Reelin and APP Cooperatively Modulate Dendritic Spine Formation In Vitro and In Vivo

Amyloid precursor protein (APP) plays an important role in the pathogenesis of Alzheimer’s disease (AD), but the normal function of APP at synapses is poorly understood. We and others have found that APP interacts with Reelin and that each protein is individually important for dendritic spine formation, which is associated with learning and memory, in vitro. However, whether Reelin acts through APP to modulate dendritic spine formation or synaptic function remains unknown. In the present study, we found that Reelin treatment significantly increased dendritic spine density and PSD-95 puncta number in primary hippocampal neurons. An examination of the molecular mechanisms by which Reelin regulates dendritic spinogenesis revealed that Reelin enhanced hippocampal dendritic spine formation in a Ras/ERK/CREB signaling-dependent manner. Interestingly, Reelin did not increase dendritic spine number in primary hippocampal neurons when APP expression was reduced or in vivo in APP knockout (KO) mice. Taken together, our data are the first to demonstrate that Reelin acts cooperatively with APP to modulate dendritic spine formation and suggest that normal APP function is critical for Reelin-mediated dendritic spinogenesis at synapses.

Risk factors for deaths associated with COVID-19 according to the cause of death classification in Republic of Korea

Objectives@#This study aimed to classify coronavirus disease 2019 (COVID-19)-related deaths according to whether COVID-19 was listed as the cause of death, and to investigate thedifferences in demographic characteristics and risk factors for COVID-19 death classifications. @*Methods@#A total of 5,625 deaths in South Korea among patients with confirmed COVID-19 from January 20, 2020 to December 31, 2021 were selected. Excluding false reports and unnatural deaths, 5,597 deaths were analyzed. Based on death report data, deaths were classified according to whether the cause of death was listed as COVID-19 (CD) or not (NCD). The epidemiological characteristics and causes of deaths were investigated using descriptive, univariate, and multivariate statistical analyses. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to analyze the risk factors. @*Results@#The case fatality ratio was 0.89% and increased with age. Additionally, 96.4% of the subjects had an underlying disease, and 53.4% died in winter. The proportion of NCDs was 9.3%, of whom 19.1% died at home and 39.0% were confirmed to have COVID-19 after death. Malignant neoplasms (102/416 vs. 637/4,442; OR, 1.71; 95% CI, 1.36−2.16; p < 0.001) were significantly associated with NCD. @*Conclusion@#This is the first study to analyze risk factors by cause of death using COVID-19death report data in South Korea. These results are expected to be used as evidence forestablishing a death monitoring system that can collect timely information in a new infectiousdisease pandemic.

Risk Factors for Sudden Death Within 2 Days After Diagnosis of COVID-19 in Korea

Background@#We aimed to analyze the risk factors for sudden death after diagnosis of coronavirus disease 2019 (COVID-19) in South Korea and to provide evidence for informing prevention and control interventions for patients at risk of sudden death. @*Methods@#We included 30,302 COVID-19 related deaths registered in the patient management information system (Central Disease Control Headquarters) between January 1, 2021, and December 15, 2022. We collected their epidemiological data recorded by the reporting city, province, or country. We performed multivariate logistic regression analysis to identify risk factors for sudden death after diagnosis of COVID-19. @*Results@#Among the 30,302 deaths, there were 7,258 (24.0%) and 23,044 (76.0%) sudden and non-sudden deaths, respectively. Sudden death means a person who died within 2 days of diagnosis and who did not receive inpatient treatment. Underlying condition, vaccination status, and place of death were significantly associated with the survival period in all age groups. Moreover, region, sex, and prescription were significantly associated with the survival period only in certain age groups. However, reinfection was not significantly associated with the survival period in any age group. @*Conclusion@#To our knowledge, this is the first study on the risk factors for sudden death after a diagnosis of COVID-19, which included age, underlying condition, vaccination status, and place of death. Additionally, individuals aged < 60 years without an underlying condition were at high risk for sudden death. However, this group has relatively low interest in health, as can be seen from the high non-vaccination rate (16.1% of the general population vs. 61.6% of the corresponding group). Therefore, there is a possibility for the presence of an uncontrolled underlying disease in this population. In addition, many sudden deaths occurred due to delayed hospital visits to continue economic activities even after the onset of COVID-19 symptoms (7 days overall vs. 10 days average for the group). In conclusion, ‘continued interest in health’ is a key factor in avoiding sudden death in the economically active group (under 60 years of age).

