SD) of TVOC (42.5 microg/m3 [22.2-81.5]), formaldehyde (24.3 microg/m3 [15.0-39.9]), PM10 (26.6 microg/m3 [14.6-48.4]), and airborne mold (49.9 CFU [colony forming unit]/m3 [26.3-94.6]) were not significantly higher than the standard recommended levels of multiplex buildings. Two-thirds of the subjects were sensitized to at least 1 of the common allergens. CONCLUSION: Generally, indoor air pollution was not serious in socioeconomically disadvantaged households. However, indoor CO2 concentrations are closely related to the severity of AD in children living in socioeconomically disadvantaged houses. Environmental amelioration targeting vulnerable population may improve the quality of life and decrease the prevalence of environmental allergic diseases.

Effects of Hearing Recorded Mother's Voice on Physiological Reactions and Behavioral State of Sleep, Weight of Very Low Birth Weight Infants

PURPOSE: The purpose of this study was to identify whether hearing a recording of mother's voice affected physiological reactions, behavioral state related to sleep and weight of very low birth weight (VLBW) infants. METHODS: This was a nonequivalent control group pre-post test quasi-experimental design. The participants were 11 VLBW infants in the experimental group and 11 in the control group. In the experimental group, a recording of mother's voice was played to her infant by voice recorder four times each day for five minutes over 10 consecutive days in the incubator. RESULTS: For physiological response (heart rate, respiration rate, oxygen saturation), there were statistically significant differences between the experimental and control groups. Behavioral state during sleep was more very quiet and quiet in the experimental group. In the daily weight change, there was no significant difference between the experimental and control groups. CONCLUSION: The findings suggest that, for VLBW infants, the intervention of hearing a recording of mother's voice had some significance as a nursing intervention having a positive impact. Such interventions can help pediatric nurses to stabilize the physiological response and maintenance more very quiet sleep state and improve VLBW infants' growth.

Validity of Cough-Holter Monitoring for the Objective Assessment of Cough and Wheezing in Children with Respiratory Symptoms / 소아알레르기및호흡기학회지

PURPOSE: Cough and wheezing are the most common respiratory symptoms in children. Recently, the cough-holter monitoring has been used to estimate the frequency and intensity of cough and wheezing, objectively. In this study, we aimed to evaluate the validity of cough-holter monitoring for the objective assessment of cough and wheezing in the hospitalized children with respiratory symptoms. METHODS: Cough-holter monitoring was performed in 59 children who suffered from cough and/or wheezing. We obtained the information on the frequency and intensity of cough and wheezing from the parents, a pediatrician, and cough-holter monitoring. Visual Analogue Scale (VAS) scores were taken by parents, and the pediatrician estimated the wheezing score by using a stethoscope. We assessed a relationship between the VAS scores, wheezing score, and cough-holter monitoring data. RESULTS: The frequencies and intensities of cough correlated positively with the VAS scores (r=0.301, P=0.032; and r=0.540, P=0.001, respectively) and the frequencies and intensities of wheezing also correlated positively with the Wheezing scores. (r=0.335, P=0.011; and r=0.457, P=0.001, respectively) The wheezing intensity did not correlate with the Wheezing score in wheezing children. (r=0.321, P=0.089) CONCLUSION: Cough-holter monitoring correlated positively with the VAS scores and the wheezing scores. Cough-holter monitoring appears to be a useful objective assessment tool for the children who have suffered from cough and/or wheezing.

Ipsilateral Posterior Spinal Artery Infarction on Lower Medulla and Upper Cervical Spinal Cord: A case report

Spinal cord infarction is uncommon and accounts for only 1% of all strokes in comparison with cerebral infarction. Furthermore, posterior spinal cord infarction is particularly rare because of an anastomotic network of direct penetrating vessels and plexus of pial vessels fed by the paired posterior spinal arteries. We report a case of unilateral posterior spinal artery infarction on lower medulla and upper cervical spinal cord in a patient of 60-year-old woman. She complained of continuous headache for several weeks and suddenly presented right facial paresthesia, slow progression of motor weakness and proprioceptive sensory loss on right extremity, and voiding difficulty. Magnetic resonance and computed tomography imaging studies confirmed acute infarction at the right posterolateral aspect of the lower medulla and upper cervical cord (C1-2 level) with right vertebral artery hypoplasia. Transcranial doppler sonography also showed right vertebral artery hypoplasia rather than stenosis with atherosclerosis.

