Diesel Exhaust Particles Impair Therapeutic Effect of Human Wharton’s Jelly-Derived Mesenchymal Stem Cells against Experimental Colitis through ROS/ERK/cFos Signaling Pathway

Background and Objectives@#Epidemiological investigations have shown positive correlations between increased diesel exhaust particles (DEP) in ambient air and adverse health outcomes. DEP are the major constituent of particulate atmospheric pollution and have been shown to induce proinflammatory responses both in the lung and systemically. Here, we report the effects of DEP exposure on the properties of human Wharton’s jelly-derived mesenchymal stem cells (WJ-MSCs), including stemness, regeneration, and immunomodulation. @*Methods@#and Results: Non-apoptotic concentrations of DEP (10 μg/ml) inhibited the migration and osteogenic differentiation capacity of WJ-MSCs. Gene expression profiling showed that DEP increased intracellular reactive oxygen species (ROS) and expression of pro-inflammatory and metabolic-process-related genes including cFos. Furthermore, WJ-MSCs cultured with DEP showed impaired suppression of T cell proliferation that was reversed by inhibition of ROS or knockdown of cFos. ERK inhibition assay revealed that DEP-induced ROS regulated cFos through activation of ERK but not NF-κB signaling. Overall, low concentrations of DEP (10 μg/ml) significantly suppressed the stemness and immunomodulatory properties of WJ-MSCs through ROS/ERK/cFos signaling pathways. Furthermore, WJ-MSCs cultured with DEP impaired the therapeutic effect of WJ-MSCs in experimental colitis mice, but was partly reversed by inhibition of ROS. @*Conclusions@#Taken together, these results indicate that exposure to DEP enhances the expression of pro-inflammatory cytokines and immune responses through a mechanism involving the ROS/ERK/cFos pathway in WJ-MSCs, and that DEP-induced ROS damage impairs the therapeutic effect of WJ-MSCs in colitis. Our results suggest that modulation of ROS/ERK/cFos signaling pathways in WJ-MSCs might be a novel therapeutic strategy for DEP-induced diseases.

Effects of Acceptance Commitment Therapy Based Recovery Enhancement Program on Psychological Flexibility, Recovery Attitude, and Quality of Life for Inpatients with Mental Illness / 정신간호학회지

PURPOSE: The purpose of this study was to (1) develop an acceptance commitment therapy (ACT) based recovery enhancement program for inpatients with mental illness and (2) test the effects of the program on patients' psychological flexibility, recovery attitude, and quality of life. METHODS: A mixed methods design was used: a combination of a repeated-measure design with a non-equivalent control group and qualitative data collection. The participants were 41 inpatients with mental illness (experimental group: 20, control group: 21). The ACT based recovery enhancement program was conducted over four sessions for a total of two weeks. Data were collected from December 2018 to January 2019. RESULTS: Study results revealed that the ACT based recovery enhancement program was effective for psychological flexibility (F=150.71, p<.001), recovery attitude (F=60.22, p<.001), and quality of life (F=31.59, p<.001) for inpatients with mental illness. CONCLUSION: The results of this study suggest that the ACT based recovery enhancement program can be used as an effective mental health nursing intervention for psychological flexibility, recovery attitude, and quality of life of inpatients with mental illness.

Differences between Perceived Readiness for Interprofessional Learning in Nursing and Other Health-related Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to investigate the level of perceived readiness for interprofessional learning and its differences between nursing and other health-related students. Methods METHODS: A web-based survey was conducted from April 25 to June 30, 2017 in one university in Korea. A total of 325 undergraduate nursing students and other health-related disciplines completed the structured questionnaire consisting of Readiness for Interprofessional Learning Scale and general characteristics. Data were analyzed by descriptive statistics, t-test, ANOVA, and multiple linear regression. RESULTS: The scores of readiness for interprofessional learning in nursing students were significantly higher than those in other health-related students (t=3.50, p=.001). Nursing students had higher collaboration, professional identity, and roles and responsibilities than other health-related students. The class experiences with other major students was a significant factor related to the readiness for interprofessional learning both in nursing (p=.001) and other health-related students (p=.001). CONCLUSION: The findings suggest that nursing educators consider the different level of readiness for interprofessional learning between nursing and other health-related students while integrating interprofessional education into nursing education curricula.

