Preliminary Report of Validity for the Infant Comprehensive Evaluation for Neurodevelopmental Delay, a Newly Developed Inventory for Children Aged 12 to 71 Months

Objectives@#Early detection of developmental issues in infants and necessary intervention are important. To identify the comorbid conditions, a comprehensive evaluation is required. The study’s objectives were to 1) generate scale items by identifying and eliciting concepts relevant to young children (12–71 months) with developmental delays, 2) develop a comprehensive screening tool for developmental delay and comorbid conditions, and 3) assess the tool’s validity and cut-off. @*Methods@#Multidisciplinary experts devised the “Infant Comprehensive Evaluation for Neurodevelopmental Delay (ICEND),” an assessment method that comes in two versions depending on the age of the child: 12–36 months and 37–71 months, through monthly seminars and focused group interviews. The ICEND is composed of three parts: risk factors, resilience factors, and clinical scales. In parts 1 and 2, there were 41 caretakers responded to the questionnaires. Part 3 involved clinicians evaluating ten subscales using 98 and 114 questionnaires for younger and older versions, respectively. The Child Behavior Checklist, Strengths and Difficulties Questionnaire, Infant-Toddler Social Emotional Assessment, and Korean Developmental Screening Test for Infants and Children were employed to analyze concurrent validity with the ICEND. The analyses were performed on both typical and high-risk infants to identify concurrent validity, reliability, and cut-off scores. @*Results@#A total of 296 people participated in the study, with 57 of them being high-risk (19.2%). The Cronbach’s alpha was positive (0.533–0.928). In the majority of domains, the ICEND demonstrated a fair discriminatory ability, with a sensitivity of 0.5–0.7 and specificity 0.7–0.9. @*Conclusion@#The ICEND is reliable and valid, indicating its potential as an auxiliary tool for assessing neurodevelopmental delay and comorbid conditions in children aged 12–36 months and 37–71 months.

Model Predicting Irritable Bowel Syndrome Severity in University Students

Purpose@#The purpose of this study was to build and verify a structural model that could predict the severity of irritable bowel syndrome in university students. @*Methods@#Participants were 205 students enrolled in college with irritable bowel syndrome using the irritable bowel syndrome module of the ROME IV Adult Questionnaire. The data were collected using online questionnaires in April- May 2019. The data were analyzed using the SPSS WIN 25.0 and AMOS 20.0 programs. @*Results@#1) The symptom severity that participants experienced were mild (14.6%), moderate (45.4%), and severe (40%). 2) Fit indices of the model were x2=79.66 (df=52, p=.009), CFI=.94, TLI=.96, RMSEA=.05, RMR=1.59, GFI=.94, and TLI=.96.3). The severity of irritable bowel syndrome was influenced directly by anxiety and sleep, and indirectly by family history, perfectionism, social support, coping, and stress. The severity of irritable bowel syndrome was indirectly affected by the following: family history through anxiety; perfectionism through stress, anxiety, and sleep; social support through coping, stress, anxiety, and sleep; coping through stress and anxiety; and stress through anxiety and sleep. @*Conclusion@#Based on the results of this study, a nursing intervention is needed to reduce the anxiety and stress and improve the quality of sleep to improve the health of the college students and manage the symptoms of patients with irritable bowel syndrome.

Validity and Reliability of the Behavior Development Screening for Toddlers-Questionnaire/Parents(BeDevel-Q/P): A Korean Autism Screening Instrument for Infants aged 24–35 Months

Objective@#This study tested the validity and reliability of the Behavior Development Screening for Toddlers-Questionnaire-Parents (BeDevel-Q/P), a new autism spectrum disorder (ASD) screening instrument being developed in South Korea. The parents of 24–35-month-old infants were recruited to complete the questionnaire. @*Methods@#The participants were 791 infants aged 24–35 months. There were 623 typically developing infants, 88 infants with ASD, and 80 developmentally delayed infants. For test-retest, the participants were surveyed every 1–4 weeks. Participants were recruited nationwide. Subjects’ parents completed the BeDevel-Q/P and concurrent validity questionnaires. The data were used for statistical analysis. @*Results@#A total of 24 items consisting of 16 items from factor 1 (F1), 6 items from factor 2 (F2), and 2 items from factor 3 (F3), were selected for the final BeDevel-Q/P items. @*Conclusion@#The factors of the screening instrument developed in this study were analyzed, and three factors were extracted, confirming the theoretical foundation of the BeDevel-Q for the parents of 24–35-month-old infants.

