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상급종합병원 임상실습 학생의 메르스 예방행위 수행 예측요인 (Predictors of MERS-related Preventive Behaviors Performance among Clinical Practice Students in a Tertiary Hospital)

  • 김희선;박진희
    • 한국산학기술학회논문지
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    • 제19권9호
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    • pp.174-185
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    • 2018
  • 본 연구는 2015년 국내 메르스(중동호흡기증후군) 유행시 상급종합병원에 임상실습을 경험하는 학생의 메르스에 대한 지식, 태도 및 예방행위 수행 정도를 파악하고 메르스 예방행위 수행 예측요인을 확인하기 위해서 시도되었다. 본 연구 대상자는 3, 4학년 간호학과와 의과대학 학생 480명이었으며, 자료수집은 2015년 6월 9일부터 6월 30일까지 구조화된 설문지를 이용하였다. 자료분석은 SPSS/WIN 24.0을 이용하여 분석하였고, 메르스 예방행위 수행에 영향을 미치는 예측요인들은 위계적 회귀분석(hierachial regression)을 이용하였다. 임상실습 학생의 메르스에 대한 지식 수준은 9.56점(13점 기준)으로 보통 이상으로 높았으며, 메르스의 심각성 인지와 예방가능성에 대한 신념인 메르스에 대한 태도는 4.15점(5점 기준)으로 긍정적이었다. 메르스 예방행위 수행정도는 3.02점(5점 기준)으로 보통 수준이었다. 메르스 예방행위는 여학생인 경우, 메르스에 관한 교육 경험이 있는 경우, 지난 해 인플루엔자 접종을 한 경우, 올해 인플루엔자 접종 의도가 있는 경우, 메르스 감염에 대한 두려움이 높은 경우, 메르스에 대한 지식 수준이 높고, 태도가 긍정적일수록 수행 정도가 높게 나타났다. 이에 감염환자들을 치료하고 돌보게 될 간호학과와 의과대학 임상실습 학생의 메르스 예방행위 수행률을 높이기 위해서는 메르스 예방행위 수행에 영향을 미칠 수 있는 임상실습 학생의 특성을 고려해야 한다. 더 나아가 임상실습 학생들이 메르스를 예방하기 위하여 필수적으로 습득해야 하는 내용이 포함된 효과적인 감염예방 교육프로그램을 개발하고 실시하여 미래 보건의료인들의 메르스 관련 지식 수준을 높이고, 질환 전파를 막으려는 태도를 강화함으로써 전염성 감염질환 예방에 기여해야 한다.

메르스(Middle East Respiratory Syndrom)의 유행이 의사의 정신건강에 미치는 영향 : 확진자 발생 병원 근무 여부, 메르스 진료 참여 여부에 따른 비교 (Psychological Effects on Medical Doctors from the Middle East Respiratory Syndrome (MERS) Outbreak : A Comparison of Whether They Worked at the MERS Occurred Hospital or Not, and Whether They Participated in MERS Diagnosis and Treatment)

  • 엄대현;김장섭;이해우;이소희
    • 신경정신의학
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    • 제56권1호
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    • pp.28-34
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    • 2017
  • Objectives The purpose of this study was to evaluate psychological effects of an outbreak of Middle East respiratory syndrome (MERS), a newly emerged infectious disease, on doctors. Methods After the MERS outbreak was over, we conducted an online survey of doctors who worked at the hospitals in which exposure to MERS cases had been confirmed or who were directly involved in MERS diagnosis and treatment. The Patient Health Questionnaires-9 (PHQ-9) and the Impact of Event Scale-Revised (IES-R) assessment methods were used to assess the severity of depressive and posttraumatic stress symptoms among the 64 doctors participating in the survey. Results The results of the survey indicate that 26.6% (n=17) of participants exhibited depressive symptoms and 7.8% (n=5) had post-traumatic stress symptoms. The doctors employed at hospitals with MERS cases had higher PHQ-9 and IES-R mean scores than those in doctors were not so employed. In contrast, there was no significant difference in those test scores between doctors who participated directly in MERS diagnosis and treatment and those doctors who did not. Conclusion The survey demonstrated that 28.1% (n=18) of doctors involved in MERS care suffered from depressive or posttraumatic stress symptoms, even though the MERS infection was being controlled. Working at a hospital with MERS cases was the primary determinant of the adverse psychological outcomes among doctors ; however, direct participation in the diagnosis and care of MERS patients was not significantly related to such outcomes.

