• Title/Summary/Keyword: Clinical consequences

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Epilepsy in various metabolic disorders (여러 가지 대사질환에서의 간질)

  • Lee, Young-Mock
    • Clinical and Experimental Pediatrics
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    • v.51 no.12
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    • pp.1290-1294
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    • 2008
  • Seizures are a frequent symptom in metabolic disorders, although metabolic disorders are rarely found to be the cause of epilepsy. A precise diagnosis might not only influence treatment, but it might also call for counseling of the family, even if there are no direct therapeutic consequences. We review the main characteristics of epilepsy in metabolic disorders with regard to energy metabolism, toxic effects, neurotransmitters, and vitamins.

Clinical Usefulness of Gastric Residual Volume as An Indicator to Provide Approximately Enteral Nutrition for Patients in Intensive Care Units: A Systematic Literature Review (중환자의 경관영양 공급 지표로서 위 잔여량의 임상적 효용성: 체계적 문헌고찰)

  • Kim, Hyunjung;Chang, Sun Ju
    • Journal of Korean Biological Nursing Science
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    • v.16 no.4
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    • pp.267-275
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    • 2014
  • Purpose: The practice of enteral nutrition with gastric residual volumes (GRVs) as a clinical indicator is poorly standardized in intensive care units. This study aims to summarize the results from studies that evaluated the clinical outcomes related to the GRVs. Methods: This systematic review study analyzed 11 studies consisting of four randomized controlled trials, one non-randomized controlled trial, and six observational studies. Results: No consistent relationship between GRV thresholds and clinical outcomes was observed. Higher GRVs were not consistently correlated with clinical outcomes such as higher gastrointestinal complications, aspiration pneumonia, or mortality. Higher GRVs significantly generate complications more often. Findings show that a single GRV more than 200 mL or two consecutive GRVs more than 150 mL should raise concern about negative consequences. Conclusion: Critical care nurses need to monitor GRVs closely during their practice of enteral nutrition. For critically ill patients receiving enteral nutrition, a GRV threshold of 200 ml would be a desirable limit to provide safe and adequate nutrition with a conservative approach.

Analysis and Ethical Review of the Compensation System for Clinical Trial Injury in India (인도 임상시험 피해보상제도 분석 및 윤리적 고찰)

  • Lee, Chan Joo;Choe, Byung In
    • The Journal of KAIRB
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    • v.3 no.1
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    • pp.1-10
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    • 2021
  • In 2004, India began investing in the clinical trial industry; the country now boasts a 20% market share with the help of a valuable resource - the world's second largest population. The Contract Research Organization has been able to generate profits efficiently conducting clinical trials via a large pool of participants, skilled researchers, and reduced developmental costs. As the demand and sheer number of global clinical trials increased, the International Council of Harmonization-Good Clinical Practice was introduced, and the need for the Institutional Review Board increased. While the clinical trial industry in India boomed, it came at the expense of the participants' civil rights. The increased media attention regarding the ethical issues forced the Indian Supreme Court to take action. Consequently, India is the only country, by law, that specifically compensates participants suffering from injury directly resulting from participation in clinical trials. This research paper will describe and compare the relevant laws of India and Korea including compensation criteria. In addition, the ethical issues and aspects of indemnity in clinical trials will be discussed. While the clear advantage of the compensation is one of the protected rights of a clinical subject, the current system is not perfect. Furthermore, laws created to redeem ethical issues can have unintended, negative consequences.

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The Relationship among Workplace Bullying, Organizational Commitment and Turnover Intention of the Nurses Working in Public Medical Institutions (공공의료기관에 근무하는 간호사가 경험하는 근무지 약자 괴롭힘과 조직몰입, 이직의도간의 관계)

