Effect of amaranth seed extracts on glycemic control in HepG2 cells / 한국영양학회지

Purpose@#This study was carried out to investigate the effect of amaranth seed extracts on glycemic regulation in HepG2 cells. The 80% ethanol extracts of amaranth seeds were used to evaluate α-amylase and α-glucosidase activities, cell viability, glucose uptake and messenger RNA (mRNA) expression levels of acetyl-CoA carboxylase (ACC), glucose transporter (GLUT)-2, GLUT-4, insulin receptor substrate (IRS)-1 and IRS-2. @*Methods@#The samples were prepared and divided into 4 groups, including germinated black amaranth (GBA), black amaranth (BA), germinated yellow amaranth (GYA) and yellow amaranth (YA). Glucose hydrolytic enzyme, α-amylase and α-glucosidase activities were examined using a proper protocol. In addition, cell viability was measured by MTT assay. Glucose uptake in cells was measured using an assay kit. The mRNA expression levels of ACC, GLUT-2, GLUT-4, IRS-1 and IRS-2 were measured by reverse transcription polymerase chain reaction. @*Results@#The inhibitory activities of α-amylase and α-glucosidase were highly observed in GBA, followed by BA, GYA and YA. Similar results were observed for glucose. The GBA effect was similar compared to the positive control group. The mRNA expression levels of ACC, GLUT-2, GLUT-4, IRS-1, and IRS-2 were significantly increased. The potential hypoglycemic effects of amaranth seed extracts were observed due to the increase in glucose metabolic enzyme activity, and glucose uptake was mediated through the upregulation of ACC, GLUT-2, GLUT-4, IRS-1, and IRS-2 expression levels. @*Conclusion@#Our findings suggest that the amaranth seed is a potential candidate to prevent a diabetes. The present study demonstrated the possibility of using amaranth seeds, especially GBA and BA for glycemic control.

The Effects of Clinical Practice Stress and Resilience on Nursing Students’ Academic Burnout / 의학교육논단

The high degree of academic burnout experienced during academic life indicates that job skill levels during the first year following graduation are low, and the correlation with turnover intention is high. We investigated the effects of clinical practice stress and resilience on nursing students’ burnout, and searched for factors that can prevent or control burnout. We recruited a convenience sample of 202 nursing students. Academic burnout, general characteristics, clinical practice stress, and resilience were assessed via self-reported questionnaires. The mean total score of academic burnout was 44.0 points; exhaustion was the highest at 18.5 points, inefficacy was 15.9 points, and cynicism was 9.6 points. High levels of clinical practice stress affected academic burnout (β=0.194, p=0.003), while high resilience was a factor that lowered the degree of academic burnout (β=-0.449, p<0.001). Based on our results, factors affecting students’ experiences of academic burnout were clinical practice stress and resilience. We therefore propose the implementation of a new curriculum aimed at increasing satisfaction with the major, reducing clinical practice stress, and increasing resilience, including an efficient peer mentoring program for clinical practice.

Prevalence of Sleep Disturbance in Korean University Students: A Systematic Review and Meta-Analysis

Background@#This systematic review and meta-analysis aimed at investigating the current status and prevalence of sleep disturbance in Korean university students and provide evidence to develop appropriate strategies for improving sleep disturbance. @*Methods@#Pooled prevalence of sleep disturbance in Korean university students was assessed using PubMed, CINAHL, Research Information Sharing Service, National Assembly Library, Korean studies Information Service System, and Korea Citation Index databases. A total of 1,843 studies were retrieved from the literature search, and 14 studies were included in the analysis. Statistical analysis was performed using comprehensive meta-analysis software. @*Results@#The overall pooled prevalence was 48.9% (95% confidence interval [CI], 41.6-56.3%). Subgroup analyses revealed that the pooled prevalence rates were 59.2% (95% CI, 38.8-50.7%) in the Pittsburgh Sleep Quality Index (PSQI)-based and 26.0% (95% CI, 19.5-33.9%) in non-PSQI-based studies, 23.2% (95% CI, 15.6-33.1%) in low-quality and 56.9% (95% CI, 49.3-64.2%) in moderate-quality studies, 35.6% (95% CI, 33.4-37.8%) in studies published before 2010 and 51.4% (95% CI, 42.9-59.8%) in studies published since 2011. @*Conclusions@#The prevalence of sleep disturbance is higher in university students. Therefore, further studies are needed to identify sleep problems of university students and gain future-oriented insights to develop mediation strategies.