Development of Fall Assessment Scale in Adult Inpatients / 임상간호연구

PURPOSE: The purpose of this study was to develop a valid Adult Fall Assessment Scale Korean version (FAS-K) for inpatients in general hospitals in Korea. METHODS: This a 14 item FAS-K was developed based on a review of national and international research and expert opinions in related field. Interrater reliability of FAS-K was analyzed using the ICC (Intraclass Correlation Coefficients). To examine the validity of FAS-K, a CVI (Content Validity Index), the Pearson correlation coefficients between FAS-K and two widely used scales, the Morse Fall Scale (MFS) and the Johns Hopkins Hospital Fall Risk Assessment Tool (JHFRAT), and the Mann-Whitney test were used. RESULTS: The ICC was .958. The CVI ranged from .70 to 1.00. The FAS-K was significantly associated with the MFS (r=.74, p<.001) and with the JHFRAT (r=.87, p<.001), verifying the concurrent validity of FAS-K. As for the construct validity of FAS-K, significant differences between the fall and non-fall groups were found not only in the MFS (Z=−3.23, p=.001) but also in the FAS-K (Z=−3.10, p=.002). CONCLUSION: The findings indicate that the FAS-K is a reliable fall risk assessment tool with high validity.

A Study on the Appropriateness of Health Insurance Fee in Main Nursing Practices / 임상간호연구

PURPOSE: This study was to present improvement strategy and the problems of the nursing fee in national health insurance system. METHODS: A total of 23 nursing activities performed by nurses were selected. Data were collected the relative value score and criteria of the Health Insurance Review & Assessment Agency. Sixty clinical nursing experts panels were composed and nursing time surveyed self-reported method. The actual fee was calculated through the nursing time, relative value score and actual labor costs. Nextly, the labor costs analyzed was compared with that in the national health insurance. RESULTS: Although the practices were mainly performed by the nurse, other occupations have been recorded as main practitioners and the time of the nursing activity is partially improperly reflected. Additionally, although the nurse practiced mainly in glucose (semi-quantitative) test, it was confirmed that the principal practitioner was described as a clinical pathologist. The the labor cost gap was estimated that is 9.3 times (median) and 11.9 times (average) in this analysis. CONCLUSION: This study suggests that it is necessary to legislate a policy that can improve the quality of clinical nursing by reinforcing the appropriateness and improving nursing fee through reflection of the actual time spent for nursing care.

Multidimensional Factors Influencing Burnout in Intensive Care Unit Nurses / 임상간호연구

PURPOSE: This study aimed to identify multidimensional factors influencing burnout in intensive care unit(ICU) nurses. METHODS: A descriptive cross-sectional design was used. Data were collected during February 2016 from a convenience sample of 222 tertiary hospital ICU nurses and analyzed using t-test, ANOVA, correlation analysis, and multiple regression analysis. RESULTS: Burnout correlated positively with compassion fatigue (CF)(r=.37, p < .001), and negatively with compassion satisfaction (CS)(r=-.66, p < .001). The regression model explained 57% of the variance in burnout. For individual characteristics in the model, perceived health status (β=-.27, p < .001) and gender (β=.14, p=.028) were the most influential factors for ICU nurses' burnout. In the model with added work-related characteristics, nursing environment (β=-.22, p=.001), perceived health status (β=-.20, p=.001), and satisfaction with department (β=-.19, p=.007) were the most influential factors. Finally, for the model with psychological characteristics added, CS (β=-.56, p < .001) and CF (β=.35, p < .001) were the most influential factors. CONCLUSION: Results reveal that most ICU nurses have a moderate level of CF and a moderate to high level of CS and burnout, and that individual, work-related and psychological factors are relevant in ICU nurses' burnout. Programs or interventions to reduce burnout should be developed taking into account these multidimensional factors.

The Relationship among Nurses' Perception of Super-leadership, Self-leadership and Organizational Commitment / 간호행정학회지

PURPOSE: This study was designed to assess the level of super-leadership and self-leadership, identify correlations among variables and identify the factors influencing organizational commitment of clinical nurses. METHODS: Participants were 217 nurses working in four hospitals located in Seoul and Gyeonggi Province. Data were analyzed using descriptive statistics, independent t-test, one way ANOVA, Scheffé test, Pearson Correlation, and Multiple Regression. RESULTS: The most influential factor for organizational commitment was super-leadership (β=.28, p<.001), followed by education (β=.16, p=.007), the number of unit nurses (β=-.18, p=.003), self-leadership (β=.17, p=.008), and the number of patients being under 10 (β=.12, p=.046). These factors accounted for 23% of the variance in organizational commitment (F=13.46, p<.001). CONCLUSION: The results of this study suggest a need for strategies to improve organizational commitment of nurses by enhancing nurse' self-leadership through nursing managers' super-leadership.

