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Colonization Rate of Methicillin-resistant Staphylococcus aureus in Neonates: A Single Center Experience (단일병원 신생아 환자의 메티실린내성 황색포도알균 보균율)

  • Choi, Soo Young;Han, Sang Woo;Yoon, Hye Sun;Ki, Moran
    • Pediatric Infection and Vaccine
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    • v.19 no.3
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    • pp.111-120
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    • 2012
  • Purpose: The aim of this study is to investigate the colonization rate of Methicillin-resistant Staphylococcus aureus (MRSA) in neonates by different clinical characteristics, to presume the origin of MRSA acquisition, and to identify the risk factors associated with MRSA colonization. Methods: We retrospectively reviewed the medical records of 1,733 neonates admitted to Seoul Eulji hospital Neonatal Intensive Care Unit between January 2008 and December 2011. Nasal, inguinal and rectal swab specimens were obtained upon admission and each week until discharge. We classified the route of MRSA acquisition as; hospital associated (HA-MRSA) and community associated (CA-MRSA) according to the case definition. Results: Among 1,733 neonates, 415 (23.9%) were colonized with MRSA. Gestational age, birth weight, delivery type, maternal antibiotics usage before delivery, birth place and care place before admission were influencing factors in colonization of MRSA. The colonization rate was significantly high in neonates without maternal prophylactic antibiotics use before delivery than in the other group (relative risk 2.77, 95% CI 1.88-4.07; P<0.01), and outborns showed higher MRSA colonization rate compared to inborns (relative risk 2.28, 95% CI 1.17-4.42; P=0.015). Conclusion: We identified the neonatal MRSA colonization rate to be 23.9%. We estimated HA-MRSA colonization rate to be 10% (51/511) and CA-MRSA colonization rate to be 36% (309/858). We ascertained that risk factors in MRSA colonization in neonates were prophylactic use of antibiotics in mothers and the birth place.

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The Effect of Simulation Training applying SBAR for Nursing Students on Communication Clarity, Self-Confidence in Communication, and Clinical Decision-Making Ability (SBAR를 적용한 시뮬레이션 교육이 간호대학생의 의사소통명확성, 의사소통자신감, 임상의사결정능력에 미치는 효과)

  • Cho, Hun-Ha;Nam, Keum-hee;Park, Jung-Suk;Jeong, Hyo-Eun;Jung, Yu-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.73-81
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    • 2020
  • This study is a single-group study to check the effectiveness of nursing students on their communication credibility, communication confidence and clinical decision-making ability by implementing SBAR-applied simulation training to improve the difficulty of delivering clear information to medical personnel during transition. By combining simulation practices and SBAR training based on emergency situations of mothers and newborns, programs were developed and applied to communicate clearly and briefly to the medical staff about emergencies and to enhance communication skills. The subjects were 91 fourth-year nursing college students from one university in B metropolitan city. The data were collected from Feb. 18, 2019 to Feb. 28, 2019 and were analyzed using the SPSS/WIN 18.0 program as a paired t-test. The results revealed that the communication clarity measured after the simulation exercise (t=-3.99, p<.001), Communication Confidence (t=-8.60, p<.001), Clinical Decision Capacity (t=-4.66, p<.001) Statistically, it has increased significantly. Therefore, the purpose of this research is significant in that it seeks to promote the expertise of nursing college students by developing and applying simulation practical education programs to enhance the communication skills and clinical decision-making skills of nursing college students as prospective medical personnel.

A Comparative Study of Reported Nursing Needs and Nursing Care During Labor and Delivery (산부의 간호요구와 간호원의 간호활동과의 비교 연구)

  • 안혜숙
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.51-59
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    • 1976
  • Contemporary nursing is concerned with meeting patients physical psychological and secio-economical needs and with helping persons to sore their own problems. At the time of confinement and delivery, women often have physical and psychological disco- mort related to fear, tension or anxiety. Pain related to these causes varies with the individual woman. Effective nursing care to meet individual needs during labor and delivery is important if nurses are to understand and relieve woman's physical and psychological pain. A questionnaire prepared for the purpose by the investigator was administered to 162 women in two general hospitals, one in Seoul and one in TaeGu, during August 1 and September 20, 1975 and to the 13 delivery-room nurses who cared for them. It was hoped that the study would contribute to comprehensive nursing care during labor and delivery and to improve maternal and child health. 1. The sample of mothers ranged in age from 18 to 39; the majority were from 25 to 29 years old (54.3%). Most of them were housewives (87.6%). Sixty-three percent had high school or higher education. They had a range of one to seven deliveries. Sixty-one percent were primiparas Most had some prenatal care (87.6%). 2. The age of the group of nurses ranged from 22 to 39. Ten were 22 or 23. Five of the 13 had from six to ten months experience in the de]ivory room. Twelve were single and ten had a religious affiliation. 3. Both primiparas and multiparas thought equally that physical and psychological care, nursing skills and attitudes were important during labor and delivery, but did not relate basic nursing care directly to normal delivery. Need for nursing care was rated more highly by primiparas (2.83-3.48) than by multiparas (2.51-3.17) (p〈0.05). 4. There was no difference in need for nursing care according to the educational level of the women nor according to whether they had a religious affiliation or not (p〉0.05). 5. There was no difference in the reported nursing care given regarding of the educational preparation of the nurses (p〉 0.05). 6. There the reported nursing needs of the women and the reported nursing care given were compared, physical and psychological nursing care directed toward protecting the mother and fetus and a safe do]ivory were considered important by both groups. Neither group related simple nursing care directly to protection of the mother and fetus or to a safe delivery. The women rated highly their needs for nourishment (3.05) and having a relative with them (2.90) for emotional support but there was little evidence (2.39) that the nurses provided care to meet these needs (p〈0.05). In conclusion, the nursing needs of the women during the three stages of labor and the nursing care given were generally similar. The women had more psychological needs than physical needs but in comparison, nurses gave a little more physical than psychological care. The results point up the need to make adjustments in labor and delivery room nursing care the nurse should Prepared to pay more attention and bigger consideration in psychological comfort care than physical care.