Depression in Patients with Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis

BACKGROUND: Symptoms of subclinical hypothyroidism include depression, memory loss, myocardial contractility disorder, lipid metabolic disorder, and atherosclerosis. However, the relationship between subclinical hypothyroidism and depression has not been consistent. Therefore, the purpose of this study was to provide the scientific evidence for the relationship between subclinical hypothyroidism and depression. METHODS: This study was a meta-analysis of depression in subjects with subclinical hypothyroidism. The search engine of PubMed, EBSCO, ScienceDirect, and RISS was used to search the studies published since the 1990s. A total of 176 documents were retrieved from the literature search, and finally 10 studies were included in the analysis. Statistical analysis of effect sizes was performed using Comprehensive Meta-Analysis software version 2.2.064. RESULTS: Of the 10 studies, five studies reported that depression was associated with subclinical hypothyroidism. Two of these studies were on women and two were on the elderly. The effect size of depression in patients with subclinical hypothyroidism was 3.46 (95% confidence interval 0.20–0.74, P=0.001), and the subclinical hypothyroidism was significantly associated with depression. CONCLUSIONS: This study showed that subclinical hypothyroidism is associated with depression. The results also suggest the need for regular screening of depressive symptoms of patients with subclinical hypothyroidism. Especially, elderly and women with subclinical hypothyroidism may be the main targets of depressive symptom.

Effects of Academic Resilience and Interpersonal Competence on the Happiness of Nursing Students / 의학교육논단

The purpose of this study was to investigate the effects of academic resilience and interpersonal competence on the happiness of nursing students. A descriptive design was used to study 158 nursing students in nursing school through convenience sampling. IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA) was used to analyze data for descriptive statistics, t-test, analysis of variance, Tukey post hoc test, Pearson's correlations, and multiple regressions. The results showed that the level of nursing students' happiness was lower than that of college students in other majors, but academic resilience and interpersonal competence among nursing students were relatively high. Nursing students' happiness was positively correlated with academic resilience and interpersonal competence. The factors affecting happiness were academic resilience (β=0.459, p < 0.001), satisfaction with major (β=0.272, p=0.006), perceived subjective health status (β=0.223, p=0.013), and interpersonal competence (β=0.185, p=0.003). Explained variance for happiness was 56.4%, and academic resilience was the most influential factor in the happiness of nursing students. Nursing students are caring human beings and should be able to pursue a happy life; therefore, it is necessary to improve satisfaction levels with the nursing major, guide students to excel in their academic achievement, prepare health education programs, and design curriculum that inspires confidence in interpersonal relationships.

Individual and School Factors Affecting Critical Thinking Ability among Nursing Students / 의학교육논단

The purpose of this study was to investigate factors associated with the critical thinking ability of nursing students at the individual and school levels. The study adopted a descriptive design and recruited 465 nursing students from four nursing schools from November 2014 to September 2015 through convenience sampling. The Clinical Critical Thinking Skill Test was used to measure critical thinking ability, and the data were analyzed with the SAS ver. 9.4 program (SAS Institute Inc., Cary, NC, USA) for descriptive statistics, t-test, analysis of variance, and multi-level model. The results showed that clinical practicum experience (β=−0.72, p=0.025), taking critical thinking courses (β=0.63, p=0.010), and taking simulation courses (β=0.56, p=0.035) improved critical thinking ability in the individual level model. In the school level model, the interaction effect between the years of clinical practice done by the student and the presence of full-time clinical instructors was significant (β=1.29, p=0.011). These results suggest that critical thinking ability improves with the more years of clinical practice individual nursing students have, and this improvement is greater with the presence of full-time clinical instructors in the school. Therefore, it is recommended that nursing students undergo critical thinking and simulation courses to develop their critical thinking ability, and dedicated clinical instructors in nursing schools should play a vital role.

Depression in Patients with Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis

BACKGROUND@#Symptoms of subclinical hypothyroidism include depression, memory loss, myocardial contractility disorder, lipid metabolic disorder, and atherosclerosis. However, the relationship between subclinical hypothyroidism and depression has not been consistent. Therefore, the purpose of this study was to provide the scientific evidence for the relationship between subclinical hypothyroidism and depression.@*METHODS@#This study was a meta-analysis of depression in subjects with subclinical hypothyroidism. The search engine of PubMed, EBSCO, ScienceDirect, and RISS was used to search the studies published since the 1990s. A total of 176 documents were retrieved from the literature search, and finally 10 studies were included in the analysis. Statistical analysis of effect sizes was performed using Comprehensive Meta-Analysis software version 2.2.064.@*RESULTS@#Of the 10 studies, five studies reported that depression was associated with subclinical hypothyroidism. Two of these studies were on women and two were on the elderly. The effect size of depression in patients with subclinical hypothyroidism was 3.46 (95% confidence interval 0.20–0.74, P=0.001), and the subclinical hypothyroidism was significantly associated with depression.@*CONCLUSIONS@#This study showed that subclinical hypothyroidism is associated with depression. The results also suggest the need for regular screening of depressive symptoms of patients with subclinical hypothyroidism. Especially, elderly and women with subclinical hypothyroidism may be the main targets of depressive symptom.