Sequence-based 5-mers highly correlated to epigenetic modifications in genes interactions

  • Salimi, Dariush;Moeini, Ali;Masoudi?Nejad, Ali
    • Genes and Genomics
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    • 제40권12호
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    • pp.1363-1371
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    • 2018
  • One of the main concerns in biology is extracting sophisticated features from DNA sequence for gene interaction determination, receiving a great deal of researchers' attention. The epigenetic modifications along with their patterns have been intensely recognized as dominant features affecting on gene expression. However, studying sequenced-based features highly correlated to this key element has remained limited. The main objective in this research was to propose a new feature highly correlated to epigenetic modifications capable of classification of genes. In this paper, classification of 34 genes in PPAR signaling pathway associated with muscle fat tissue in human was performed. Using different statistical outlier detection methods, we proposed that 5-mers highly correlated to epigenetic modifications can correctly categorize the genes involved in the same biological pathway or process. Thirty-four genes in PPAR signaling pathway were classified via applying a proposed feature, 5-mers strongly associated to 17 different epigenetic modifications. For this, diverse statistical outlier detection methods were applied to specify the group of thoroughly correlated genes. The results indicated that these 5-mers can appropriately identify correlated genes. In addition, our results corresponded to GeneMania interaction information, leading to support the suggested method. The appealing findings imply that not only epigenetic modifications but also their highly correlated 5-mers can be applied for reconstructing gene regulatory networks as supplementary data as well as other applications like physical interaction, genes prioritization, indicating some sort of data fusion in this analysis.

중동호흡기증후군과 지카바이러스의 대응사례분석을 통한 해외유입 신종감염병 예방시스템 구축 방안 (Developing Prevention System of Overseas Infectious Disease Based on MERS and Zika Virus Outbreak)

  • 김자영;방준석
    • 한국임상약학회지
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    • 제26권4호
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    • pp.330-340
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    • 2016
  • Objective: The outbreak of Middle East Respiratory Syndrome (MERS) started in South Korea in May 2015 and the end of crisis was declared in December 2015 by Korea Centers of Disease Control and Prevention (KCDC). However, Zika virus emerged in less than 2 months following MERS and showed higher mortality than other countries. This study is to assess the current prevention system of overseas infectious diseases, based on MERS and Zika virus outbreak and to suggest effective response system for the future. Methods: We conducted two surveys on medical specialists working at tertiary general hospitals regarding the effectiveness of responding system by KCDC against MERS and Zika virus and education in individual medical institutions using 5-Likert points. Response system was examined in three different periods as initial period, spreading period, and post disease period. Results: Although medical specialists received the notifications in initial period, no practical prevention was proven to be placed in responding stage by medical facilities (averagely 3.5/5 points in total and sub-analyses). During spreading period, there were several academic seminars conducted, which were evaluated as helpful. In post disease period, all answered that there were changes on patient treatment in all medical facilities, with mainly report system and the treatment regulations in case of suspicious patients for infection. Only 49% respondents answered positive on the possibility of initial responses. For questionnaire items regarding Zika virus, all answered that there were notifications prior to the first outbreak of the infected patient. Eighty% of respondents were aware of 'the Guideline system for traveling to dangerous areas', and answered that the system was moderately effective (averagely 3.8/5 points in total). For the effectiveness of prevention measures for foreign novel disease by KCDC, the average point was 3.0 in both of total and sub-analyses. Conclusion: There is not enough response system to prevent infectious disease in medical institutional and governmental levels in Korea. It would warrant the modification of overall medical system to improve preventive measures for initial spread of such diseases.

Generation and characterization of a monoclonal antibody against MERS-CoV targeting the spike protein using a synthetic peptide epitope-CpG-DNA-liposome complex

  • Park, Byoung Kwon;Maharjan, Sony;Lee, Su In;Kim, Jinsoo;Bae, Joon-Yong;Park, Man-Seong;Kwon, Hyung-Joo
    • BMB Reports
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    • 제52권6호
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    • pp.397-402
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    • 2019
  • Middle East respiratory syndrome coronavirus (MERS-CoV) uses the spike (S) glycoprotein to recognize and enter target cells. In this study, we selected two epitope peptide sequences within the receptor binding domain (RBD) of the MERS-CoV S protein. We used a complex consisting of the epitope peptide of the MERS-CoV S protein and CpG-DNA encapsulated in liposome complex to immunize mice, and produced the monoclonal antibodies 506-2G10G5 and 492-1G10E4E2. The western blotting data showed that both monoclonal antibodies detected the S protein and immunoprecipitated the native form of the S protein. Indirect immunofluorescence and confocal analysis suggested strong reactivity of the antibodies towards the S protein of MERS-CoV virus infected Vero cells. Furthermore, the 506-2G10G5 monoclonal antibody significantly reduced plaque formation in MERS-CoV infected Vero cells compared to normal mouse IgG and 492-1G10E4E2. Thus, we successfully produced a monoclonal antibody directed against the RBD domain of the S protein which could be used in the development of diagnostics and therapeutic applications in the future.