Factors Influencing Hand Dermatitis in Nurses

PURPOSE: This descriptive research was on hand dermatitis in clinical nurses. Nurses often have a high rate of hand dermatitis with several factors associated with the dermatitis. The factors analyzed in this study included; general characteristics, work-related factors, hand washing, and allergies relate to hand dermatitis. METHODS: Data were collected from April to May 2016. The subjects were nurses who had worked 12 months or more in a University Hospital. They voluntarily gave their consent for the research. The Symptombased questionnaires were sent to 220 nurses and 199 responses were returned. Collected data were analyzed using frequency, percentage, mean, standard deviation, χ2-test, and logistic regression analysis using SPSS 23.0. RESULTS: Prevalence of dermatitis in nurses was 48.2%. Nurses who had worked for over three years were twice more likely to suffer hand dermatitis than nurses who had worked for 3 years or less (adjusted odds ratio [adj. OR]=1.97, p=.036). Nurses who used alcohol sponge swabs more than 20 times per shift were 2.5 times more likely to suffer hand dermatitis as compared to those who used them less times (adj. OR=2.51, p=.023). CONCLUSION: Results revealed that about a half of the clinical nurses suffered from hand dermatitis, hence it is crucial to find appropriate interventions for dermatitis prevention. This concern needs to be addressed especially in nurses who have more work experience and use more alcohol sponge swabs.

Current Status of Biological Nursing Science Education for Clinical Nurses in General Hospital

PURPOSE: The purpose of this study was to investigate the extent and the nature of biological nursing science education for clinical nurses in general hospital. METHODS: Five advanced general hospitals located in Seoul and Gyeonggi province were conveniently sampled. Contents of education for nurses conducted by the hospital nursing department from January 1 to December 31 of 2015 were collected. Contents of education included biological nursing science and the scope of inclusion and time of assignment were analyzed. RESULTS: A total of 271 cases of nursing education data were collected and 223 cases were analyzed after excluding 48 cases whose contents were not confirmed. Biological nursing science was included in the contents of education for 117 cases (52.5%), but not for 106 cases (47.5%). Regarding the frequency of the biological nursing science education contents, ‘pathophysiology’was the most frequently included (n=286), followed by ‘structure and function of the human body’ (n=191), ‘mechanisms and effects of drugs’ (n=114) and ‘clinical microbiology’ (n=43). CONCLUSION: Results of this study confirmed that the education for clinical nurses included a lot of biological nursing science related contents. These results can be used as basis for the development of curriculum and training course for nurses.

Incidence and Comorbidity of Reactive Attachment Disorder: Based on National Health Insurance Claims Data, 2010–2012 in Korea

OBJECTIVE: We aimed to investigate the current diagnostic incidence, and medical and psychiatric comorbidities of reactive attachment disorder (RAD) using the National Health Insurance Review and Assessment (HIRA) claims data. METHODS: To examine the diagnostic incidence, we selected patients who were under 10-year-old and who had at least one medical claim containing a 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) code for RAD (F94.1 and F94.2) and who had not been diagnosed in the previous 360 days, from 2010 to 2012. In this study, we used the term ‘reactive attachment disorder’ representing for both RAD per se and Disinhibited social engagement disorder. Comorbid disorders were categorized according to ICD-10. RESULTS: Among 14,029,571, the total population under 10-year-old during 2010–2012, incident cases of RAD were 736. The mean diagnostic incidence of RAD was 5.25 per 100,000 annually. Language disorders (F80-84) were the most common psychiatric comorbidities in both boys and girls in age groups 0–3 years and 4–6 years, and attention deficit hyperactivity disorder was the most common in both sex aged 7–9 years. In non-psychiatric comorbidities, diseases of the respiratory system (J00–99) were the commonest in both sex in all age groups, and diseases of the digestive system (K00–99) were the next. CONCLUSION: RAD was very rare in practice and would be disguised as other psychiatric disorders. Children with RAD might have more medical comorbidities than typically developed children.