Comparative Study of BMP-2 Alone and Combined with VEGF Carried by Hydrogel for Maxillary Alveolar Bone Regeneration

The effect of vascular endothelial growth factor (VEGF) combined with bone morphogenetic protein-2 (BMP-2) for bone regeneration is still controversial as to whether or not VEGF has a synergistic or additive effect. This study attempted to evaluate the synergistic effect of VEGF and BMP-2 compared to BMP-2 alone for maxillary alveolar bone regeneration using collagen sponge/hydrogel complex sheets in a canine model. After mixing BMP-2 and VEGF with a hyaluronic acid-based hydrogel (HAH), the collagen sponge/hydrogel complex was transplanted into maxillary alveolar bone defects (n=14) after the extraction of canine upper first molars on both sides. Bone regeneration was evaluated in three groups (control group without growth factors, experimental groups I and II with BMP-2 alone and BMP-2 and VEGF, respectively) using micro-computed tomography and histological staining. The total amount of new bone formations and bone mineral density were significantly higher in the group with BMP-2 only and the group with BMP-2 combined with VEGF than it in the control group. The area with positive staining of von Willebrand factor bone defect was significantly greater in the group with BMP-2 only and with dual growth factors than the control. BMP-2 released from the HAH promoted new bone formation. However, the combination of BMP-2 and VEGF did not show a synergistic or additive effect on bone regeneration at canine maxillary alveolar bone defects.

Surgical Outcomes of a Modified Infarct Exclusion Technique for Post-Infarction Ventricular Septal Defects

BACKGROUND: Postinfarction ventricular septal defects (pVSDs) are a serious complication of acute myocardial infarctions. The aim of this study was to analyze the clinical outcomes of the surgical treatment of pVSDs. METHODS: The medical records of 23 patients who underwent operations (infarct exclusion in 21 patients and patch closure in two patients) to treat acute pVSDs from 2001 to 2011 were analyzed. Intra-aortic balloon counter-pulsation was performed in 19 patients (82.6%), one of whom required extracorporeal membrane support due to cardiogenic shock. The mean follow-up duration was 26.2+/-18.6 months. RESULTS: The in-hospital mortality rate was 4.3% (1/23). Residual shunts were found in seven patients and three patients required reoperation. One patient needed reoperation due to the transformation of an intracardiac hematoma into an abscess. No patients required reoperation due to recurrence of a ventricular septal defect during the follow-up period. The cumulative survival rate was 95.5% at one year, 82.0% at five years, and 65.6% at seven years. CONCLUSION: The use of a multiple-patch technique with sealants appears to be a reliable method of reducing early mortality and the risk of significant residual shunting in patients with pVSDs.

Isolated Tricuspid Regurgitation: Initial Manifestation of Cardiac Amyloidosis

Amyloid deposits in the heart are not exceptional in systemic amyloidosis. The clinical manifestations of cardiac amyloidosis may include restrictive cardiomyopathy, characterized by progressive diastolic and eventually systolic bi-ventricular dysfunction; arrhythmia; and conduction defects. To the best of our knowledge, no previous cases of isolated tricuspid regurgitation as the initial manifestation of cardiac amyloidosis have been reported. We describe a rare case of cardiac amyloidosis that initially presented with severe tricuspid regurgitation in a 42-year-old woman who was successfully treated with tricuspid valve replacement. Unusual surgical findings prompted additional evaluation that established a diagnosis of plasma cell myeloma.

Persistent Atrial Fibrillation Related to a Congenital Pericardial Defect and Left Atrial Appendage Herniation

Congenital pericardial defects (CPDs) are infrequent anomalies that are usually asymptomatic and are discovered incidentally during unrelated interventions. Here we report the case of a CPD with herniation of an enlarged left atrial appendage identified during total thoracoscopic ablation (TTA) for persistent atrial fibrillation (AF). The persistent AF was successfully treated with a hybrid procedure, in which TTA was followed by an electrophysiological study.