응급구조(학)과 학생의 메르스에 관한 지식, 태도 및 예방행위와의 관계 (Correlation between knowledge, attitudes and preventive behaviors regarding the MERS of a student in the Department of Emergency Medical Technology)

  • 김성령;유영건
    • 한국산학기술학회논문지
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    • 제21권5호
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    • pp.401-408
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    • 2020
  • 본 연구는 응급구조(학)을 전공하는 학생들의 메르스에 관한 지식, 태도 및 예방행위와의 관계를 파악하여 메르스 예방교육에 대한 기초자료를 제공하고자 하였다. 연구방법은 2019년 11월 8일부터 2019년 11월 30일까지 P시 3년제 대학 응급구조과에 재학 중인 167명을 대상으로 하였고, 연구도구는 구조화된 설문지를 이용하였다. 연구결과는 SPSS/WIN 23.0을 사용하여 분석하였다. 대상자의 메르스 교육 경험은 경험자 74명(44.3%), 비 경험자 93명(55.7%)으로 경험하지 않은 대상자가 많은 것으로 나타났으며, 메르스에 관한 태도 항목에서는 '메르스 환자를 다룰 때는 반드시 개인보호장비를 착용해야 한다'에서 평균 4.54±0.87로 높게 나타났으며, 메르스에 관한 예방행위항목에서는 '평소보다 더 자주 손을 씻었다'에서 평균 3.82±1.06으로 높게 나타났다. 메르스에 대한 상관관계분석 결과 '친구 모임, 외식, 스포츠 관람, 쇼핑 등을 취소하거나 미루었다' 한 항목에서 r=-.63, p<.004로 음(-)의 상관관계를 제외하고 모두 태도가 높을수록 예방행위 수준이 높았다. 따라서 본 연구의 결과를 토대로 메르스에 대한 교육수준 및 지식수준을 향상시킬 수 있는 교육 프로그램의 개발이 필요하며, 메르스에 대한 체계적이고 반복적인 교육이 필요하다고 사료된다.

병원 간호사의 중동호흡기증후군 격리 지침에 대한 지식과 수행도 (Knowledge and Practice of Middle East Respiratory Syndrome Isolation Precaution among Hospital Nurses)

  • 김선주;송라윤
    • 기본간호학회지
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    • 제25권1호
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    • pp.46-57
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    • 2018
  • Purpose: The purposes of the study were to examine the knowledge and practice about Middle East Respiratory Syndrome (MERS) isolation precaution, and to explore influencing factors of the isolation practice among hospital nurses. Methods: A total of 182 nurses were recruited from four general hospitals where MERS patients had been treated. The knowledge and practice of MERS isolation precaution were measured by the scales developed based on the CDC guidelines. The collected data were analyzed by SPSS/WIN 22 with descriptive statistics, T-test, One-way ANOVA, Pearson correlation coefficients, and hierachical multiple regression analysis. Results: The nurses were 30 years old in average, and half of them had less than 5 years of clinical experience. and knowledge on droplet precautions (${\beta}=.171$, p=.019) were the significant predictors, explaining 19.6% of variance in the MERS isolation guideline practice. Clinical experience (${\beta}=.225$, p=.002), working at infection unit (${\beta}=-.203$, p=.011). Conclusion: The knowledge on droplet precaution and general knowledge on MERS were the important modifiable factor to improve the MERS isolation guideline practice among hospital nurses, even after adjusting clinical experience and demographic variables. It is necessary to develop an efficient education program on specific guidelines for prevention and management of infection by improving the knowledge on infectious disease such as MERS as well as droplet precaution which are modifiable factors.