Pediatric Deaths Associated With Coronavirus Disease 2019 (COVID-19) in Korea

As of September 3, 2022, 5,388,338 coronavirus disease 2019 (COVID-19) cases and 46 deaths (3 in 2021 and 43 in 2022) were reported in children ≤ 18 years in Korea. Cumulative confirmed cases accounted for 67.3% of the population aged ≤ 18 years and case fatality rate was 0.85/100,000. Among 46 fatal cases, 58.7% were male and median age was 7 years.Underlying diseases were present in 47.8%; neurologic diseases (63.6%) and malignancy (13.6%) most common. Only four had history of COVID-19 immunization. COVID-19 associated deaths occurred at median 2 days from diagnosis (range: −1 to 21). Among COVID-19 deaths, 41.3% occurred before admission; 2 before hospital arrival and 17 in the emergency department. Among children whose cause was documented, myocarditis, respiratory and multiorgan failure were most common. COVID-19 associated death was seen early after diagnosis in children and public health policies to provide access to medical care for children with COVID-19 are essential during the pandemic.

Effects of Ponderal Index on Neonatal Mortality and Morbidities in Extremely Premature Infants

Background@#To evaluate how intrauterine stress affects extremely premature infants in terms of intrauterine growth restriction. We hypothesized that extremely premature infants with mildly-low ponderal index (MPI) would have better neonatal outcomes. @*Methods@#We selected 2,721 subjects of 23 to 28 weeks of gestation between 2013 and 2015 from Korean Neonatal Network database. They were divided into 4 groups based on ponderal index (PI) percentile; PI ≤ 3rd as severely-low PI (SPI, n = 82), 3rd 90th as high PI (HPI, n = 270). @*Results@#The mortality in MPI and API groups was comparable (16.3% vs. 16.9%). It was significantly lower than that in the SPI and HPI groups (30.5% and 24.9%, respectively;P = 0.001). The MPI and API groups had better neonatal morbidities compared with the SPI and/or HPI groups, while the MPI group (8.2%) showed a lower incidence of severe intraventricular hemorrhage (IVH) than the other groups (SPI, 21.3%; API, 15.0%; HPI, 19.7%, respectively; P = 0.004). The MPI group had a trend of a bottom in neonatal mortality and morbidities in extremely premature infants. @*Conclusion@#The MPI and API groups had lower mortality, massive pulmonary hemorrhage, severe bronchopulmonary dysplasia or death, pulmonary hypertension and neonatal seizure rates than the SPI and/or HPI groups, while the MPI group showed a lower incidence of severe IVH than the other groups. We speculate that the lower incidence of neonatal morbidities and mortality in the MPI group indicating mild intrauterine stress might accelerate fetal maturation resulting in better outcomes in extremely premature infants.

The COVID-19 Correspondence Work Experience of Community Health Practitioners

Purpose@#This study aims to describe and understand the meaning and nature of community health practitioners’ coping with COVID-19. @*Methods@#In-depth interviews were conducted with 12 community health practitioners from August to October 2021, to describe and understand the nature of their coping with COVID-19. The collected data were examined and described based on Colaizzi’s phenomenological method. @*Results@#16 theme clusters and five categories were derived from the community health practitioners’ experience of coping with COVID-19. The categories derived were: a war that began without notice, a variety of correspondence tasks assigned, struggling to fulfill given roles, correspondence tasks becoming more systematic, and a fight that has not yet ended. @*Conclusion@#Community health practitioners handled various response tasks related to COVID-19, and faithfully fulfilled their professional roles while performing the primary task of medical care. Hence, attention is required on issues related to the establishment of the national emergency healthcare system and improvement of professional competence of community health practitioners even after the COVID-19 pandemic is over. Furthermore, it is necessary to make ceaseless efforts to address those issues and, in order to do so, social interest and institutional support are needed.