Effect of Perception of Career Ladder System on Job Satisfaction, Intention to Leave among Perioperative Nurses / 간호행정학회지

PURPOSE: This was a correlational study to identify effects of perception of clinical ladder system on job satisfaction and intention to leave in perioperative nurses. METHODS: Participants were 154 of perioperative nurses from larger general hospitals in Seoul. Data were collected from April, 16 to 22, 2013 using self-report questionnaires which included items on perception of clinical ladder system, job satisfaction, and intention to leave. Data were analyzed using frequency, t-test, ANOVA, Scheffe? test, Pearson correlation coefficients, and multiple stepwise regression. RESULTS: The average mean score for perception of clinical ladder system was midline at 2.69 point out of 4 point. Perception of clinical ladder system correlated positively with job satisfaction (r=.38, p<.01) and negatively with intention to leave (r=-.88, p<.01). Perception of clinical ladder system was the factor which most influenced job satisfaction explaining 17.1% of the variance, also perception of clinical ladder system was the factor which most influenced intention to leave, explaining 12.7% of the variance. CONCLUSION: Results of this study suggest that there is a need to enhance the perception of the clinical ladder system and to find ways to fulfill the expected effects for improving perioperative nurses' job satisfaction and reducing the intention to leave.

Effects of Silver-Care-Robot Program on Cognitive Function, Depression, and Activities of Daily Living for Institutionalized Elderly People

PURPOSE: The purpose of this study was to identify the effects on cognitive function, depression, and activities of daily living of Silver-Care-Robot Program for institutionalized elders. METHODS: This study was a nonequivalent control group pretest-posttest design. The participants were 42 institutionalized elders (17 in the experimental group and 25 in the control group). The Silver-Care-Robot Program was provided as an intervention which was conducted twice a week for 5 weeks. The Silver-Care-Robot Program is an integrated entertainment program to help the mental, emotional, and physical health of elderly people. Pre-test was conducted on the two groups, and, in order to examine the effects of intervention, a post-test was conducted after 5 weeks. RESULTS: There were significant differences in cognitive function and ADL (activities of daily living) between two groups after the program. But the difference in depression in the institutionalized elders was not statistically significant between the two groups. CONCLUSION: The Silver-Care-Robot Program should be considered as a regular program for cognitive function and activities of daily living for institutionalized elders.

Effects of a Cardiocerebrovascular Disease Prevention Education Program for Postmenopausal Middle-aged Women

PURPOSE: This study was conducted to examine effects of a cardiocerebrovascular disease (CVD) prevention education program on knowledge, self-efficacy and health behavior among postmenopausal middle-aged women. METHODS: A non-equivalent control group pretest-posttest design was used. Participants were 53 postmenopausal middle-aged women who registered in two community culture centers in G metropolitan city. Experimental group (n=26) received a CVD prevention education program 8 times over 8 weeks. Knowledge, self-efficacy and health behavior of the participants were examined with self-report structured questionaries. Data were collected between October 15 and December 11, 2013, and were analyzed using chi-square test, Fisher's exact test, independent t-test, and analysis of covariance with SPSS/PC version 21.0. RESULTS: After the intervention the experimental group showed significant increases in the knowledge of CVD symptoms (p<.001) and CVD risk factors (p<.001), level of self-efficacy (p=.028) and health behavior (p<.001) compared to the control group. However, no significant difference was found between groups for knowledge of CVD prevention (p<.133). CONCLUSION: Results suggest that a CVD prevention education program can be an effective strategy to improve knowledge on CVD symptoms and risk factors, self-efficacy and health behavior for postmenopausal middle-aged women.

Influencing Factors on Practice of Healthcare-associated Infection Control among Clinical Nurses / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to identify the factors influencing on practice of healthcare-associated infection control among clinical nurses. METHODS: The subject of this study were 118 nurses who worked in medical . surgical ward and ICU of 2 general hospital in Gwangju city. Data were collected with a questionnaire. Data were analysed using descriptive statistics, t-test, one-way ANOVA, Scheffe test, Pearson correlation and stepwise multiple regression analysis using SPSS/WIN 12.0. RESULTS: The major findings of this study were as follow: There were significant positive correlation between knowledge, recognition, empowerment and practice of healthcare-associated infection control. The significant factors influencing practice of healthcare-associated infection control were recognition and empowerment, which explained 68.8% of the practice of healthcare-associated infection control. CONCLUSION: These results indicate that recognition on healthcare-associated infection control and empowerment among clinical nurses should be reinforcement via consistent education, administrative and organizational support at the level of hospital.

Factors Influencing Burnout in Emergency Room Nurses / 한국직업건강간호학회지

PURPOSE: The study was done to identify the influences of violence experience and violence response on burnout of emergency room nurses. METHODS: The subjects of this study were 185 nurses who worked in emergency rooms of 3 university and 15 general hospitals. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Sheffe test, Pearson correlation coefficient and stepwise multiple regression analysis using SPSS version 12.0. RESULTS: The major findings of this study were as follow: There were significant differences in age, education, emergency room career, position, exercise in general characteristics. There were significant positive correlation between violence experience and burnout, violence response and burnout. The significant factors influencing burnout were job stress, verbal violence, violence preventive program. Shift pattern, which explained 28% of the burnout. CONCLUSION: It is necessary to develop an intervention program for emergency room nurses to improve job stress, verbal violence, violence preventive program. Shift pattern.