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A Study on the Maternal and Child Health Status in a Rural Area (일부농촌지역(一部農村地域)의 모자보건실태(母子保健實態)에 관(關)한 연구(硏究))

  • Nam, Sang-Duk
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.2
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    • pp.333-342
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    • 1974
  • In September 1974, a survey was conducted towards 900 women respondents, each representing a household, residing in 18 selected Myuns(townships) of 18 Guns(counties) in Kyunggi-Do. Fifty households were selected randomly in each Myun and the sample Myuns were also randomly selected from the 18 Guns home-visiting interviews were carried out by Myun level maternal and child health workers with questionnair forms designed to measure the maternal and child health status at each household. Major findings obtained from this survey can be summarized as follows: 1. Of the women responents who were investigated in this survey, 13.1% of them were comprised in the illiterates, indicating no difference in literacy rate from that in most urban areas. 2. Most(93.8%) of the respondents were found to have married at ages of 20-24 years old. 3. Most(85.8%) of the respondents were found to have delivered their first babies at ages of 20-24, while only 13.4% had their first babies at 25-29. 4. About 22% of the respondents had 2 children, while 19% and another 19% had 2 and 4 children, respectively. 5. A great majority of the respondents (78%) experienced not a single death of a child within the family, while about 17% experienced death of one child. 0.7% of the women experienced deaths of 4 or more children. 6. 18% and 17% of the women experienced 4 and 3 pregnancies, respectively, and 12% of them experienced 7 or more pregnancies. 7. About 29% of the women experienced an induced abortion at least once. Nearly 2% of them were found to have experience of 4 or more induced abortions. 8. One half (51%) of the women were found to have received prenatal guidances in the latest pregnancies by (Ub(town) and Myun (township) level maternal and child health workers at least once or more times. 9. 52% women received professional prenatal care in the latest pregnancies: 24% at hospitals or clinics and 20% at health centers. 10. Most (89%) of the last-born children were delivered at home, while only 8.7% were delivered at hospital or clinics. 11. Materials used at delivery comprise vinyl (40%), cement bags (32%) ana gauzed or absorbent cottons (19%). 12. The largest preportion of the attendants at delivery comprises mothers in-law (48). Only 24% were found to be attended by either doctors, midwives or maternal and child health workers. 13. In most (90%) of the deliveries scissors were used to cut the umbilicus. But most (7%) of them used unsterilized scissors, 6 while only 20% of them used sterilized ones. 14. About 68% of the last-born babies were breast-fed for 12 months or more. Those who weaned during 6-12 months were 21%. 15. During 12 months after birth, 65% of the last-born babies were breast-fed, while 24% were given a combination of breast milk and cooked rice. 16. About nine out of the 10 births were found to be registered. 17. 71% of babies received BCG vaccination, while 79% and 56% received samllpox and DPT vaccinations, respectively within a year after birth. Those who were vaccinated against poliomyelitis were about 50%. 18. About 87% of the respondents recogninized the existence of government-sponsored maternal and child health guidance program.

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COMORBID PSYCHOPATHOLOGY AND PARENTAL BEHAVIORS IN TIC DISORDER CHILDREN (틱 장애아(障碍兒)들의 동반 정신병리(同伴 精神病理)와 부모양육태도(父母養育態度)에 관(關)한 연구(硏究))

  • Kim, Ja-Sung;Lee, Jeong-Seop;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.150-161
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    • 1994
  • Clinical Characteristics of 83 tic patients referred to child psychiatric clinics were studied including the patients' sexes, birth orders and onset ages. We compared the differences between patients and normal control regarding the co-morbidity, and mothering attitude using CBCL(Child Behavioral Check List) and MBRI(Mothering Behavior Rating Instrument). And we also evaluated the influence of types of tic disorder and the presence of behavioral characteristics of the tic patients. The following results were obtained. 1) The sex ration was 5.9:1, male dominant. 2) The eldest children were being twice as many as the youngest children(eldest : youngest : single=4.7 : 1.7 : 1). 3) The eldest children tended to have earlier onset than others. 4) The tic children as a whole had more accompanying behavioral problems than the normal children according to the CBCL scales' scores. 5) The mothers of tic children had more negative view of their children, more rejecting and more hostile attitude toward their children. 6) The types of tic disorder(the Tourette disorder vs chronic moter tic disorder) did not make a difference in the incidence of behavior problems. 7) Those who had attentional problems regardless the types of tic had more behavioral problems than those who had not. 8) Those who had familial loadings of tic disorder tended to have more likely Tourette disorders than chronic tic disorders.