Students’ college life adaptation experiences in the accelerated second-degree bachelor of science in nursing program in South Korea / 한국간호교육학회지

Purpose@#South Korea has expanded its accelerated second-degree Bachelor of Science in Nursing program to resolve its supply-demand imbalance in nursing, although how these students are adapting to and performing in college after admission remains unclear. Therefore, this study aimed to conduct an in-depth exploration of how Korean accelerated second-degree Bachelor of Science nursing students interact with society and adapt to college life for establishing further supportive educational policies and programs. @*Methods@#Participants comprised 20 South Korean accelerated second-degree Bachelor of Science in Nursing students. The data were collected via online or offline in-depth interviews and analyzed using Strauss and Corbin’s grounded theory and by applying a constant comparative method to achieve theoretical saturation. @*Results@#The core category, derived using open, axial, and selective coding, was “process of the uncharted journey toward a new dream.” The participants’ college adaptation processes were found to involve three phases: trial and error, adjustment, and acceptance and integration. @*Conclusion@#These findings can be used to develop, apply, test, and improve various support programs for accelerated second-degree Bachelor of Science in Nursing students and to advance the nursing profession by nurturing a workforce with diverse academic backgrounds and faster college life adaptation.

Rapidly Progressive Pericardial Effusion and Cardiac Tamponade in a Term Infant with an Umbilical Venous Catheter: A Case Report

Pericardial effusion (PCE) in neonates has various clinical presentations depending on the amount and speed of fluid accumulation and can cause cardiac tamponade (CT). We report a case of rapidly accumulating PCE and near-fatal CT with an umbilical venous catheter successfully resolved by emergent echo-guided pericardiocentesis in a term infant who had been hospitalized with meconium aspiration syndrome and persistent pulmonary hypertension. This case report suggests that if a patient with an intracardiac umbilical catheter shows sudden cardiopulmonary instability, the possibility of PCE and CT should be considered. Furthermore, if necessary, emergency drainage of the PCE and removal of the umbilical catheter should be immediately performed.

Factors Influencing Clinical Nurses’ Medication Safety Competence / 기본간호학회지

Purpose@#The purpose of this study was to measure the influence of job stress, critical thinking disposition, and clinical decision-making ability on clinical nurses’ medication safety competence. @*Methods@#A descriptive survey was conducted among 140 nurses with more than 6 months of work experience in 4 general hospitals in Busan metropolitan city. Data were collected from August 15 to October 30, 2021 and analyzed using the independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and stepwise multiple regression. @*Results@#Medication safety competence had significant correlations with job stress (r=.20, p=.021), critical thinking disposition (r=.63, p<.001), and clinical decision-making ability (r=.54, p<.001). Multiple regression analysis for medication safety competence revealed that the most powerful predictor was critical thinking disposition. Job stress and critical thinking disposition explained approximately 45% of the variance in medication safety competence. @*Conclusion@#This study confirms the need to make systematic efforts in clinical settings to improve nurses’ medication safety competence, and seeks ways to do so. To enhance clinical nurses’ medication safety competence in the future, programs that manage job stress and improve critical thinking disposition within the nursing department in particular and the hospital in general should be developed and implemented.