Current Status and Future Direction of Nursing Education for Clinical Practice / 의학교육논단

The quantitative expansion of nursing schools has necessitated the qualitative improvement of nursing education, which requires the development of nursing education for clinical practice. To identify strategies for strengthening the educational capacity of clinical fields and nursing schools, this study first examined the current status of nursing education for clinical practice, and then proposed several prospective directions for education. Nursing clinical practice-related studies from several Korean and international electronic databases were reviewed. Insufficient training hospitals and lack of qualified clinical training instructors were the main problems found within nursing educational resources for clinical practice, while the simple practice contents based on observation and inadequate evaluations were the main problems found in nursing educational management for clinical practice. This study suggests better standards and educational accountability for training hospitals and programs to nurture human resources for clinical practice, as well as a variety of training methods to integrate practical training courses and the expansion of formation evaluation. Based on these results, it is necessary to establish governance for nursing education for clinical practice and clarify the role and standards of each practitioner, strengthen the educational role of the hospital, and improve the system. In addition, introducing various types of education methods and strengthening evaluation standards are needed in order to enhance nursing education for clinical practice.

Current Status and Future Direction of Interprofessional Education in Nursing Education / 의학교육논단

This study examined the perception and readiness of nursing educators regarding interprofessional education (IPE), and discussed the validity and application of IPE in nursing. From December 2016 to January 2017, 239 nursing professors and nurses completed a structured questionnaire consisting of general characteristics, the Interdisciplinary Education Perception Scale, the Readiness for Interprofessional Learning Survey (RIPLS), and an IPE action plan. The collected data were analyzed by descriptive statistics and t-test using the IBM SPSS ver. 23.0 program (IBM Corp., Armonk, NY, USA). The analysis revealed that 91.6% of the participants had not experienced IPE, and only 11.7% knew about IPE. However, approximately 80.0% answered that IPE is necessary. The results of this study showed that the score of the perceived need for cooperation was higher in nurses than it was in professors, while the score on competency and autonomy was higher in professors than it was in nurses. With reference to the scores on the RIPLS, those of professors were high on the sub-scales of teamwork and collaboration, professional identity, and roles and responsibility. The results revealed that participants considered the upper-grade undergraduate years as the ideal time for imparting IPE, and it was deemed suitable to include communication, simulation, and clinical practice in IPE. Doctors, pharmacists, and physiotherapists were thought to require cooperation for IPE the most. Despite the presence of several barriers to IPE, the participants thought that IPE can achieve learning outcomes such as interprofessional communication and cooperation, conflict resolution, and teamwork. It is necessary to cooperate with professionals in the complex clinical environment as professional areas are specialized and subdivided. Therefore, it is necessary to examine the application of IPE in undergraduate education and in on-the-job training.

Multiple intelligences and critical thinking disposition in nursing students / 기본간호학회지

PURPOSE: This study was conducted to examine relationships between critical thinking disposition and multiple intelligences. METHOD: Participants were nursing students (N=186) who completed a questionnaire assessing critical thinking disposition and multiple intelligences. Data were analyzed using descriptive statistics, t-test, analysis of variance with post hoc comparison, and Pearson correlation coefficients. RESULTS: For type of multiple intelligences, 32.9% of students had the strongest fit for "interpersonal intelligence" type and 20.1% for "intrapersonal intelligence" type. Mean score for critical thinking disposition was 3.42+/-0.37. Factors related to critical thinking disposition were participation in club activities (F=5.962, p=.001) with a representative role in the club (t=2.140, p=.034). There were significant differences in interpersonal intelligence scores by personality traits (t=2.445, p=.015), participation in club activities (F=10.003, p<.001), and friendship (t=2.539, p=.012); and significant differences in intrapersonal intelligence scores by participation in club activities (F=3.862, p=.010), having a representative role in the club (t=2.101, p=.037), and friendship (t=2.220, p=.029). CONCLUSION: Results indicate that critical thinking disposition is significantly associated with multiple intelligences and suggest that multiple intelligences should be considered to enhance critical thinking disposition when tailored teaching is adopted in nursing education.

The Composition of the Root of Ixeris dentata var. albiflora Nakai. and Cell Viability and DPPH Radical Scavenging Activities of its Extract

Ixeris dentata var. albiflora Nakai, a herbal plant, is often used to make a strong stomach as an antiphlogistic used when dyspepsia and to improve appetite in Korea and China. And also it is used for adult diseases such as diabetes and liver diseases as Korean traditional medicine. In this study, the composition and DPPH radical scavenging activities of the root of Ixeris dentata var. albiflora Nakai and its effects on cell viability on vero and chang cells were investigated. Moisture, crude ash, crude protein and crude lipid were 79.14, 2.49, 8.28 and 2.56 g/100 g respectively. The highest mineral content was K. The major free sugars were glucose, fructose and sucrose. Major fatty acid are linoleic acid, palmic acid and linolenic acid. Major amino acids were glutamic acid, arginine and aspartic acid and the total contents of amino acids were 28.12 mg/g. The methanol extracts were further fractionated with n-hexane, chloroform, ethylacetate, butanol and water to get an active fraction. In addition, cell viabilities in each fraction were determined. Methanol extract, butanol, and aqueous fraction showed strong survival rates in vero cell and chang cell viability test, and hexane, chloroform, and ethylacetate fraction were examined for toxin in a cell. The root of Ixeris dentata var. albiflora Nakai had scavenging activities against DPPH radicals in a dose-dependent assay. Ethylacetate fraction's SC50 was 6.8 microgram/mL, very strong DPPH radical scavenging activities, but water fraction did not show any activity.