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Effects of Single Fetal Death on Mother and Live Co-twin in Twin Pregnancy (쌍태 임신에서 일측 태아의 자궁내 사망이 산모와 생존아에 미치는 영향)

  • Kim, So Youn;Chung, Hae Yul;Back, Hee Jo;Choi, Ic Sun;Cho, Chang Yee;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1512-1518
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    • 2002
  • Purpose : Twins have a higher mortality and morbidity than singletons. Co-twin with one fetal death is particularly at risk. We investigated the neonatal outcome of live co-twins when one fetus had died after the 20th gestational week, and associated risk factors. Methods : A retrospective study was performed in fifteen cases of twin pregnancy with single intrauterine fetal deaths after the 20th gestational week during the period from January 1996 to December 2000 at Chonnam University Hospital. Results : Gestational age was $33.7{\pm}3.2weeks$, birth weight was $1,992{\pm}592g$. Interval between one fetal death being detected and the delivery of a live co-twin was $32.4{\pm}29.5days$. There were 11 cases(73.3%) of premature babies less than 37 gestational weeks. Main causes of preterm delivery were preterm labor and premature rupture of membranes. Hematologic findings suggesting disseminated intravascular coagulopathy(DIC) were not found in all mothers before delivery, and was not associated with DIC and encephalomalacia of the live co-twin. Perinatal outcome of fifteen live co-twins was as follows : six were normal(40%), three were DIC(20.0%), three were encephalomalacia(20.0%), one suffered intrauterine growth retardation, there was one case of twin to twin transfusion syndrome, and one of congenital heart disease(atrial septal defect with pulmonary stenosis). The occurrence of DIC and encephalomalacia in live co-twins was not related to placental chorionicity, birth weight, gestational week, and the interval between the detection one fetal death and the delivery of a live co-twin. Conclusion : We could not find any maternal hematologic problems in twin pregnancies complicated by one fetal death. Twenty percent of live co-twins showed DIC and encephalomalacia. However, its associated risk factors were not found. We need to investigate more closely the cases of live co-twins with one intrauterine fetal death.

The Achievements and limitations of the U. S. Welfare Reform (미국 복지개혁의 성과와 한계)

  • Kim, Hwan-Joon
    • Korean Journal of Social Welfare
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    • v.53
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    • pp.129-153
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    • 2003
  • This study examines the socio-economic impacts of recent welfare reform in the United States. Based on the neo-conservative critique to the traditional public assistance system for low-income families, the 1996 welfare reform has given greater emphases on reducing welfare dependency and increasing work effort and self-sufficiency among welfare recipients. In particular, the welfare reform legislation instituted 60-month lifetime limits on cash assistance, expanded mandatory work requirements, and placed financial penalties for noncompliance. With the well-timed economic boom in the second half of the 1990s, the welfare reform seems to achieve considerable progress; welfare caseload has declined sharply to reach less than 50% of its 1994 peak, single mothers' labor force participation has increased substantially, and child poverty has decreased. In spite of these good signals, the welfare reform also has several potential problems. Many welfare leavers participate in the labor market, but not all (or most) of them. The economic well being of working welfare leavers did not increased significantly, because earnings increase was canceled out by parallel decrease in welfare benefits. Furthermore, most of working welfare leavers are employed in jobs with poor employment stability and low wages, making them highly vulnerable to frequent layoff, long-time joblessness, persistent poverty, and welfare recidivism. Another serious problem of the welfare reform is that a substantial number of welfare recipients are faced with extreme difficulties in finding jobs, because they have severe barriers to employment. The new welfare system with 5-year time limit can severely threaten the livelihoods of these people. The welfare reform presupposes that welfare recipients can achieve self-reliance by increasing their labor market activities. However, empirical evidences suggest that many people are unable to respond to the new, work-oriented welfare strategy. It may be a very difficult task to achieve both objectives of the welfare reform((1) providing adequate income security for low-income families and (2) promoting self-sufficiency) at the same time, because sometimes they are conflicting each other. With this in mind, a possible solution can be to distinguish welfare recipients into "(Very)-Hard-to-Employ" group and "(Relatively)-Ready-to-Work" group, based on elaborate examinations of a wide range of personal conditions. For the former group, the primary objective of welfare policies should be the first one(providing income security). For the "Ready-to-Work" group, follow-up services to promote job retention and advancement, as well as skill-training and job-search services, are very important. The U. S. experiences of the welfare reform provide some useful implications for newly developing Korean public assistance policies for the able-bodied low-income population.

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