The Influence of Organizational Commitment and Resilience on Presenteeism among Clinical Nurses / 한국직업건강간호학회지

Purpose@#This study was conducted to identify the factors influencing organizational commitment and resilience onpresenteeism in clinical nurses. @*Methods@#The subjects were 202 nurses working at 5 hospitals in B city. The data were collected through questionnaires and analyzed by t-test, one-way ANOVA, Pearson’s correlation coefficients, and stepwise multiple regression. @*Results@#Work impairment was negatively correlated with organizational commitment and resilience. Perceived productivity was positively correlated with organizational commitment and resilience. Influencing factors on work impairment were organizational commitment (β=-.22 p=.005) and hardiness (β=-.16, p=.042), with 10% explanatory power. Influencing factors on perceived productivity were organizational commitment (β=.24, p=.002) and hardiness (β=.16, p=.042), with 11% explanatory power. @*Conclusion@#Based on this research, appropriate programs and policies that consider influencing factors such as organizational commitment and hardiness in resilience are needed to reduce the level of presenteeism in clinical nurses.

Adopting Advance Directives Reinforces Patient Participation in End-of-Life Care Discussion / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: In Korea, most terminal cancer patients have still not been included in end-of-life (EOL) discussions. The purpose of this study was to evaluate the proportion of patients participating in EOL discussions after adopting advance directives. MATERIALS AND METHODS: Medical records of 106 hospice patients between July 2012 and February 2013 were reviewed retrospectively. The proportion of patient participation in EOL discussions, barriers, and favorable factors for completion of advance directives, as well as outcomes of advance directives were evaluated. RESULTS: Patient participation in EOL discussion had increased from 16/53 (30%) to 27/53 (51%) since adopting advance directives (p < 0.001). Median time between completion of an advance directive and death increased from 8 days (range, 0 to 22 days) to 14.5 days (range, 0 to 47 days). Patients' poor condition after late referral was the main barrier to missing EOL discussions; however, family members' concerns about patient's distress was also a main reason for excluding the patient from EOL discussions. In univariate analysis, patient age, education status, and time from diagnosis to completion of an advance directive influenced advance directive completion favorably. Following multivariate analysis, higher education and periods of more than 2 years from diagnosis to completion of an advance directive remained favorable (odds ratio [OR], 9.586, p=0.024 and OR, 70.312; p=0.002). Preferences of all patients regarding cardiopulmonary resuscitation or hemodialysis were carried out by physicians. Orders for nutrition and palliative sedation showed discordance, with concordance rates of 74.2% and 51.6%, respectively. CONCLUSION: Our results suggested that the use of advance directive promote patient participation in EOL discussion.

Bone Mineral Density in Ambulatory Epileptic Children with New Antiepileptic Drug Monotherapy / 대한소아신경학회지

PURPOSE: This study was conducted for evaluation of the effects of new antiepileptic drugs on bone mineral density in children with epilepsy. METHODS: The study group consisted of 35 age and gender matched controls and 35 epileptic children taking new antiepileptic drugs: 14 on topiramate, 10 on lamotrigine, and 11 on oxcarbazepine in monotherapy. All patients were treated for more than one year and all were normally ambulatory children. We measured serum levels of calcium, alkaline phosphatase, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D. BMD was measured by dual-energy X-ray absorptiometry at lumbar spine regions L1-L4. RESULTS: Vitamin D levels of the oxcarbazepine group (25-hydroxyvitamin D: 40.3+/-10.5 ng/mL and 1,25-dihydroxyvitamin D: 57.9+/-15.2 pg/mL) were significantly lower than in controls (44.6+/-11.5 ng/mL, 66.2+/-10.5 pg/mL, P<0.05); however, they did not differ significantly in the topiramate and lamotrigine groups. The bone mineral density value was significantly lower in the oxcarbazepine (L1-L4: 0.73+/-0.11 g/cm2) group, compared with the controls (0.84+/-0.06 g/cm2, P<0.05) or patients taking topiramate or lamotrigine. CONCLUSION: Monitoring of bone metabolism is recommended for patients treated with new antiepileptic drugs, particularly oxcarbazepine.

