Influencing Factors Affecting Caregivers’ Service Quality for the Elderly with Dementia: Focusing on Dementia Knowledge, Work Value, and Job Performance Confidence

Purpose@#The purpose of this study was to verify influencing factors affecting service quality provided by caregivers working for the elderly with dementia. @*Methods@#Data were collected using a self-reported questionnaire from 214 caregivers in a long-term care facility in D city. The data were analyzed with service quality, dementia knowledge, work value, and job performance confidence. For data analysis, the descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression were performed using SPSS/WIN 21.0 program. @*Results@#There were significant differences in service quality depending on the health status. Factors influencing service quality were work value, and job performance confidence with R2 value of 38%. The highly influencing factors were work value, and job performance confidence. @*Conclusion@#The results of this study indicate that the effort to improve the service quality of caregivers should focus on work value and job performance confidence.

Study on Recipients' Experience of Adapting to Permanent Pacemakers / 중환자간호학회지

PURPOSE: This study develops a substantive theory on the recipients' experience of adapting to a permanent pacemaker.METHOD: The study used the grounded theory method developed by Strauss and Corbin (1998). The participants of the study were 13 adults who had received a permanent pacemaker during the previous year. The study addressed the research question “what is the experience of adaptation in people who had received permanent pacemakers?” From October 2016 to March 2017, data were collected from the participants through in-depth interviews.RESULTS: The core category indicating the essence of the adaptation experience was shown to be “accepting the pacemaker as part of my body and living in line with it.”CONCLUSION: In nursing practice, the results of this study will assist nurses in improving their communications with and developing guidelines or interventions for their clients who have received permanent pacemakers. In the field of nursing education, this study is expected to provide a framework to understand the experiences of future nurses and other healthcare workers working with permanent pacemaker recipients.

The Role of Pavlov's Theory in North Korea in the Late 1950s: Ideological Struggle in Medicine and Scientification of Traditional Medicine / 의사학

This paper deals with Pavlov theory in North Korea in the late 1950s, focusing on its role in ideological struggle in medicine and in reinterpretation of traditional medicine. In North Korean Ministry of Health found Pavlov theory to have rich resources which could be used in the construction of the North Korea's socialist medicine. First of all, Pavlov theory provided the North Korean Communist Party with a powerful ideological weapon against capitalist medical thoughts, representing superior socialist medicine based upon Marx-Leninism and dialectical materialism. This paper examines the contents of Pavlov theory introduced in the North Korea from the Soviet Union in the late 1950s. Pavlov theory in the North Korea was not merely a political slogan but a unified medical system of thought, ranging from biological theory on the organism and pathogenesis to clinical theory. Nonetheless, Pavlov theory became Pavlov doctrine in the ideological struggle in healthcare field initiated by Kim Il Sung and the Communist Party. In the process of the ideological struggle, the abducted surgeon Kim Si-Chang was accused and purged of counter-revolutionary and refusal to conform to Pavlov doctrines by the Communist Party in 1959. Interestingly, Pavlov theory was used in reinterpretation of Traditional Medicine in North Korea from unscientific practice to a rich and scientific complementary medicine by connecting the two with common theoretical components such as Pavlov's typology. By the enthusiastic Communist Party members, Pavlov doctrine was introduced, transformed and exploited to build monolithic ideology system in medicine in North Korea in the late 1950s.

A Waterborne Outbreak and Detection of Cryptosporidium Oocysts in Drinking Water of an Older High-Rise Apartment Complex in Seoul

From May to June 2012, a waterborne outbreak of 124 cases of cryptosporidiosis occurred in the plumbing systems of an older high-rise apartment complex in Seoul, Republic of Korea. The residents of this apartment complex had symptoms of watery diarrhea and vomiting. Tap water samples in the apartment complex and its adjacent buildings were collected and tested for 57 parameters under the Korean Drinking Water Standards and for additional 11 microbiological parameters. The microbiological parameters included total colony counts, Clostridium perfringens, Enterococcus, fecal streptococcus, Salmonella, Shigella, Pseudomonas aeruginosa, Cryptosporidium oocysts, Giardia cysts, total culturable viruses, and Norovirus. While the tap water samples of the adjacent buildings complied with the Korean Drinking Water Standards for all parameters, fecal bacteria and Cryptosporidium oocysts were detected in the tap water samples of the outbreak apartment complex. It turned out that the agent of the disease was Cryptosporidium parvum. The drinking water was polluted with sewage from a septic tank in the apartment complex. To remove C. parvum oocysts, we conducted physical processes of cleaning the water storage tanks, flushing the indoor pipes, and replacing old pipes with new ones. Finally we restored the clean drinking water to the apartment complex after identification of no oocysts.