Effects of Lipopolysaccharide on Oligodendrocyte Differentiation at Different Developmental Stages: an In Vitro Study

Background@#Lipopolysaccharide (LPS) exerts cytotoxic effects on brain cells, especially on those belonging to the oligodendrocyte lineage, in preterm infants. The susceptibility of oligodendrocyte lineage cells to LPS-induced inflammation is dependent on the developmental stage. This study aimed to investigate the effect of LPS on oligodendrocyte lineage cells at different developmental stages in a microglial cell and oligodendrocyte coculture model. @*Methods@#The primary cultures of oligodendrocytes and microglia cells were prepared from the forebrains of 2-day-old Sprague–Dawley rats. The oligodendrocyte progenitor cells (OPCs) co-cultured with microglial cells were treated with 0 (control), 0.01, 0.1, and 1 µg/mL LPS at the D3 stage to determine the dose of LPS that impairs oligodendrocyte differentiation. The co-culture was treated with 0.01 µg/mL LPS, which was the lowest dose that did not impair oligodendrocyte differentiation, at the developmental stages D1 (early LPS group), D3 (late LPS group), or D1 and D3 (double LPS group). On day 7 of differentiation, oligodendrocytes were subjected to neural glial antigen 2 (NG2) and myelin basic protein (MBP) immunostaining to examine the number of OPCs and mature oligodendrocytes, respectively. @*Results@#LPS dose-dependently decreased the proportion of mature oligodendrocytes (MBP+ cells) relative to the total number of cells. The number of MBP+ cells in the early LPS group was significantly lower than that in the late LPS group. Compared with those in the control group, the MBP+ cell numbers were significantly lower and the NG2+ cell numbers were significantly higher in the double LPS group, which exhibited impaired oligodendrocyte lineage cell development, on day 7 of differentiation. @*Conclusion@#Repetitive LPS stimulation during development significantly inhibited brain cell development by impairing oligodendrocyte differentiation. In contrast, brain cell development was not affected in the late LPS group. These findings suggest that inflammation at the early developmental stage of oligodendrocytes increases the susceptibility of the preterm brain to inflammation-induced injury.

Validity and Reliability of Korean Version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale

Purpose@#The aim of this study was to examine the validity and reliability of the Korean version of the self-efficacy for managing chronic disease 6-item scale (SECD-6-K). @*Methods@#The English version of the Self-Efficacy for Managing Chronic Disease 6-item Scale first underwent forward and backward translation procedures. The SECD-6-K was then used to collect data from 350 adults diagnosed with chronic diseases. Content, construct, convergent, discriminant, and criterion validity were all evaluated. Reliability was assessed using Cronbach’s α. SPSS 25.0 and the data were analyzed using AMOS 26.0 software. @*Results@#The SECD-6-K consists of six items in two domains: disease management and health behavior. The results for construct, convergent, and discriminant validity were good. Exploratory factor analysis produced eigen values between 2.27 and 3.28, with factors total explained cumulative variance of 91.1%. Confirmatory factor analysis supported goodness of fit and reliability for the modified SECD-6-K model. The criterion validity also showed significant correlation with both the Patient Health Questionnaire and 12-item Short-Form Health Survey version 2. Finally, reliability was found to be excellent. @*Conclusion@#This study identified the high reliability and validity of SECD-6-K. The SECD-6-K is an appropriate tool for determining Korean patients’ self-efficacy in managing their chronic conditions. Therefore, this scale may be used in clinical settings as well as in educational and research settings.

The mediating effect of self-leadership on the media literacy and learning agility of nursing students based on the experiences of online classes during the COVID-19 pandemic / 한국간호교육학회지

Purpose@#The purpose of this study was to investigate the mediating effect of self-leadership on the relationship between media literacy and learning agility in nursing students based on their experiences in online classes during the Coronavirus Disease-19 pandemic. @*Methods@#A descriptive survey was conducted among 165 nursing students from four universities in Busan. Data were collected from June 2 to 13, 2021, and was analyzed using a t-test, one-way ANOVA, Pearson’s correlation coefficients, and stepwise multiple regression with SPSS/WIN 26.0. @*Results@#Significant relationships were found between learning agility and media literacy (r=.62,p<.001), between learning agility and self-leadership (r=.58, p<.001), and between media literacy and self-leadership (r=.53, p<.001). Additionally, self-leadership had a partial mediating effect on the relationship between media literacy and learning agility (Z=4.30, p<.001); its explanatory power was 46.0%. @*Conclusion@#These results indicate that interventions to increase the level of media literacy, along with self-leadership, are necessary to improve the level of learning agility of nursing students who will be essential human resources in a rapidly changing healthcare field.