Vocalization of Emotional and Social Expressions in Korean-Speaking Toddlers with Autism Spectrum Disorder and Those with Developmental Delay

PURPOSE: This study aimed to examine the development of socializing and emotional expressions through vocalizations and joint attention (JA) behaviors in Korean-speaking children with autism spectrum disorder (ASD), compared to those with developmental delay (DD). MATERIALS AND METHODS: Video samples were collected from 28 toddlers with ASD and 18 age-matched toddlers with DD, and vocalizations were each coded in detail for the purpose of this retrospective research. In addition to some statistical analysis, Computerized Language Analysis was conducted to obtain the final results. RESULTS: Although they produced a higher number of vocalizations than the DD group, the ASD group did not engage in emotional or social interactions with their caretakers, whereas the DD group did. The children with ASD used more atypical vocalizations and socially unengaged vocalizations than the children with DD did. JA using vocalizations in the ASD group, in particular, was largely dyadic, with triadic types occurring at a significantly lower frequency than those in the DD group. CONCLUSION: Results from this study indicate the importance of assessing early vocalizations in toddlers with ASD, suggesting that some common symptoms of ASD, such as lack of typical, emotional, and social functions in early vocalizations, could be used to develop screening and intervention programs related to ASD.

Reliability and Validity of the Korean Version of the Infant-Toddler Social and Emotional Assessment

OBJECTIVE: This article examined the psychometric properties of the Korean version of the Infant-Toddler Social and Emotional Assessment (K-ITSEA). METHODS: Translation and back-translation of the K-ITSEA were conducted after obtaining a permission. Two thousand two hundred thirty six Korean community infants (1,199 boys and 1,037 girls) between the ages of 12 and 36 months (M=34.23, SD=3.80) and 90 clinical infant samples (60 boys and 30 girls) between the ages of 12 and 36 months (M=26.84, SD=6.24) participated in the present study. RESULTS: Confirmatory factor analyses supported the Internalizing, Externalizing, Dysregulation, and Competence domains as well as the 17 individual scales that comprise the K-ITSEA. Young children's sex and age differences emerged for some problem and most competence scales. All domains showed adequate intrascale reliability and test-retest reliability. Scale intracorrelation analyses and associations between the K-ITSEA and Korean version of PSI, Korean version of CBCL1.5-5 supported the validity of the assessment. Comparisons of the K-ITSEA scores for the Autism Spectrum Disorder, Psychiatric Disorders and Matched control groups supported the discriminant validity of the K-ITSEA. CONCLUSION: This preliminary results indicate that the K-ITSEA would be a useful assessment for detecting the early childhood's behavior problems and competences in Korean population.

Effects of Information Provision on Anxiety, Blood Pressure & and Pulse in Cerebral Angiography Clients

PURPOSE: This study was to evaluate the effects of information on anxiety, blood pressure and pulse in cerebral angiography clients. METHODS: The data were collected from June to November 2014. The participants were 42 (21 each for experimental and control group) patients who to received cerebral angiography. The information developed from researchers' materials for cerebral angiography was provided only to experimental group. Measured variables were anxiety, systolic and diastolic blood pressure, and pulse rate. Research tools for anxiety were Spielberger's state anxiety inventory, and 10 point visual analogue scale (VAS). RESULTS: The difference in mean systolic blood pressure after intervention between the experimental group (129±15.34) and the control group (141±17.70) was statistically significant (t=-2.28, p=.028). The differences between the two groups in state anxiety, VAS anxiety, diastolic blood pressure, and pulse rate after intervention were not statistically significant (p>.05). CONCLUSION: The information using educational material was effective in to decreasing systolic blood pressure in patients who received cerebral angiography. Therefore this study material could be used as a nursing intervention for patients in cerebral angiography.