Detection of Saliva Aspiration Using Salivagram in Bedridden Patients with Brain Lesion

OBJECTIVE: To investigate the aspiration of saliva itself in bedridden patients with brain lesion using the response of radionuclide salivagram, and its association with patient characteristics and clinical factors. METHOD: Thirty two patients (21 men and 11 women) in bedridden state with brain lesion were performed the radionuclide salivagram. (99m)Tc sulfur colloid (1.0 mCi in a drop of saline) was instilled into patients' tongue with supine position. The sequential images were obtained at first 5 minutes and 10 minutes interval for 1 hour, and evaluated the presence of saliva aspiration as the entrance of tracer into major airways or lung parenchyma. The characteristics of patients and the states of cooperation, drooling, tracheostomy, and method of feed were also assessed. RESULTS: Seven out of 32 subjects exhibited positive response of saliva aspiration by radionuclide salivagram. Men, uncooperative, and anterior drooling was significantly associated with positive finding of salivagram (p<0.05). CONCLUSION: In bedridden patients with brain lesion, it seems that radionuclide salivagram may be one of methods for detection of the aspiration of saliva itself.

Effects of Continuous Repetitive Transcranial Magnetic Stimulation on Pain Response in Spinal Cord Injured Rat

OBJECTIVE: To investigate the effects of continuous repetitive transcranial magnetic stimulation (rTMS) on pain response in spinal cord injured rat. METHOD: Forty Sprague-Dawley rats (200~250 grams, female) were used. Thoracic spinal cord (T9) was contused using New York University (NYU) spinal cord impactor. Ten gram weight rod was dropped from a height of 25 mm to produce spinal cord contusion model with moderate injury. The animals were randomly assigned to two groups: one exposed to real magnetic stimulation (real-rTMS group) and the other not exposed to magnetic stimulation (sham-rTMS group). rTMS was applied for 8 weeks. To assess the effect of continuous rTMS on below-level pain responses after spinal cord injury (SCI), the hindpaw withdrawal response for thermal stimuli, cold stimuli and mechanical stimuli were compared between two groups. RESULTS: Behavioral response for pain showed that hindpaw withdrawal response for cold stimuli was reduced significantly from 4 weeks after SCI in real-rTMS group compared with sham group (p<0.05). CONCLUSION: These results suggest that continuous rTMS may have beneficial effects on attenuation of cold allodynia after SCI, and it might be an additional non-invasive therapeutic method in patients with chronic neuropathic pain after SCI.

Social Support, Self-concept and Self-efficacy as Correlates of Adolescents' Physical Activity and Eating Habits

BACKGROUND: Despite growing knowledge of the importance of the management of diet and physical activity in the prevention of obesity in adolescence, a better understanding of social psychological influences could assist efforts in family, school and community settings. METHODS: Among the 3,653 adolescents who were randomly selected from seven separate school districts in Busan, 2,938 (83.9%) completed the questionnaire. The students who agreed to participate in this study were given a questionnaire which included social support as the Child and Adolescent Social Support Scale, self-efficacy as the physical self-efficacy questionnaire, self-concept as the Song and Hattie Test, physical activity as a Leisure-Time Exercise Questionnaire and eating habits as the Harris questionnaire. RESULTS: The support from parents, teachers, classmates, close friends and other people in the community predicted the level of adolescents' self-concept and physical activity, while only the support from teachers and other people in the community predicted adolescents' dietary self-efficacy. Adolescents' self-concept and physical activity self-efficacy significantly predicted the level of physical activity. Self-concept and dietary self-efficacy also predicted healthier eating habits. Only the support from close friends predicted adolescents' healthy eating habits. The support from parents, teachers, close friends, classmates and other people in the community predicted the level of physical activity through increasing the level of self- concept or physical activity self-concept. CONCLUSION: Although adolescents' behavior are ultimately individualized, they are formed through cognitive processes which are affected by social support. These social levels, therefore, should be supportive of adolescents' physical activity and healthier eating habits by providing frequent support and encouragement to establish positive self-concept and self-efficacy.

Social Support, Self-concept and Self-efficacy as Correlates of Adolescents' Physical Activity and Eating Habits

BACKGROUND: Despite growing knowledge of the importance of the management of diet and physical activity in the prevention of obesity in adolescence, a better understanding of social psychological influences could assist efforts in family, school and community settings. METHODS: Among the 3,653 adolescents who were randomly selected from seven separate school districts in Busan, 2,938 (83.9%) completed the questionnaire. The students who agreed to participate in this study were given a questionnaire which included social support as the Child and Adolescent Social Support Scale, self-efficacy as the physical self-efficacy questionnaire, self-concept as the Song and Hattie Test, physical activity as a Leisure-Time Exercise Questionnaire and eating habits as the Harris questionnaire. RESULTS: The support from parents, teachers, classmates, close friends and other people in the community predicted the level of adolescents' self-concept and physical activity, while only the support from teachers and other people in the community predicted adolescents' dietary self-efficacy. Adolescents' self-concept and physical activity self-efficacy significantly predicted the level of physical activity. Self-concept and dietary self-efficacy also predicted healthier eating habits. Only the support from close friends predicted adolescents' healthy eating habits. The support from parents, teachers, close friends, classmates and other people in the community predicted the level of physical activity through increasing the level of self- concept or physical activity self-concept. CONCLUSION: Although adolescents' behavior are ultimately individualized, they are formed through cognitive processes which are affected by social support. These social levels, therefore, should be supportive of adolescents' physical activity and healthier eating habits by providing frequent support and encouragement to establish positive self-concept and self-efficacy.