A Ten-year Survey of Giardia Cysts in Drinking Water Supplies of Seoul, the Republic of Korea

To understand the distribution of Giardia cysts in drinking water supplies in Seoul, Korea, we collected water samples quarterly at 6 intakes in the Han River, its largest stream and 6 conventional water treatment plants (WTPs) serving drinking water, from 2000 to 2009. Giardia cysts in each of 10 L water were confirmed in 35.0% of intake water samples and the arithmetic mean was 1.65 cysts/10 L (range 0-35 cysts/10 L). The lowest cyst density was observed at Paldang and Kangbuk intakes, and the pollution level was higher at 4 intakes downstream. It seemed that these 4 intakes were under influence of Wangsuk stream at the end of which cysts were found in all samples with the mean of 140 cysts/10 L. The annual mean number of cysts was 0.21-4.21 cysts/10 L, and the cyst level at the second half of the 10 years was about 1/5 of that at first half on average. The cysts were more frequently found in winter, and their mean density was 3.74 cysts/10 L in winter and 0.80-1.08 cysts/10 L in other seasons. All finished water samples collected at 6 WTPs were negative for Giardia in each of 100 L sample for 10 years and cyst removal by physical process was average 2.9-log. It was concluded that conventional water treatment at 6 WTPs of Seoul appears to remove the cysts effectively under the present level of their source water. Domestic wastewater from the urban region could be an important source of Giardia pollution in the river.

Adnexal Clear Cell Carcinoma with Comedonecrosis: A Case Report

Adnexal clear cell carcinoma with comedonecrosis (ACCCC) is a very rare malignancy of the skin with an aggressive clinical course and a predilection for the scalp. This is the first reported case of ACCCC in Korea. A 79-year-old male presented with left abdominal masses that proved to be two subcutaneous nodules. The tumors histologically consisted of epithelial nests that showed a distinctive zonal arrangement. The centrally located clear cell areas with comedonecroses were merged with the peripheral squamoid cells, often exhibiting retraction artifacts and an infiltrating border. Nuclear pleomorphism and frequent mitoses were prominent. The clear cells were immunopositive for carcinoembryonic antigen and epithelial membrane antigen. We report here on a case of ACCCC involving the abdominal skin, and this tumor should be distinguished from the more indolent squamous cell and tricholemmal carcinomas.

A Survey of Cryptosporidium Oocysts in Water Supplies during a 10-Year Period (2000-2009) in Seoul

This study has been conducted to estimate the occurrence of Cryptosporidium oocysts in water supplies in the Metropolitan area of Seoul, South Korea, for 10 years from 2000 to 2009. Water samples were collected quarterly at 6 intakes in the Han River and its largest stream and 6 conventional Water Treatment Plants (WTPs) serving drinking water for 10 million people of Seoul. Cryptosporidium oocysts were found in 22.5% of intake water samples and arithmetic mean was 0.65 oocysts/10 L (range 0-22 oocysts/10 L). Although the annual mean of oocyst number was as low as 0.04-1.90 oocysts/10 L, 3 peaks in 2004 and 2007 were observed and the pollution level was a little higher in winter. The lowest density was observed at Paldang intake and the pollution level increased at Kuui and Jayang intakes. At the end of the largest stream, oocysts were found in 70% of collected samples (mean 5.71 oocysts/10 L) and it seemed that its joining the Han River resulted in the increase at Kuui intake and downstream. Oocyst removal by physical process exceeded 2.0-2.3 log and then all finished water samples collected at 6 WTPs were negative for Cryptosporidium in each 100 L sample for 10 years. These results suggested that domestic wastewater from the urban region could be a source of Cryptosporidium pollution and separating sewage systems adjacent to the intakes could be meaningful for some intakes having weakness related to parasitological water quality.

Expression of p16, Rb and FHIT Proteins in Urothelial Carcinoma of the Urinary Bladder

BACKGROUND: The goal of this study was to investigate the expression of p16, retinoblastoma (Rb) and fragile histidine triad (FHIT) proteins in urothelial carcinomas of the urinary bladder, and to evaluate the relationship between clinicopathlogic parameters and each protein expression level. METHODS: The expression of p16, Rb, and FHIT proteins were studied in 176 patients with urothelial carcinoma of the urinary bladder by immunohistochemistry. RESULTS: The diffuse positive expression of the p16 protein was significantly associated with high grade and advanced tumor depth (p=0.007 and p=0.020). The loss of the Rb protein was significantly associated with old age and disease recurrence (p=0.020 and 0.037). The loss of the FHIT protein was significantly associated with advanced tumor depth (p=0.002). CONCLUSION: Our data suggest that p16 and FHIT proteins may be involved in the progression of urothelial carcinoma. In addition, p16 may be a useful prognostic marker for individual urothelial carcinoma patients.