  • Kang, Hei Young;Kim, Sanghee;Han, Kihye
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.2
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    • pp.178-187
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    • 2018
  • Purpose: The purpose of this study was to explore the relationships among workplace bullying, organizational commitment, and turnover intention of nurses. Methods: A cross-sectional study was conducted. Data were collected using a structured questionnaire from nurses at five public hospitals (N=190). Results: The experience of bullying was 31.29 points (range 16-64) on average: Work-related bullying was the highest, followed by verbal/non verbal bullying and external threats. The consequences of bullying were 30.54 points (range 13-52) on average: The physical/psychological withdrawal was the highest, followed by increasing distrust and the poor quality of patient care. The experiences of bullying had positive correlations with the consequences of bullying (r=.55, p<.001) and the turnover intention (r=.27, p<.001), and had a negative correlation with organizational commitment (r=-.28, p<.001). The consequences of bullying had a positive correlation with the turnover intention (r=.52, p<.001), and had a negative correlation with organizational commitment (r=-.49, p<.001). Organizational commitment showed a negative correlation with the turnover intention (r=.63, p<.001). Conclusion: The findings of this study suggests the needs of a regular monitoring system and organizational management for workplace bullying, which helps nurses to commit to their organization and to be retained in a workplace.

Self-Care in Elders with Dementia: A Concept Analysis

  • Yeom Hye-A
    • Journal of Korean Academy of Nursing
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    • v.34 no.8
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    • pp.1402-1408
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    • 2004
  • Purpose: The purpose of this study was to analyze the concept of self-care in elders with dementia through a review of nursing literature and to provide more understanding of the definition and perspectives of the concept of self-care notion in elders with dementia. Methods: The technique developed by Walker and Avant was used as a guide in analyzing the concept of self-care. Results: Attributes of self-care in dementia may include a single or group of actions needed for sustaining life, a personal effort to maintain functional independence while minimizing other's assistance, an outcome behavior from the person's interaction with inter-personal and/or contextual environment, and a functional ability that may decline in parallel to cognitive impairment. Antecedents of self-care in dementia may include at least presence of a certain degree of cognitive appraisal for the self-care needs, self-willingness for the self-care action, spatial and visual orientation, cultural pre-conception of the self-care behavior, presence of environmental context/equipment available for self-care, and sufficient time available. The consequences may include sustaining of life, feel of satisfaction, achieving independence, extended life expectancy, increased self-confidence, decreased caregiver distress and/or burden, savings in health care costs. Discussion: Defining attributes and antecedents and consequences of self-care in dementia identified in this study provided empirical ground of a middle-range theory of self-care for a clinical population with dementia and generated possible hypotheses to be tested in future studies.

Consequences of Doses of Herbal Medicine Including Buja and Cheono on Electrocardiography (부자(附子) 및 천오(川烏)를 포함한 처방이 심전도 변화에 미치는 영향)

  • Ahn, Su-yeun;Hwang, Won-deok;Kim, Won-ill
    • The Journal of Internal Korean Medicine
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    • v.36 no.4
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    • pp.458-469
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    • 2015
  • Objectives: Buja and Cheono, containing aconitine known for its cardiotoxicity, are not commonly prescribed, but they are necessary for some clinical conditions. Hence, consequences for electrocardiography (EKG) after short- and long-term dosage of herbal medicine including Buja and Cheono are here reported.Methods: From September 2014 to April 2015, 36 patients belonging to the sixth internal medicine department of the Dong Eui Oriental Medicine Hospital took herbal medicine including Buja and Cheono, and after these doses, they underwent an EKG. Thirty-one patients who took the medicine for 7-8 days comprised the short-term group, and 18 patients taking the medicine for 17-106 days comprised the long-term group. The results of the EKGs for each group, before and after dosage with herbal medicine, are compared.Results: No significant changes in EKG appeared in either the short- or the long-term group after taking herbal medicine including Buja and Cheono.Conclusions: If Buja or Cheono are prescribed along with other suitable herbs by a doctor of Korean medicine, no cardiac trouble will occur on an EKG regardless of the term of the dosage.

The Effect of Food on Absorption of Drug in the Gastrointestinal Tract (소화관에서의 약물 흡수에 대한 음식물의 영향)

  • Yun, Hwi-Yeol;Baek, Min-Sun;Kwon, Kwang-Il
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.147-154
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    • 2006
  • Drugs are often taken together with meals and there are numerous opportunity for food-drug interaction to occure. Food-drug interactions and their clinical consequences are very complex indeed. The composition of the meal, and the volume of fluid that is ingested often are decisive factors in food-drug interactions. Various formulations of a specific drug may behave differently. Solutions and suspensions seem to be less susceptible and enteric-coated preparations are more susceptible, to food interactions than are other dosage forms but exceptions to this rule do exist. Furthermore, generic and environmental factors, disease and other drugs cause considerable inter- and intraindividual variation in food-drug interactions. Also, eating habits are dissimilar in different parts of the world, and diets often vary greatly from day to day. The taking of drugs together with meals offers some obvious benefits. It may help to reduce gastrointestinal irritation and compliance is improved. On the other hand, in some cases food interferes seriously with drug absorption. The purpose of this review is to clarify the complexity of food-drug interactions, and to discuss interactions that may be of clinical importance.