Trends in Nursing Research in Korea: Research Trends for Studies Published from the Inaugural Issue to 2010 in the Journal of Korean Academy of Nursing and the Journals Published by Member Societies under Korean Academy of Nursing Science

PURPOSE: The purpose of this study was to identify trends for studies published in the Journal of Korean Academy of Nursing and journals published by member societies from inaugural issues to 2010. METHODS: A total of 6890 studies were analyzed using descriptive statistics. RESULTS: Quantitative studies accounted for 83.6% while qualitative studies accounted for 14.4%. Most frequently used research designs were quasi-experimental (91.1%) for experimental research and survey (85.2%) for non-experimental research. Most frequent study participants were healthy people (35.8%), most frequent nursing interventions, nursing skills (53.5%), and 39.8% used knowledge, attitude and behavior outcomes for dependent variables. Most frequently used keyword was elderly. Survey studies decreased from 1991 to 2010 by approximately 50%, while qualitative studies increased by about 20%. True experimental research (1.2%) showed no significant changes. Studies focusing on healthy populations increased from 2001-2005 (37.5%) to 2006-2010 (41.0%). From 1970 to 2010, studies using questionnaire accounted for over 50% whereas physiological measurement, approximately 5% only. Experimental studies using nursing skill interventions increased from 1970-1980 (30.4%) to 2006-2010 (64.0%). No significant changes were noted in studies using knowledge, attitude and behavior (39.9% ) as dependent variables. CONCLUSION: The results suggest that further expansion of true experimental, qualitative studies and physiological measurements are needed.

Effect of bite force on orthodontic mini-implants in the molar region: Finite element analysis / 대한치과교정학회지

OBJECTIVE: To examine the effect of bite force on the displacement and stress distribution of orthodontic mini-implants (OMIs) in the molar region according to placement site, insertion angle, and loading direction. METHODS: Five finite element models were created using micro-computed tomography (microCT) images of the maxilla and mandible. OMIs were placed at one maxillary and two mandibular positions: between the maxillary second premolar and first molar, between the mandibular second premolar and first molar, and between the mandibular first and second molars. The OMIs were inserted at angles of 45degrees and 90degrees to the buccal surface of the cortical bone. A bite force of 25 kg was applied to the 10 occlusal contact points of the second premolar, first molar, and second molar. The loading directions were 0degrees, 5degrees, and 10degrees to the long axis of the tooth. RESULTS: With regard to placement site, the displacement and stress were greatest for the OMI placed between the mandibular first molar and second molar, and smallest for the OMI placed between the maxillary second premolar and first molar. In the mandibular molar region, the angled OMI showed slightly less displacement than the OMI placed at 90degrees. The maximum Von Mises stress increased with the inclination of the loading direction. CONCLUSIONS: These results suggest that placement of OMIs between the second premolar and first molar at 45degrees to the cortical bone reduces the effect of bite force on OMIs.

Gastric Cancer Screening in Korea: Report on the National Cancer Screening Program in 2008 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The National Cancer Screening Program (NCSP) began in 1999. The objective of this report is to evaluate the results of the NCSP in 2008 and provide essential evidence associated with the gastric cancer screening program in Korea. MATERIALS AND METHODS: Data was obtained from the National Cancer Screening Information System; participation rates in gastric cancer screening were calculated. According to screening modalities, recall rates were estimated with 95% confidence intervals (CIs). RESULTS: The target population of the gastric cancer screening program in 2008 was 7,132,820 Korean men and women aged 40 and over, 2,076,544 of whom underwent upper endoscopy or upper gastrointestinal (UGI) series as screening tools (participation rate, 29.1%). Disparities in participation rates were observed relating to gender and health insurance type. Overall, recall rates of upper endoscopy and UGI series were 3.1% (95% CI, 3.0 to 3.1) and 33.3% (95% CI, 33.3 to 33.4), respectively. CONCLUSION: According to our research, efforts to facilitate participation and to reduce disparities in gastric cancer screening among Korean men and women are needed. These results will provide essential data for evidence-based strategies in gastric cancer control in Korea.

