Effects of Cycled Lighting on Circadian Rhythms of Premature Infants

PURPOSE: Instead of a chaotic non circadian environmental approach, continuing regular day-night rhythm in neonatal nurseries may benefit the development of preterm infants. The purpose of this study was to define the effects of cycled lighting on circadian rhythms of premature infants. METHODS: The experimental group included 15 preterm infants, and the control group, 15 premature infants in the NICU of a general hospital in Seoul. All infants were between 32 and 37 weeks' postconceptional age. The experimental group infants were provided with cycled lighting before discharge. The incubator or bassinet cover of the experimental group was off between 7 AM and 7 PM, and was covered between 7 PM and 7 AM. RESULTS: There were significant differences in the NNNS score (p=.039), and some significant differences in the sleep-activity pattern between the experimental group and the control group, but distinct differences in sleep-activity patterns between the two groups could not be defined. CONCLUSION: The results of this study suggest that cycled lighting can be helpful in the neurobehavioral development of preterm infants. By modifying the NICU environment to provide a more developmentally supportive milieu, nursing professionals can better meet the infants' physiologic and neurobehavioral needs.

A Case of Cytomegalovirus Splenic Infarct in an Immunocompetent Adult / 감염과화학요법

Cytomegalovirus (CMV) infection is often asymptomatic in immunocompetent patients, but it could be reactivated to incur several serious complications in immunocompromized patients. There are several case reports of CMV induced vasculitis and endothelial cell inflammation that cause ischemia of organs in immunocompromised patients. However, CMV infection causing splenic infarct is rare in immunocompetent patients. Only twenty cases have been reported worldwide and this case report appears to be the first documented case of CMV infection causing splenic infarction in immunocompetent patient in Korea.

Acute Hemolysis and Renal Failure caused by Hepatitis A Infection with Underlying Glucose-6-Phosphate Dehydrogenase Deficiency / 대한진단검사의학회지

Although glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme disorder worldwide, it has rarely been reported among Korean. The patient was previously healthy 39 yr old male who showed severe hemolytic anemia and acute renal failure accompanied by hyperbilirubinemia after hepatitis A infection. The additional studies for differential diagnosis of hemolytic anemia showed a moderate deficiency of G6PD enzyme. Because hepatitis A infection in patient with G6PD deficiency present much more severe clinical symptoms, G6PD enzyme should be examined in patients with triggering factors of hemolysis such as hepatitis A infection.

A Case of Cytomegalovirus Splenic Infarct in an Immunocompetent Adult / 감염과화학요법

Cytomegalovirus (CMV) infection is often asymptomatic in immunocompetent patients, but it could be reactivated to incur several serious complications in immunocompromized patients. There are several case reports of CMV induced vasculitis and endothelial cell inflammation that cause ischemia of organs in immunocompromised patients. However, CMV infection causing splenic infarct is rare in immunocompetent patients. Only twenty cases have been reported worldwide and this case report appears to be the first documented case of CMV infection causing splenic infarction in immunocompetent patient in Korea.

Health Problems and Health Services in Child Day Care Centers / 아동간호학회지

PURPOSE: To investigate the health problems and health services in child day care centers. Methods: Data were collected from 115 teachers at 16 child day care centers in Seoul city. A questionnaire was used to collect data, which were analyzed with the SPSS 12.0 program. RESULTS: Most teachers had experienced various child health problems such as colds, hand?foot?mouth diseases, chicken pox, skin injuries, nasal bleeding, vomiting and diarrhea. Furthermore, they even experienced some serious ones including dysentery, measles, asthma and seizures, which demand professional skill. However, there were no registered nurses and most teachers requested that parents take a child home when these health problems happened. Only 31.3% of the child care centers had a teacher with CPR training. Approximately half of the centers kept child health records which included reports on allergic substances, and medical history but only 18.7% of the child care centers offered regular immunizations for the children. CONCLUSION: Various health problems were found in child day care centers. To maintain the children's health, there is a need to develop and make provisions for health services and programs in child day care centers.