Aryl Hydrocarbon Receptor and Autophagy-Related Protein Microtubule-Associated Protein Light Chain 3Expression in Psoriasis

Background@#The aryl hydrocarbon receptor (AHR) and autophagy are both important to maintain skin homeostasis.However, they are also involved in skin disorders. So far, their roles in psoriasis pathogenesis are unknown. @*Objective@#We studied the immunohistochemical and gene expression of AHR, CYP1A1, and microtubule-associated protein light chain 3 (LC3) in lesional skin of psoriasis patients to determine correlations among them. @*Methods@#We included 24psoriasis patients and ten healthy volunteers. Skin biopsies were collected. AHR, CYP1A1, and LC3 protein expression was examined by immunohistochemistry, immunofluorescence, and western blotting. AHR, CYP1A1, LC3, ATG5, BECN1 and Nrf2 mRNA levels were measured by quantitative polymerase chain reaction. @*Results@#AHR and CYP1A1 protein expression were higher in psoriasis lesional skin than in normal skin. LC3 protein expression was lower in psoriasis lesions than in normal controls. AHR and CYP1A1 protein expression in psoriasis lesions showed significant positive correlations with mean epidermal thickness and inflammatory cell density. Significant negative correlations were noted between LC3 protein expression in psoriasis lesions and the mean epidermal thickness or inflammatory cell density. A significant negative correlation was found between AHR and LC3 expression in psoriatic skin. AHR, CYP1A1 and Nrf2 mRNA expression were upregulated while LC3, ATG5, and BECN1 mRNA were down-regulated, in psoriatic lesional skin compared with normal controls. @*Conclusion@#AHR and autophagy could play a role in psoriasis pathogenesis by modifying epidermal hyperproliferation and inflammation. AHR and autophagy regulation are potential therapeutic targets in chronic inflammatory skin diseases.

Efficacy of Tranexamic Acid during Primary Total Knee Arthroplasty:Comparative Study between Intravenous Use and Topical Use / 대한정형외과학회잡지

Purpose@#This study examined the effectiveness of tranexamic acid in reducing postoperative blood loss in total knee arthroplasty by comparing the methods of administration between an intravenous group, topical group, and non-tranexamic acid group. @*Materials and Methods@#This was a retrospective case series study of patients who underwent primary total knee arthroplasty from March 2017 to February 2019 performed by a single surgeon. The study population was divided into three groups according to the method of tranexamic acid administration (Group I: intravenous group, Group II: topical group, Group III: non-tranexamic acid group). To evaluate the effectiveness of tranexamic acids, the total amount of postoperative blood loss, postoperative hemoglobin loss, and volume of red blood cell transfusion in the three groups were compared. @*Results@#The total amount of postoperative blood loss was lower in the tranexamic acid administered group than in the non-tranexamic acid group (1,366±866 ml). Among the administration methods, the intravenous group (987±449 ml) was significantly lower than the topical group (1,136±339 ml) (p=0.004). Postoperative hemoglobin loss was lower in the tranexamic acid group than the non-tranexamic acid group.Among the administration methods, the intravenous group was lower than the topical group. The transfusion rate was higher in the nontranexamic acid group (5.7%) than the tranexamic administered group. The transfusion rate of the intravenous group was 1.4%, and no patient required a transfusion postoperatively in the topical group. The number of postoperative thromboembolic events, as a complication of tranexamic acid, was similar in the three groups. @*Conclusion@#Tranexamic acid was effective in reducing postoperative blood loss after primary total knee arthroplasty compared to the nontranexamic acid administered group. No significant difference in the complications induced by tranexamic acid was observed among the three groups.