Effects of Fatigue on Health Promotion Behavior and Mental Health of Automotive Manufacturing Workers / 산업간호학회지

PURPOSE: This study investigated to relationship of fatigue, health promotion behavior and mental health in automotive manufacturing workers. METHODS: As a descriptive research design, the data were collected from 198 workers in a city. It was analyzed using the SPSS/WIN 12.0. RESULTS: The level of fatigue was beyond moderate, health promotion behavior was low, mental health was slightly unhealthy. The fatigue was significantly correlated with health promotion behavior. The global fatigue, job satisfaction and drinking explained 22.3% of health promotion behavior. CONCLUSION: It is necessary for the automotive manufacturing workers and their companies to reduce level of fatigue and mental health and to increase level of health promotion behavior.

Comparison of Health Locus of Control, Depression, Wellbeing, and Health Promoting Lifestyle Profile II in Middle Aged Korean and Korean-American Women / 여성건강간호학회지

PURPOSE: The purpose of this study was to identify differences in Health Locus of Control (HLOC), depression, wellbeing, and Health Promoting Lifestyle Profile II (HPLP) between middle aged Korean and Korean-American women. METHODS: Data from 80 Korean-American women living in Los Angeles, USA and 82 Korean women living in W-city, Korea, were collected using a self administered questionnaire including items on HLOC, HPLP, a Wellbeing Index and Major Depression Inventory. RESULTS: There were statistically significant differences between the middle aged Koreans and Korean-Americans on mean age, education, religion, and current health insurance. Significant differences were found on HLOC (F=2.504, p=.033) and Wellbeing (F=2.451, p=.036). The results also showed significant differences on HPLP (total HPLP, F=4.655, p=.001; physical activity, F=2.967, p=.014; nutrition, F=4.250, p=.001; spiritual growth, F=4.398, p=.001; interpersonal relations, F=2.648, p=.025; and stress management, F=5.201, p<.001) using ANCOVA. However, there were no significant differences on depression, or health responsibility in HPLP between the groups. CONCLUSION: Understanding middle aged women's health adjustments based on their culture will enhance the ability of health professionals to provide culturally congruent care and enable middle aged women to develop healthy lifestyles.

The Effects of a Tai Chi Exercise Program for Patients with Arthritis in Rural Areas

PURPOSE: The purpose of this study was to evaluate the effects of a Tai-Chi exercise program on subjective health and physiological function index. METHODS: This study was designed as non-equivalent control group pretest-posttest research. Eighteen women in each group completed the posttest with an attendance rate of 78.3 % after 12 weeks. The Tai Chi exercise program was provided two times a week over three months for the experimental group, but no program for the control group. A questionnaire was used for subjective health index, which consisted of Korean-WOMAC Index for joint stiffness, K-HAQ for physical disability, EQ-5D for quality of life and perceived health status, and CES-D for depression. To measure the effect on the physiological function index, femoral muscle strength, shoulder joint and back flexibility were measured. RESULTS: All variables except left anterior femoral muscle strength had significant homogeneity between the two groups. There were statistically significant differences between the experimental group and the control group in joint stiffness (t=-2.165, p=.03), physical disability (t=-2.231, p=.038), EQ-5D index (t=3.783, p=.001), perceived health status (t=-2.349, p=.025) and femoral posterior muscle strength (t=2.487, p=.038). CONCLUSION: The Tai-Chi exercise program was beneficial for women with arthritis in rural communities.

IgA Multiple Myeloma Presenting with Pathologic Fracture at Clavicle in a Patient with Ankylosing Spondylitis / 대한류마티스학회지

Multiple myeloma (MM) is a malignant monoclonal proliferation of plasma cells that commonly causes pathologic fractures in the vertebrae, femur, humerus and rib. Although the association of MM and ankylosing spondylitis (AS) has rarely been reported, most of MM patients with AS share the characteristic of IgA type paraproteinemia, which suggests the presence of mechanisms that possibly connect the two conditions. In this report, we describe a 47-year-old man with a 25-year history of AS, and he was diagnosed as having IgA kappa type MM with a pathologic fracture at the left clavicle. To the best of our knowledge, this is the first case of IgA myeloma presenting with a pathologic fracture in a patient with AS. We report here on this case along conducting a review of the relevant medical literature.