The Evaluation of the Child-Care Web Sites on the Internet / 아동간호학회지

PURPOSE: This study was conducted to analyze web sites that provide child-care information and to provide a proper model for child-care web sites. METHOD: The evaluation tool with 23 items including purpose, contents, timeliness and reliability, interaction, and function was developed and modified. Quantitative analyses of 48 web sites, which were selected using popular search engines, were done. Result: 1) The aim of the web site was clearly shown for 24 sites (63.2%) and 17 sites (44.7%) provided the information for judging whether the informant was an expert. 2) Most web sites provided information on feeding, nutrition, and common health problems, and 11 sites provided information on care of problem behavior, but only 6 sites provided information on mother-infant interaction. 3) Timely information was provided on 21 sites, however none of the sites provided information sources. 4) Methods for contact the authors were found for 31 sites (81.6%) and 19 sites (50%) had active bulletin boards to receive opinions from users. 5) There were 32 sites where information could be found by clicking less than 3 times. CONCLUSION: We suggest that the evaluation criteria for child-care web sites used in this study is a tool that can be used to evaluate web sites with consistency, but there is a need for further study to develop standardization of the evaluating tool.

A Study of Humor as a Nursing Intervention for Hospitalized Children / 아동간호학회지

PURPOSE: Humor is an important part of life. Humor has many benefits as an intervention for hospitalized children. Humor is one strategy that pediatric nurses can use to help children cope with illness and hospitalizations. The purposes of the study were to 1) review the definition of humor, 2) identify methods and skills in using humor as an intervention, 3) identify the effects of humor as an intervention, and 4) suggest further research. METHOD: The design was a descriptive study with literature review. Previous studies were identified by searches of MEDLINE, CHNIAL, PUBMED and ProQuest. RESULTS: Humor has positive physiological, psychological, social and communicative effects on patients and humor has a positive effect on the immune system. CONCLUSION: The main point identified from this study suggests that humor as a nursing intervention be developed for nurses to use with children who are hospitalized. Further research is needed to develop programs for humor as an intervention for health promotion and disease prevention in children.

Dimensions and Attributes of Quality of Life in Korean School-age Children / 아동간호학회지

PURPOSE: The purpose of this study was to describe quality of life (QOL) in Korean school-age children by identifying dimensions and attributes of QOL from the child's point of view. METHOD: In-depth interviews with focus questions were used for the study. Twelve children, aged 10 to 13 years, were recruited from Seoul and rural areas. The interviews were audio-taped and transcribed before content analysis. The data were analyzed for themes and attributes. The researchers read the data together and discussed their conclusions until a consensus was reached. RESULTS: Eight dimensions, 57 subdimensions and 101atttributes were identified for QOL in school-age children. The eight dimensions of QOL were physical, social, emotional, learning, leisure, family, self-value, and material aspects. CONCLUSION: The study results can be utilized in developing reliable instruments to measure quality of life specific to school-age children. It is proposed that a consistent and unified policy should be established by school, family, and community for the purpose of improving the QOL of school-age children.

Annual Report on External Quality Assesment in Hematology in Korea (2004) / 임상검사와정도관리

Four trials of external quality assessment in diagnostic hematology were performed in 2004 with about 440 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, red blood cell count, platelet count, white cell differential count, red blood cell morphology and coagulation test. The response rate was more than 96%. The coefficients of variation in hemoglobin and RBC number was stable but variable in platelet number and WBC number according to measuring cell counts. Blood coagulation study was performed twice. Test results show wide variation according to measuring machine and reagents.

Development of Korean Infant Developmental Assessment Scale / 아동간호학회지

PURPOSE: To develop an Infant Developmental Assesment Scale appropriate for Korean infants that includes cultural context. METHOD: The total sample included 990 infants aged birth to 24months. The developmental tests were conducted at hospital well baby clinic, daycare centers, public health centers and homes located in city, urban and rural areas. Item analysis was done to examine content validity of the scale. Test responses were analyzed by SPSS to examine the inter-rater reliability, and construct validity. RESULTS: Based on the naturalistic observation and analysis of other developmental instruments, 260 Korean infant developmental items were created. The mean score of the developmental quotient of 966 infants was 101.63+/-10.89. Correlation coefficient of inter-rater reliability was .99. In addition, 84.6% of total items showed Kappa .70 and above. The development quotient was significantly different depending upon the residential area and father's occupation, therefore, construct validity using known group technique was supported. CONCLUSION: The developed instrument can be used to assess the development of handicapped infants, as well as normal infant's general abilities and to study individual differences within the normal range for Korean.

Annual Report on External Quality Assesment in Hematology in Korea (2003) / 임상검사와정도관리

Four trials of external quality assessment in diagnostic hematology were performed in 2003 with about 430 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, red blood cell count, platelet count, white cell differential count, red blood cell morphology and coagulation test. The response rate was more than 95%. The performance of quality assessment appeared to be gradually improved year by year.