Factors Influencing Burnout in Emergency Room Nurses / 한국직업건강간호학회지

PURPOSE: The study was done to identify the influences of violence experience and violence response on burnout of emergency room nurses. METHODS: The subjects of this study were 185 nurses who worked in emergency rooms of 3 university and 15 general hospitals. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Sheffe test, Pearson correlation coefficient and stepwise multiple regression analysis using SPSS version 12.0. RESULTS: The major findings of this study were as follow: There were significant differences in age, education, emergency room career, position, exercise in general characteristics. There were significant positive correlation between violence experience and burnout, violence response and burnout. The significant factors influencing burnout were job stress, verbal violence, violence preventive program. Shift pattern, which explained 28% of the burnout. CONCLUSION: It is necessary to develop an intervention program for emergency room nurses to improve job stress, verbal violence, violence preventive program. Shift pattern.

Influencing Factors on Practice of Healthcare-associated Infection Control among Clinical Nurses / 산업간호학회지

PURPOSE: The purpose of this study was to identify the factors influencing on practice of healthcare-associated infection control among clinical nurses. METHODS: The subject of this study were 118 nurses who worked in medical . surgical ward and ICU of 2 general hospital in Gwangju city. Data were collected with a questionnaire. Data were analysed using descriptive statistics, t-test, one-way ANOVA, Scheffe test, Pearson correlation and stepwise multiple regression analysis using SPSS/WIN 12.0. RESULTS: The major findings of this study were as follow: There were significant positive correlation between knowledge, recognition, empowerment and practice of healthcare-associated infection control. The significant factors influencing practice of healthcare-associated infection control were recognition and empowerment, which explained 68.8% of the practice of healthcare-associated infection control. CONCLUSION: These results indicate that recognition on healthcare-associated infection control and empowerment among clinical nurses should be reinforcement via consistent education, administrative and organizational support at the level of hospital.

Factors Affecting the Perception of Importance and Practice of Patient Safety Management among Hospital Employees in Korea

PURPOSE: The study was undertaken to identify factors affecting perception of the importance and practice of patient safety management (PSM) among hospital employees in Korea. METHODS: This study was conducted using a descriptive design and a self-report questionnaire. Two hundred and eighty employees were recruited from three hospitals using a convenience sampling method. Measures were perception of the importance, practice, and characteristics of PSM. Data were analyzed using descriptive statistics including t test, one-way analysis of variance, Pearson's correlation analysis, and multiple regression. RESULTS: Factors affecting perception of the importance of PSM were whether hospital employees were in contact with patients while on duty, weekly working hours, education on PSM, and perceived adequacy of PSM system construction. Factors affecting the practice of PSM were perceived adequacy of work load, perceived adequacy of PSM system construction and perception of its importance. CONCLUSION: The findings of this study indicate a need for developing strategies to improve perception of the importance and practice of PSM among all hospital employees, and provide a reference for future experimental studies.

What Are Patients with Thyroid Cancer Surgery Concerned about? / 대한갑상선학회지

BACKGROUND AND OBJECTIVES: To prevent getting wrong information and improve high quality of life, it is necessary to provide accurate information and patient education. This study aimed to collect basic data and develop educational program for thyroid cancer patient by understanding their educational needs. MATERIALS AND METHODS: Between April 16 and June 15, 2012, 159 patients who underwent thyroid cancer surgery were enrolled. This survey consisted of 5 areas including management of the symptom and the complication after surgery, postoperative wound and dietary management, treatment plan after discharge, medication management, and daily life. RESULTS: The most common way for the patients to acquire information about the disease was Internet and the patients who used INTERNET as their information source were 54.7%. Doctors (76.1%) and nurses (21.4%) were the preferred educators for the patients, and small group education was the preferred education method. Specifically the need for "management of the symptom and the complication after surgery" was the highest (3.33), followed by "treatment plan after discharge" (3.31), "medication management" (3.19), "postoperative wound and dietary management" (3.17). CONCLUSION: Medical team including doctors and nurses should be the center to activate small group education for patients. Professional and individualized education program should be developed to give the proper education to patients and their family.