The Review on Characteristics, Pathophysiology and Risk Factors of Irritable Bowel Syndrome / 재활간호학회지

PURPOSE: Irritable bowel syndrome (IBS) is frequently yet little understood disease. Review was performed to promote understanding on the characteristics, pathophysiology, and risk factors of IBS. CONTENT: IBS is characterized by abdom in women and people with higher educational and social background, but there are some controversies. IBS is diagnosed by the Rome II or Manning criteria after excluding organic gastrointestinal diseases. The pathophysioloy is explained by abnormal control mechanism of central and enteric nervous system. Mucosal immunity, secretions, and neurotransmitter are also associated with the hypersensitivity and motility change of bowel function. Stress is known as a major triggering factor and contributed to symptoms. Other risk factors are genetic elements, childhood experiences, inflammation, anxiety, depression, diet, and sleep disorders.

A Case of Acute Renal Failure Caused by Cresol Ingestion / 대한신장학회잡지

Cresol, a commonly used disinfectant, is an extremly toxic material and can cause systemic effects such as respiratory, neurological, gastrointestinal, hepatic and renal damage. Cresol intoxication can be caused by inhalation, cutaneous adsorption or oral ingestion. Cresol denatures and precipitates cellular proteins, thus exer ts their toxic effects directly on all cells. There is only one case of cresol intoxication in Korea, but a case of chemical burn. We report a case of acute renal failure caused by cresol ingestion. A 39-year-old male attempted suicide by ingesting 200 mL of 50% cresol solution. Acute renal failure developed, but he recovered by only supportive care. It was reported that the lethal dose of saponated cresol solution is approximately 60-120 mL and the lethal blood level is 71-190 microgram/mL. The amount of cresol ingested by the patient far exceeded the reported lethal dose. This is the first case of acute renal failure caused by cresol ingestion successfully treated with only supportive care in Korea.

Turnover Experience of Hospital Nurses in Korea / 성인간호학회지

PURPOSE: The purpose of the study was to explore how hospital nurses decide to quit working as professional nurses using the grounded theory method. METHOD: The data was collected by individual in-depth interviews with 12 hospital nurses who recently resigned from work and it was analyzed using 'constant comparative analysis.' RESULT: The core category that emerged was "in search of new balance with self, work, and family". Three stages were identified: 1) "unconditionally accepting the working situation of itself," 2) "weighing advantages and disadvantages of working as a hospital nurse", and 3) "redesigning a future". Each stage contains three major strategies. The major strategies of the first stage are "maintaining a learning attitude", "enduring physical burnout," and "enduring unfair interpersonal relationships". The second stage contains "identifying advantages of working", "identifying disadvantages of working", and "comparing the advantages with the disadvantages". Lastly, the third stage includes "reassessing the aim of life", "beginning to construct an alternative life", and "deciding to quit working at a certain point". CONCLUSION: The results of the study will help nursing administrators in designing and implementing an effective turnover prevention program for nurses by understanding more deeply the process of turnover phenomenon among hospital nurses.

Horizontal versus Vertical Reading in Neglect Dyslexia: A Case Study

BACKGROUND: Neglect dyslexia is a type of neglect syndrome, in which patients with unilateral hemisphere injury omit or misread the contralateral side of a text or the initial letters of a word. Hangul can be arrayed vertically (vertical reading, VR) as well as horizontally (horizontal reading, HR). Thus, HR and VR can be differentially affected in neglect dyslexia. We conducted an experiment in a 66 year-old woman who suffered from neglect dyslexia after a right cerebral infarction. We compared HR with VR in terms of error frequencies and patterns. METHODS: Stimuli for neglect dyslexia consisted of 227 words. The 227 words were written horizontally or vertically (total 554 words) and were pre-sented in random order. The patient was asked to read the words and the examiner recorded the patient's responses and reaction times. RESULTS: The differences in HR and VR were as follows: 1) the error frequency in HR (59.0%) was higher than the error frequency in VR (20.3%), 2) the most frequent error in HR was syllabic deletion (79.1%) whereas phonemic substitution (89.1%) predominated in VR, 3) the error rate was highest at the first syllabic position in HR whereas no position effect was noted in VR. CONCLUSIONS: Patients with neglect dyslexia make less error in VR than in HR. The neural processing of HR may be different from that of VR. VR may be an alternative reading strategy that may be useful during the recovery stage of neglect dyslexia.