Polymorphisms of methylenetetrahydrofolate reductase are not a risk factor for Kawasaki disease in the Korean population / 소아과

PURPOSE: Hyperhomocysteinemia is known as a risk factor for atherosclerosis. Preclinical arteriosclerosis is noted and premature atherosclerosis is known to be accelerated in Kawasaki disease (KD) patients. Genetic polymorphisms in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene result in elevated plasma homocysteine concentrations and are known to be associated with the development of coronary artery disease. Our hypothesis is that single nucleotide polymorphisms (SNPs) of the MTHFR gene are related to the development of KD and coronary artery lesions (CALs). METHODS: For this study, we selected 3 candidate single nucleotide polymorphisms (SNPs) (rs2274976, rs1801131, and rs1801133) of MTHFR. These SNPs are located on chromosome 1p36.3. We included 101 KD patients and 306 healthy adults as controls in this study. CALs were seen in 38 patients. Genotypes of the selected SNPs were determined by direct sequencing and analyzed with SNPAlyze. RESULTS: The genetic distribution and allelic frequency of the 3 MTHFR SNPs (rs2274976, rs1801131, and rs1801133) were not significantly different in patients with KD compared to the control group (P=0.71, 0.17, and 0.96, respectively). There was no difference in the genetic distribution of the MTHFR SNPs between the normal control group and the CAL group (P=0.43, 0.39, 0.52 respectively). CONCLUSION: The genetic distribution of the MTHFR SNPs (rs2274976, rs1801131, and rs1801133) was not different in the KD group compared to the control group. In addition, the genetic distribution of these SNPs was not different in the CAL group compared to the control group in the Korean population.

Giant Brain Abscess in a Neonate: Good Outcome with Single Transfontanelle Aspiration and Antibiotic Therapy

Brain abscesses in neonates are extremely rare and usually occur in patients with certain risk factors. A 1-month-old boy presented at the hospital with fever and irritability. As a result of preterm delivery and low birth weight, he had a history of admission to the neonatal intensive care unit. Neuroimaging revealed a large, space-occupying lesion in both frontal lobes, which was suspected to be an abscess with the midline shifting to the right. With a single aspiration and abscess drainage along with concurrent prolonged parenteral antibiotic therapy, the patient showed an excellent treatment outcome with normal development. The focus will be placed on minimally invasive surgical management as well as positive outcomes.

Analysis of Infant Mortality Rate in Korea Concerning According to Birth Weight and Gestational Age from 2005 to 2009

PURPOSE: Recently in Korea, there have been significant improvements in neonatal mortality rate (NMR) and infant mortality rate (IMR). This study aimed to investigate the proportion of the NMR among IMR, with the goal of discerning the influence of improved NMR on the reduction of IMR in the last 5 years in Korea. METHODS: All data were from Statistics Korea. Changes in the NMR percentage among IMR and the percentage of the death by the distribution of the birth weight and gestational were investigated. RESULTS: The total birth rate decreased, but the total number of preterm and low birth weight infants increased. These was a large decrease in NMR and IMR. The proportion of NMR among INR exceeded 50%. Early NMR was higher than late NMR. Among the total infant death, the mortality of preterm and low birth weight infants was high. CONCLUSION: Between 2005 and 2009, the total birth has declined in Korea, but the frequency of low birth weight infants is trending upward. The improvements in NMR and IMR, and the downtrend of the NMR percentage in IMR, are encouraging. It seems that the continued decrease of mortality of preterm and LBWI is required for better improvements NMR and IMR in Korea. This result is expected to be used for the basic data to improve the management of the newborns in Korea.

Effects of Edible and Medicinal Plants Intake on Blood Glucose, Glycogen and Protein Levels in Streptozotocin Induced Diabetic Rats

The hypoglycemic effects of four edible plants (Angelicae tenuissimae (A. ten.), Pleurospermum kamtschaticum (P. kam.), Adenophora remotiflora (A. rem.) and Zanthoxylum schinifolium (Z. sch.)) in streptozotocin (STZ)-induced diabetic rats were investigated. Sprague-Dawley male rats weighing 190-230 g were induced diabetes mellitus by the STZ injection (45 mg/kg) into the tail vein and were divided into six groups ; normal, STZ-control and four edible plant groups (A. ten., P kam., A. rem. and Z. sch. groups). Normal and STZ-control groups were fed a AIN-93 diet and four groups of STZ-induced diabetic rats were fed one of each experimental diets containing 10% of the edible plant powder for 4 weeks. Diabetic rats showed the lower weight gain compared to the normal rats. In experimental groups except P. kam., AST activities were close to normal. A. ten. group were lowered ALT activities slightly. The plasma glucose levels of the diabetic experimental groups were significantly decreased at 4th week. The plasma insulin levels in diabetic experimental groups were not significantly different compared to the STZ-control group. The liver glycogen levels in STZ injected rats were significantly lower in compared to the normal rats. However no significant differences were found in response experimental plants intake in diabetic rats. The muscle glycogen were not significantly different among all the groups.