Middle East Respiratory Syndrome Coronavirus-Encoded Accessory Proteins Impair MDA5-and TBK1-Mediated Activation of NF-κB

  • Lee, Jeong Yoon;Bae, Sojung;Myoung, Jinjong
    • Journal of Microbiology and Biotechnology
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    • 제29권8호
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    • pp.1316-1323
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    • 2019
  • Middle East respiratory syndrome coronavirus (MERS-CoV) is a newly emerging coronavirus which is zoonotic from bats and camels. Its infection in humans can be fatal especially in patients with preexisting conditions due to smoking and chronic obstructive pulmonary disease (COPD). Among the 25 proteins encoded by MERS-CoV, 5 accessory proteins seem to be involved in viral evasion of the host immune responses. Here we report that ORF4a, ORF4b, and ORF8b proteins, alone or in combination, effectively antagonize nuclear factor kappa B ($NF-{\kappa}B$) activation. Interestingly, the inhibition of $NF-{\kappa}B$ by MERS-CoV accessory proteins was mostly at the level of pattern recognition receptors: melanoma differentiation-associated gene 5 (MDA5). ORF4a and ORF4b additively inhibit MDA5-mediated activation of $NF-{\kappa}B$ while that of retinoic acid-inducible gene 1 (RIG-I) is largely not perturbed. Of note, ORF8b was found to be a novel antagonist of MDA5-mediated $NF-{\kappa}B$ activation. In addition, ORF8b also strongly inhibits Tank-binding kinase 1 (TBK1)-mediated induction of $NF-{\kappa}B$ signaling. Taken together, MERS-CoV accessory proteins are involved in viral escape of $NF-{\kappa}B$-mediated antiviral immune responses.

2015년 메르스 사태의 사회의료학적 조명 (A Reflection on Korean MERS Crisis in 2015: Socio-Medical Approach)

  • 김문조
    • 과학기술학연구
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    • 제16권1호
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    • pp.5-22
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    • 2016
  • 높은 감염성과 치사율을 지닌 급성 호흡기 질환 메르스는 2015년 5월 국내에 잠입한 후 218일 간 186명의 감염자를 산출하면서 전국적 공포 분위기를 조성하였다. 다행히 7개월 후 감염자가 끊기자 12월 24일 메르스 종식이 선언되었지만, 메르스 사태는 우리 의료계나 사회 전반에 맹성하고 혁신해야 많은 과제를 남겼다. 본 논문은 (1) 2015년 5월 20일부터 12월까지의 국내에서 벌어진 메르스 사태에 대한 간략한 복기로부터 시작해, (2) 해당 사태를 단순한 역학적(疫學的) 차원을 넘어선 범사회적 재해로 재해석하고, (3) 메르스가 우리 사회에 그토록 큰 파문을 초래했던 이유와 향후 실천과제를 사회의료학적 관점에서 탐지한 후, (4) 사회의료학의 비전과 전망에 관한 소견으로 끝을 맺고자 한다.

간호대학생의 메르스에 대한 지식, 태도, 감염예방행위 수행도의 융합적 연구 (The Convergence Study of Nursing Students' Knowledge, Attitudes and Preventive Behaviors against MERS in South Korea)

  • 김미자
    • 한국융합학회논문지
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    • 제8권4호
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    • pp.149-157
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    • 2017
  • 한국의 메르스 유행발생은 역학적으로 의료기관과 관련된 감염을 보였다. 이 당시 메르스로 인한 의료인 감염자 수는 39명이었고 그 중 간호사는 15명 이었다. 미래의 간호사로서 이러한 감염환자를 돌보게 될 간호대학생들에게 메르스에 대한 지식과 태도 및 감염예방행위 수행도에 대하여 조사하여 감염예방에 기여하고자 하였다. 본 연구는 서술적 조사연구로, 연구 시기는 2016년 4월부터 5월까지이며 연구대상자는 간호대학생 350명이다. 연구결과 메르스를 예방하려는 태도(p<.001)와 감염예방행위 수행도가 통계적으로 유의미한 정(+)의 상관관계가 나타났다. 메르스 감염예방행위 수행도에 대한 지식과 태도의 영향은 회귀모형의 설명력이 15.2%이었고 통계적으로 유의미하였다(F=31.081, p<.001). 즉, 메르스를 예방하려는 태도(${\beta}=.383$, p<.001)가 높을수록 감염예방행위를 더욱 준수하려는 것을 알 수 있었다. 향후 간호대학생에게 메르스와 같은 감염질환에 대한 융합적 교육프로그램을 실시하여, 감염질환의 전파를 막으려는 태도를 강화하고 감염예방행위를 실천하게 하는 연구가 필요하다고 제언한다.