Granular Cell Tumors of the Abdominal Wall

Granular cell tumors (GCT) are found in virtually any body site, including the tongue, skin, subcutaneous tissue, breast, rectum and vulva. However, they are rarely seen in the abdominal wall. We report here on a rare case of GCT in the rectus muscle of the abdominal wall. A 44-year-old woman presented with a non-tender, hard mass in the right lower abdominal wall. Upon microscopic examination, the tumor was found to comprise of large polygonal cells with an abundant eosinophilic granular cytoplasm and round to oval nuclei. Upon immunohistochemical staining, the large cells showed S-100 and CD68 positive granular aggregates in the cytoplasm. Many lysosomes of variable size were observed in the cytoplasm.

Granular Cell Tumors of the Abdominal Wall

Granular cell tumors (GCT) are found in virtually any body site, including the tongue, skin, subcutaneous tissue, breast, rectum and vulva. However, they are rarely seen in the abdominal wall. We report here on a rare case of GCT in the rectus muscle of the abdominal wall. A 44-year-old woman presented with a non-tender, hard mass in the right lower abdominal wall. Upon microscopic examination, the tumor was found to comprise of large polygonal cells with an abundant eosinophilic granular cytoplasm and round to oval nuclei. Upon immunohistochemical staining, the large cells showed S-100 and CD68 positive granular aggregates in the cytoplasm. Many lysosomes of variable size were observed in the cytoplasm.

Juvenile Xanthogranuloma of the Nasal Cavity: A Case Report and Review of the Literature

Juvenile xanthogranuloma (JXG) is a benign and self-limiting non-Langerhans-cell histiocytosis that generally occurs during infancy and childhood. It develops frequently in the head and neck but is very rare in the nasal cavity. To date, only five cases of JXG in the nasal cavity have been reported. Here, we report the second case of JXG in the nasal cavity in Korea. A 19-year-old male patient presented with a protruding 1.1 cm mass in the left nasal vestibule. Histologically, a dense dermal infiltrate of histiocytes with Touton giant cells was observed. Immunohistochemically, the histiocytes tested positive for CD68 and the S-100 protein but negative for CD1a. This shows that a S-100-positive histiocytic lesion dose not exclude a diagnosis of JXG.

Application and Efficacy Evaluation of Nutritional Screening Tool

PURPOSE: Malnutrition has been frequently reported for patients on their admission to the hospital and it has been associated with an increase in morbidity, mortality and the length of the hospital stay. Although a number of screening tools have been developed to identify those patients at risk for malnutrition, there is no 'gold standard' for defining malnutrition and the malnourished patients remain largely unrecognized. The aim of this study is to evaluate the efficacy of a nutritional screening tool for use in Dankook University Hospital. METHODS: Nutritional evaluation was performed for 53 patients who were admitted to the department of surgery and internal medicine between October and December 2004. The screening tool was completed by the ward nurse and the nutritional support team nurse on the same patients within 24 hours of admission. The nutritional support team nurse performed the full assessment. The screening sheet included 4 questions regarding body mass index, recent unintentional weight loss, food intake and disease severity. Each answer was scored and a total of 5 was tested as the criterion for malnutrition. The full assessment included current body weight, recent weight loss, triceps skinfold thickness, mid- arm muscle circumference, serum albumin and total lymphocyte count. Malnutrition was defined by 3 or more values below the reference values. The reliability of the screening tool was assessed using kappa statdtatistic. Sensitivity, specificity and accuracy were calculated to evaluate the validity of the screening tool. The receiver operating characteristic (ROC) curve was drawn to choose a cutoff value that maximizes sensitivity and specificity. RESULTS: The level of agreement between the ward nurse and the NST nurse was good for BMI and food intake and moderate for weight loss and disease severity. The full assessment identified 7 patients (13.2%) as malnourished. The screening sheet had a sensitivity of 86% and a specificity of 80%. According to the ROC curve, a score of 5 points provided the best validity. CONCLUSION: The nutritional screening tool is reliable when completed by different observers and it is valid for nutritional assessment.