Status of Nosocomial Urinary Tract Infections in the ICU: Molecular Epidemiology of Imipenem Resistant P. aeruginosa / 간호학회지

PURPOSE: This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors andtransmission route of causal IRPA through molecular epidemiology. METHOD: Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA. RESULT: The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection. CONCLUSION: Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.

Effects of Patient-Controlled Analgesia Pump on the Postoperative Patient's Pain Management and Recovery of Bowel Movement with Gastrointestinal Cancer / 기본간호학회지

PURPOSE: The purpose of this study was to explore the effects of Patient Controlled Analgesia (PCA) on the postoperative patient's pain management and recovery of bowel movement with gastrointestinal cancer. METHOD: The participants were 249 patients diagnosed with gastrointestinal disease and scheduled for elective surgery, who were recruited to either the postoperative patient-controlled analgesia group or epidural analgesia group. Participants aged 20 and above were recruited from P, K, D, and I university hospitals in B city. Pain visual analogue scale, and recovery of bowel movement according to PCA-related characteristics were measured using structured questionnaires from April 2005 through December 2005. Descriptive statistics t-test and F-test were used to analyze the data. SPSS WIN 10.0 program was used. RESULTS: Mean score for pain was 62.31. Scores for pain on the visual analogue scale were significantly lower in the epidural-PCA than in the intravenous PCA, and also significantly lower in the absence of side effect of PCA than in the presence of side effect. Recovery time for bowel movement was significantly faster in the absence of side effect of PCA than in the presence of side effect. CONCLUSION: Based on the findings, there is a significant difference in pain and no difference in first passage of flatus according to PCA infusion route in patients who are post-operative for gastrointestinal cancer.

A Study of Airborne Microbes in the NSICU According to Number of Persons Who Pass through Every Hour / 기본간호학회지

PURPOSE: The purpose of this study was to analyze the colony count of airborne microbes contamination every hour in the Neurosurgical Intensive Care Unit (NSICU) in order to identify the relationship of colony count to person-visits. METHODS: Data were collected during from 11:00 a.m. September 5 to 11:00 a.m. September 6, 2002. This study used blood agar & nutrient agar and handtally counter (USA) for collection of airborne microbes and number of person-visits. Data was analyzed using the SPSSWIN 10.0 with means, Pearson correlation coefficient, and simple regression. RESULTS: The result of this study are as follows. Total colony count of airborne microbes for 24 hours in the NSICU was 4,609. Total number of person-visits to the NSICU was 15,347. The highest scores for the total colony count in different areas of the NSICU was the rear door, followed by the preparation room, and the front entrance, while the lowest count was in the isolation rooms. There was a statistically significant relationship between colony count and number of person-visits to the NSICU. The most frequently airborne microbes in the NSICU were Micrococcus, CNS, Staphylococcus Micrococcus, Aureus. CONCLUSION: These findings indicate that the number of person-visits in hospitals influences total colony count of airborne microbes. This study contributes to assessment of biological indoor air quality in hospital and in the development of an NSICU care plan.

A study on the Compliance and Educational Demand of Renal Transplantation Patient / 재활간호학회지

This study was started for the purpose of providing the basic data for continous managment of kidney transplantation patients after discharge. This study was conducted on 180 patients who received renal transplants at three hospital ( B, M. P) pusan, korea.. The data collection was done for june 1. to August 31. 2002. General characteristics, renal transplantaton characteristics. physical characteristics, the level of compliance and the degree of educational demand were done by the number and percentage. the mean. standard deviation. The level of compliance and educational demand followed by the characteristics of general and kidney transplantation were analyzed by t-test and ANOVA. The result were as fallows: 1. Man was higher than woman such as 60.0%, Mean age was 42.5 years old. Average total duration of after operation was 5.5 years. 2. Cases of systolic blood pressure over 140mmHg were 10.0%, cases of diastolic blood pressure over 90mmHg were 22.8% and obesity factor in BMI was 15.6%. The person who daily water intake amount is 5000cc was 0,6%, the case that daily urine output is below 1000cc was 8.9%. and the case that urine output is zero was 0,6%. 3. The mean score of compliance was 77.47 point. The score in medication part was highest such as 4.67 point, that in stress situation was lowest such as 3,50 point. 4. The average score of educational demand was 154.02 point. and physical state part was 4.36 points highest. activation part was 3.48 points lowest. As a role of nurse Confirmation of compliance is very important encourage to make good through regular hospital visitation. point out the noncompliance part and then increase compliance of renal transplantation patient As well there will be maintain the normal kidney function to satisfy educational demand through continous education.