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Leadership Experience of Clinical Nurses: Applying Focus Group Interviews (임상간호사의 리더십 경험: 포커스 그룹 인터뷰 적용)

  • Lee, Byoung-Sook;Eo, Yong-Sook;Lee, Mi-Aie
    • Journal of Korean Academy of Nursing
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    • v.45 no.5
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    • pp.671-683
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    • 2015
  • Purpose: The purpose of this study was to understand and describe the leadership experience of clinical nurses. Methods: During 2014, data were collected using focus group interviews. Three focus group interviews were held with a total of 20 clinical nurses participating. All interviews were recorded as they were spoken and transcribed and data were analyzed using qualitative content analysis. Results: Fifteen categories emerged from the five main themes. 1) Thoughts on the leadership category: to lead others, to cope with problem situations adequately and to serve as a shield against difficulties. 2) Situations requiring leadership: situation that requires correct judgement, coping and situations that need coordination and cooperation. 3-1) Leadership behaviors: other-oriented approach and self-oriented approach. 3-2) Leadership behavior consequences: relevant compensation and unfair termination. 4-1) Facilitators of leadership: confidence and passion for nursing and external support and resources. 4-2) Barriers to leadership: non-supportive organization culture and deficiency in own leadership competencies. 5) Strategies of leadership development: strengthen leadership through self-development and organizational leadership development. Conclusion: In conclusion, the results indicate that it is necessary to enhance clinical nurses' leadership role in healthcare. Enhancement can be achieved through leadership programs focused on enlarging leadership experience, constant self-development, leadership training, and development of leadership competencies suited to the nursing environment.

Diagnosis and Evaluation for the Early Detection of Delirium (섬망의 조기 발견을 위한 진단 및 평가 방법)

  • Chon, Young-Hoon;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.1
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    • pp.3-14
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    • 2011
  • Delirium is a common psychiatric disorder and occurs in many hospitalized older patients and has serious consequences including increased mortality rate. Despite its importance, health care clinicians often fail to recognize delirium or misdiagnosed as other psychiatric illness. Awareness of the etiologies and risk factors of delirium should enable clinicians to focus on patients at risk and to recognize delirium symptoms early. To improve early recognition of delirium, emphasis should be given to terminology, psychopathology and knowledge regarding clinical rating scale for delirium in the specific medical and surgical clinical settings. In this study, authors introduce rating scales for delirium and knowledge of clinical diagnostic process for delirium and give rise to appropriate assessment of delirium in the clinical situation.

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Recent advances in histiocytic disorders (조직구증식증후군의 최신지견)

  • Seo, Jong Jin
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.524-530
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    • 2007
  • The recent advances in the basic hematology and immunology have significantly enhanced the understanding of histiocytic disorders. The Histiocyte Society which was established in 1985 enabled the randomized trials for these diseases, and important knowledge regarding pathogenesis, clinical presentation, diagnosis, therapy and late consequences has been obtained. The treatment of Langerhans cell histiocytosis (LCH) has varied greatly over last decades, and is still controversial. Therapy can be reduced for low risk patients, and it is possible to discriminate early the non-responding patients with risk disease who might require more intensified treatment. Current therapy of LCH recommended by the Histiocyte Society (LCH-III protocol) is activated in 2001. Hemophaocytic histiocytosis (HLH) is fatal if diagnosis is delayed and appropriate therapy is not instituted rapidly. The diagnostic criteria for HLH is revised by the Histiocyte Society for the current treatment protocol (HLH-2004) which consists of dexamethasone, etoposide, and cyclosporin in combination with intathecal methotrexate. Hematopoietic stem cell transplantation is usually necessary for the primary HLH and recurrent secondary HLH.