Clinical trial of Aromatherapy on Postpartum Mother's Perineal Healing / 간호학회지

PURPOSE: This study was designed to verify the effect of aromatherapy on a postpartum mother's perineal healing. METHOD: The research design was a clinical trial. The methods of aromatherapy were applied sitz bath or soap application using essential oils with Lavender, Myrrh, Neroli, Rose, Grapefruit, Mandarin, Orange, and Roman Chamomile. The subjects of this experiment were postpartum mothers who delivered vaginally with an episiotomy. They were allocated to one of three groups; the aroma-sitz bath group, aroma-soap application group or control group. To evaluate the effect of aromatherapy, the perineal healing status was measured using the REEDA scale and smears of episiotomy wound were obtained. The data were analyzed by repeated measures of ANOVA, ANCOVA, x2-test, and multiple response analysis via SPSS program. RESULT: The REEDA scale was significantly low in the experimental group at postpartum 5th and 7th days (P=.009, P=.003), respectively. Most were observed 'few'(5-10 bacteria per field) bacteria in the smears of episiotomy wound. The one bacteria was identified in the 50.8% of subjects in pretest and two bacteria in the 60.3% in posttest. Most frequently identified bacteria were Escherichia coli and Enterococcus faecalis. CONCLUSION: In conclusion, these findings indicate that postpartum aromatherapy for perineal care could be effective in healing the perineum perineal care could be effective in healing the perineum.

Effects of Aromatherapy on the Stress Response of College Women with Dysmenorrhea during Menstruation / 간호학회지

PURPOSE: The purpose of this study was to verify the effect of aromatherapy on the stress response in menstrual period. METHODS: A randomized, single-blind, pretest- posttest design was used. The study subjects were 60 college women with dysmenorrhea and they were randomized into 3 groups, experimental, 1st control(placebo) and 2nd control group. The researchers massaged treatment oil(3% dilution essential oil of Lavender, Clary sage and Rose) into the abdomen of experimental group. The placebo group used almond oil(carrier oil) instead, and the 2nd control group did not give any treatment. Baseline data including pre- treatment stress response score were obtained on the first day of usual period. Aromatherapy provided for about 7 days until the next cycle began. Post-treatment stress responses were measured by 94 item SOS(symptom of stress) scale on the first day of the cycle. RESULTS: As a results, the stress response score of experimental group was significantly lower than two control groups. And there was no significant difference in stress responses of two control groups. CONCLUSION: The results show aromatherapy using selected essential oils to be an effective intervention for stress response during menstruation.

Effects of Aromatherapy on Menstrual Cramps and Dysmenorrhea in College Student Woman: A Blind Randomized Clinical Trial / 성인간호학회지

This study was designed to verify the effect of aromatherapy on menstrual cramps and dysmenorrhea by a quasi experiment (nonequivalent control group pretest-posttest design), from March to October, 2000. The subjects of this experiment consisted of 45 college women with menstrual cramps and dysmenorrhea. They were randomized by 25 for the experimental group and 20 for the control group. Their mean age was 20.6 years, mean menstrual period 28.7 days, mean menstrual cramps(VAS) 7.25, mean dysmenorrhea (Dysmenorrhea Scale) was 27.34. As treatment, aromatherapy was to give effleurrage of the abdomen with lavender, clary sage and rose as aroma oil, almond oil as carrier oil. For the control group, abdominal massage was given with only almond oil. Data collection included menstrual cramps, dysmenorrhea, the change of symptoms(low abdominal pain, lumbago, headache, nausea, fatigue, edema). Menstrual cramps, dysmenorrhea and general, menstrual characteristics of subjects were measured the first day of the pre menstrual period before treatment (pre-test), menstrual cramps, dysmenorrhea, the change of symptoms were measured the first and second day of post menstrual period after treatment (posttest). Data were analyzed by t-test, X2-test, repeated measures ANOVA, Cronbach's alpha with SAS Program. The results of this study was as follows; 1. Menstrual cramps was significantly lower in the experimental group(p = .001). 2. Dysmenorrhea was significantly lower in the experimental group(p = .027). 3.Less women in the experimental group complained about the six symptoms than women in the control group after treatment on the first day of the menstrual period(p <0.05, p <0.01) In conclusion, these findings indicate that aromatherapy with lavender, clary sage, and rose could be effective to decrease menstrual cramps, and dysmenorrhea. So, aromatherapy could be applied to women suffering with menstrual cramps, dysmenorrhea periodically as an nursing intervention.