An Analysis of the Concepts in Child Health Nursing Studies in Korea (2): The Practice, The Client-Nurse, The Environmental Domain / 아동간호학회지

The main purpose of this study is to examine the concepts appeared on research and provide future research directions in field of child health nursing. 205 studies of the total 318 studies had been analyzed first for the concepts of the client domain and this time 113 studies were analyzed for the practice, the client-nurse and the environmental domain in nursing. The practice domain includes mentalistitic, enactment, knowledge utilization, role related phenomenon, the client-nurse domain includes touch, communication, interaction phenomenon, and the environmental domain includes physical, social, symbolic environment. All were originally published between 1990 and 2000 in Korea. An analysis of concepts for this study was used the metaparadigm framework for nursing proposed by H. S. Kim(2000). 1. 103 studies belonged to the practice domain. Among them, 56(54%) studies used concepts related to enactment phenomenon like education(21.4%), giving information(7.1%), breast feeding(5.4%), caring(5.4%), airway suction(5.4%), nonnutritive sucking(5.4%). 44(43%) studies used concepts related to knowledge utilization like program development and evaluation of smoking, mother-infant interaction, home health nursing, obesity management. And only 3(3%) studies used role related concepts like quality of nursing, direction of health education, contents of child health nursing education. 2. Only 2(0.006%) studies belonged to the client-nurse domain. One concept is empathy in communication phenomenon and the other concept is role conflict in interaction phenomenon. 3. 8(0.02%) studies belonged to the environmental domain. Among them, 3 studies related to physical environment like space, noise and 5 studies related to social environment like social support, home environment. But the concept of symbolic environment was not used. The findings of this study provide the evidence that research related to the client-nurse domain and the environmental domain should be conducted actively to improve the practice of child health nursing. So that the research in field of child health nursing should be dealt with the concepts of four domains to develop knowledge systematically.

Behavioral Item List for Korean Infants by Naturalistic Observation / 아동간호학회지

PURPOSE: This study was conducted to identify behavioral items for Korean infants under 24months by naturalistic observation. These items will be the basis for developmental scale for Korean infants. METHOD: Data were collected by observing and interviewing fifty one infants and their mothers during the period from November 15 to December 14, 2003. Raw data in descriptive form were obtained by unstructured naturalistic observation, and were reformed to behavioral items through discussion with professors in pediatric nursing and experienced nurses in child care department. Also, behavioral items were classified into five developmental areas. RESULT: Total number of behavioral items was two hundreds and thirty eight. 52 items for motor development, 66 items for personal-social, 40 items for hearing and speech, 41 items for eye-hand coordination, and 39 items for performance. CONCLUSION: This is meaningful that fundamental items for Korean developmental scale for infants were identified by observing behaviors of Korean infants. On the basis of these items, average age will be calculated for passing each item by testing Korean infants. We hope to develop Korean infant developmental scale as a final outcome in the future research.

Annual Report on External Quality Assesment in Hematology in Korea (2002) / 임상검사와정도관리

Four trials of external quality assessment in diagnostic hematology were performed in 2002 with about 400 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, red blood cell count, platelet count, reticulocyte count, white cell differential count, and red blood cell morphology test. The response rate was more than 90%. The performance of quality assessment appeared to be gradually improved year by year.

Comparison of Nursing Activities Reflected in Nursing Notes and In-depth Interviews of Nurses in an Acute Hospital / 간호학회지

PURPOSE: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. METHOD: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. RESULT: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. CONCLUSION: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.

Quantities of Receptor Molecules for Colony Stimulating Factors on Leukocytes in Measles