A Study on Hip Arthroplasty Patient Compliance of Medical Regimen / 재활간호학회지

PURPOSE: The purpose of this study is to examine how well patients who had hip arthroplasty comply with medical regimens given to them after the operation. METHOD: The subjects of the study were patients who had arthroplasty at P Hospital between April 1. 2001 and August 30, 2002. 20 patients of the subjects experienced complications after the operation and the other 20 did not. Data from a survey using the qustionnaire were statistically analyzed in terms of real number, percentage point, mean and standard deviation by using chi2test. t-test and ANOVA. RESULT: 1) the surveyed patients were significantly different in the compliance of medical regimen among them according to their education background as one of the subjects general characteristics. 2) It was found that the group of complication was higher in the compliance of medical regimen than that of non-complication. The two groups showed statistically significant difference with each other in the degree of compliance with therapeutic instructions than the experimental group in terms of the maintenance of abduction after the operation, training instructions on step-by-step basis, urination cotrol on bed, accurate use of crutch, compliance with medication, balance among medical treatment, training, leisure, rest and nutrition. instructions by physicians, nurses and physical therapists, use of low armchairs and toilet bowels and no bending of the body forward, and use of a non-operated leg in case of go upstairs or downstairs. CONCLUSION: It seems necessary to develop systematic and sessional education programs for improving the compliance of medical regimen. ultimately reducing complications following hip arthroplasty.

The Actual State of Handwashing in Nurses in Medical and Surgical Wards of a University Hospital

BACKGROUND: This study investigated the handwashing in clinical nurses for prevention and control of nosocomial infection. METHODS: The subjects were 192 nurses at a university hospital in Busan. The data were collected using questionnaires, which included items to measure the method, application time, and frequency of handwashing related to nursing intervention activities, and were analyzed using the mean score, frequency and percentage. RESULTS: Each day, the nurses had an average of 10.5 times of hand washing. 34.9% of nurses had evaluated "not enough" concerning their handwashing performance. Nurses indicated that the performance of handwashing had interrupted by overwork, lack of facilities, skin irritation with itching, etc. 19.4% of nurses had not received education program about handwashing. Some nurses did not strictly follow a handwashing protocol allowing potential chances of nosocomial infection to occur. The rate of handwashing performance increased after the activities of nursing intervention than before activities related to respiration, nutrition, elimination, hygiene, medication, etc. CONCLUSION: These findings suggest that hospital administrators must develop education programs and policies for the prevention of nosocomial infection. We recommend that nurses participate in education to search for practical methods to improve the management of nosocomial infection such as handwashing performance.

A Study of Accident-Prevention Education, Accidents and School Facilities for Safety Perceived by Elementary Schoolers / 아동간호학회지

This study was conducted to obtain a basic information related to a more systematic safety education and measures against children's accidents by a descriptive survey with regard to accidents actually experienced by elementary schoolers, their perceived safety education activities and school facilities to their safety lives. The data was collected among 1,654 pupils, belonging to the 5th and 6th grades in Pusan from Nov. 20 to Dec. 1, 2000. The data was analyzed using SPSSWIN(7.5). The results were as follows ; 1. According to the perception by elementary schoolers, they received safety life instruction at school in most cases from teachers in charge of their own class (41.0%). Such safety education was provided often during formal classes(24.4%). Traffic guidance was given by parents, highest in frequency(67.3%). 2. Matters as most often treated during safety life instruction were safety knowledge or dangerous things(37.5%). A majority of notices of school safety instruction were presented sometimes(48.4%). Source of knowledge about safety lives included teacher (35.3%), parents(32.9%), TV and newspaper (29.9%). As a source of knowledge of emergency treatment, school nurses were accounted for 41.3% that was highest. 3.Among the 1,654 students, 91.8% experienced at least more than one case of safety accident. The most frequent type and cause of safety accident were wound(33.7%). and self-carelessness(38.4%) respectively. In most cases, the subject experienced such accident during a break time(32.2%) and at a playgrounds. Part of body as most often damaged by accidents were arms and legs, 25.4% higher than any other sides problem solving measures against the accident were taken by school nurse in most cases, 44.8% in percentage point. 4. Those students' perceived safety management of school facilities showed that they considered classroom facilities as most safe (61.6%), while playground facilities as least safe(42.8%). They also responded that the treatment of glass fragments or stones at playground is the most important item of safety management.