We analyzed the comparative amounts of granulocyte-colony stimulating factor (G-CSFr) and granulocyte macrophage CSF (GM-CSFr) receptors expressed on neutrophils and monocytes in measles patients to investigate the role of these CSFrs in the development of leukopenia including neutropenia and monocytopenia in measles. EDTA-anticoagulated peripheral blood of 19 measles patients, 10 children with other infections showing leukopenia and 16 children with normal complete blood cell counts (CBC)s were analyzed using flow cytometry and QuantiBRITE. The leukocyte (5260 +/- 2030/uL vs. 9900 + 2680/uL, p=0.000), neutrophil (2580 +/- 960/uL vs. 4250 +/- 2750/uL, p=0.024) and the lymphocyte counts of measles patients (1810 +/- 1430/uL vs. 4530 +/- 3450/uL, p= 0.006) were lower than in the normal controls. The neutrophils of measles patients expressed similar amounts of G- CSFr (1858 +/- 355) as normal children (1764 +/- 477, p= 0.564) and leukopenic patients (1773 +/- 673, p=0.713), but lower levels of GM-CSFr (535 +/- 118) than normal children (957 +/- 344, p=0.000) and leukopenic patients (832 +/- 294, p=0.002). The monocytes of measles patients expressed similar amounts of G-CSFr (916 +/- 336) and GM-CSFr (3718 +/- 906) as normal children (1013 +/- 391 and 4125 (2645, p > 0.05) but less than leukopenic patients (1454 +/- 398 and 5388 +/- 806, p > 0.05). The neutrophil and monocyte counts of measles patients did not correlate with the amount of G-CSFr or GM-CSFr expressed on neutrophils or monocytes (p > 0.05), but in the normal children, the monocyte count correlated with the levels of GM-CSFr on monocytes (r=0.951, p=0.049). In conclusion, neutropenia is one of the more important characteristics of measles patients, which could be due to the decreased GM-CSFr expression on neutrophils. However, the monocytopenia found in measles patients is not due to the decreased expression of CSFr on the monocytes.

An Analysis of the Concepts in Child Health Nursing Studies in Korea(1): from 1990 to 2000 / 아동간호학회지

The main purpose of this study is to examine the concepts appeared on researches and provide the future research directions in field of child health nursing. A descriptive study was conducted. 205 studies were included in an analysis the concepts in terms of the domain of client for a total 321 researches. All were originally published between 1990 and 2000 in Korea. An analysis of concepts for this study was used the metaparadigm framework for nursing proposed by H.S. Kim(2000). The concepts for this study were categorized by essentialistic concepts, problematic concepts, health-care experiential concepts with the following results. 1.Based on the four domains suggested Kim (2000), 205 studies(63.9%) belong to the domain of client ; 109 studies(34%) belong to the practice domain of nursing; 3 studies(0.9%) belong to the client-nurse domain; and 4 studies belong to the domain of environment, respectively. 2.In the domain of client, 117(57.1%) studies used concept of parent. Among them, mother was the prevailing research population(103 studies). 64 studies(31.2%) used child population and the developmental stage of children varied from preterm to puberty but school aged children was the most target population(28 studies). Family as a concept of client was used in 20 studies(9.8%) but most primary care provider was the mother. 3. In terms of research design, non-experimental design(83.5%) is the most and among them survey was 159 studies(77.6%). Qualitative research(23 studies) and experimental research(10 studies) methods were used relatively few. 4.In terms of the categories of concepts, 196 (61.4%) studies included the essentialistic concepts like stress and coping(20.4%), mothering role and child care(7.8%), health (5.6%), breast feeding(4.7%). 31 studies included problematic concepts like power- lessness, safety, obesity, pain, anxiety. And 65 studies included health-care experiential concepts like compliance, growth, hope, environment but relatively few. The findings of this study provide the evidence that research related problematic concept and health-care experiential concept should be conducted actively to improve the practice of child health nursing. Also to deeply understand the phenomena of client in field of child health nursing, interpretive research methods should be conducted actively, too.

Photocatalytic Bactericidal Effect of Titanium dioxide(TiO2) Thin Film for Escherichia coli, Aspergillus fumigatus and Mucobabterium tuberculosis / 병원감염관리

BACKGROUND: Titanium dioxide (TiO2) thin film photocatalyst generates strong oxidizing power when illuminated with Ultra Violet (UV) light with wavelengths of less than 385 nm. In this study, we evaluated the bactericidal activity of it against Escherichia coli, Aspergillus fumigatus and Mycobacterium tuberculosis. METHODS: The TiO2 film were prepared from titanium isopropoxide solution and it was coated on either inner(test) or outer(control) side on Petri dish. annealing at 500 degrees C. The test and control suspension of E. coli, A. fumigatus and M. tuberculosis were grown in the chamber coated inner and outer side. respectively with UV light. For the blank, cell suspensions were grown in TiO2 coated Petri dishes without UV light. The bactericidal activities were estimated by survival ratio calculated from the number of viable cells which form the nutrient agar. RESULTS: In the test, the survival ratio for E. coli and M tuberculosis decreased to a negligible level (i.e., essentially complete sterilization) within 1hr and 2 hr, respectively. and that for 11. fumigatus decreased markedly to about 15% within 6 hr. In the control, the survival ratio for E. coli, A. fumigatus and M. tuberculosis decreased to 40% within 150 min. 6 he and 2 hr, respectively. In the blank, the survival ratio for E. coli and M tuberculosis decreased only about 67% within 150 min and 40% within 2hr. In A. fumigatus, TiO2 only caused little Sterilization within 4 hr. CONCLUSIONS: TiO2 photocatalysts under UV light clearly showed bactericidal activity against E. coli, A. fumigarus and M. tuberculosis. This feature render TiO2 photocatalysts to be applicable to eliminate microorganism from indoor air environment combined with ventilation.

Evaluation of Parasite Lactate Dehydrogenase-based Immunochromatographic Antigen Assay (DiaMed OptiMAL(epsilon)) for Rapid Diagnosis of Malaria / 대한임상병리학회지

BACKGROUND: Microscopic examination of peripheral blood smears has been a standard diagnostic test for malarial infection for a long time, but it is labor-intensive and time-consuming. Recently, a rapid diagnostic test for malarial infection containing a dipstick bearing monoclonal antibodies against the intracellular metabolic enzyme, parasite lactate dehydrogenase (pLDH), was introduced (DiaMed OptiMAL(epsilon)). We evaluated the usefulness of the OptiMAL test in malaria diagnosis by comparing with a microscopic examination of peripheral blood smears. METHODS: Fifty-eight (initial 44 and follow-up 14) whole blood samples were obtained from 44 patients who were suspected of having malarial infection. After 1 drop of whole blood reacted with the dipstick, band numbers and positions on the dipsticks determined the results. All results were compared to those of microscopic examination findings. RESULTS: The OptiMAL test revealed 100% sensitivity and specificity by comparing with the microscopic examination. The intensity of stained bands showed positively correlated with the severity of parasitemia. The OptiMAL test revealed a more rapid negative conversion than the microscopic examination after treatment. CONCLUSIONS: The OptiMAL test is a simple, rapid and accurate test for diagnosis of malarial infection; moreover, it is good tool for monitoring after treatment.

Analysis of Telephone Counseling Service on Child Health / 아동간호학회지

This study analyzed the services as operated by the Child Health Telephone Service Center. The Center is a toll free service operated as part of the community services of the Korean Academic Society of Child Health Nursing. The aim of the study was to describe the concerns of child caregivers regarding child health care as discussed during telephone counseling. Specific objectives were as follows: 1. To analyze the activities of the Center. 2. To describe the characteristics of caregivers who made phone calls for counseling services and also the characteristics of their children. 3. To analyze the content of the counseling sessions. 4. To analyze counseling content according to the characteristics of the caregivers and their children. Data used for the study were obtained from the counseling records for the period from Sept. to Dec. 1999, as kept by the three counselors at the Center. The total number of calls was 8,261 and that consisted of 15,150 questions. The total questions were merged into 13,236 by eliminating those questions which overlapped or were of similar content. The final 13,236 questions were used for the final analyses. Almost of the callers (98.4%) were mothers. Among them 89.6% were between 25 and 35 years of age. Geographical distribution of the callers covered the whole nation. The largest numbers who made the calls were from the Seoul metropolitan area (36%), followed by 28% from Kyung Gi Province, and 20% were from the Kyung Sang area. Among 8,261 callers, 72.8% were first users. Sex of the babies and children in question for counseling was about even for males and females and ages ranged from one month to six years. The largest group (62.5%) was the less than six month age group. The finalized 13,236 questions/problems were categorized into 11 problem areas. They were in order of frequency, physical problems, feedings and nutrient concerns, information on child rearing, growth and development, guidance on utilization of child care facilities, elimination problems, sleeping concerns, immunization related concerns, behavior problems, injury and accidents, and safety measures. The most frequent problems for counseling were physical signs and symptoms (27.3%), followed by feeding and nutrients, information on child rearing, and growth and development. Of physical problems, abnormal gastrointestinal signs and symptoms were the most frequent concern and skin problems were next at 25% and 23.3% respectively. Loose bowels, vomiting and constipation were the most frequent gastrointestinal problems. Atopic dermatitis had the highest frequency at 53.3% with diaper rash being the second highest among the skin problems. About 80% of the growth and developmental category were physical development concerns related to physiological, body growth, and motor and sensory development. This study constitutes the activity report for the first year of the Center. The findings correspond with literature reports on child health problems and parents educational needs. One recommendation from this study is that since the services of the Center are carried out only by telephone, the psychology of the counselees and the counselor relationship must be considered for better services.