Impact of Posttraumatic Growth and Health Promoting Behavior on Quality of Life in Patients with Gastrointestinal Cancer / 기본간호학회지

Purpose@#The purpose of this study was to identify the influence of posttraumatic growth and health promoting behavior on quality of life (QOL) of patients with gastrointestinal cancer. @*Methods@#The study was a cross-sectional, descriptive design. Participants were 142 patients with gastrointestinal cancer who were seen at Dongnam Institute of Radiological & Medical Sciences in Busan. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, and multiple regression analysis with SPSS/WIN 23.0 program. @*Results@#The results show that QOL had a significant correlation with posttraumatic growth (r=.24, p=.004) and health promoting behavior (r=.49, p<.001). Posttraumatic growth had a significant correlation with health promoting behavior (r=.54, p<.001). Multiple regression analysis for QOL revealed that the most powerful predictor was stress management in the sub-area of health promoting behavior. Stress management, coping skills, preciousness of life, diagnosis and duration since diagnosis explained 38.0% of the variance in QOL. @*Conclusion@#Findings indicate that various factors are related to the QOL of patients with gastrointestinal cancer. Based on the results of this study, further development and application of specific nursing programs to improve posttraumatic growth and health promoting behavior with a focus on improving stress management and coping ability, are needed to improve the QOL of gastrointestinal cancer patients.

Reverse shoulder arthroplasty with os acromiale

Function and strength of the deltoid muscle are important in reverse shoulder arthroplasty (RSA). Moreover, location and shape of the acromion, clavicle, and scapular spine, which are origins of the deltoid muscle, are also important. The frequency of os acromiale is 5% to 15%; however, it is rare in the Asian population, affecting approximately 0.7% of Koreans. RSA has rarely been reported in patients with os acromiale. We present a case series of two patients with cuff tear and arthropathy combined with os acromiale who underwent RSA. From 2016 to 2018, two patients with os acromiale who presented with pain and limited range of motion (ROM) underwent RSA with cuff tear arthropathy using the subscapularis-sparing deltopectoral approach. Their ROM, visual analog scale (VAS), and satisfaction were evaluated before and after surgery. In both patients, VAS decreased, ROM increased, and postoperative satisfaction increased. There were no specific complications due to os acromiale. The VAS, ROM, and satisfaction of patients improved after surgery compared with values before surgery. Thus, os acromiale is not a contraindication for RSA. However, careful attention must be given during surgery to ensure optimal repair and recovery.

Cognitive Outcomes of Children with Very Low Birth Weight at 3 to 5 Years of Age

Developmental Outcome of Very-Low-Birth-Weight Infants without Major Brain Injuries Based on Data from the Korean Neonatal Network: A Nationwide Cohort Study

Purpose@#As preterm infants have shown advances in survival rate, many very-lowbirth-weight (VLBW) infants have shown developmental delay even without a major brain injury. Thus, the incidence of and risk factors associated with poor neurodevelopmental outcome should be evaluated. @*Methods@#A multicenter nationwide prospective longitudinal cohort study of VLBW infants born in South Korea between 2013 and 2015 was conducted. Poor neurodevelopmental outcome was diagnosed if the Bayley Scales of Infant and Toddler Development (BSID)-III composite score was ≤85 (cognition, language, motor). We analyzed the associations of baseline neonatal characteristics, environmental characteristics and neonatal morbidities with poor neurodevelopmental outcome. @*Results@#The study included 285 infants, of whom 34 (11.9%) exhibited cognition delay; 59 (20.7%), showed language delay and 32 (11.2%) showed motor delay. The mean gestational age and birth weight were 29 weeks and 1,130 g, respectively. Moderate and severe bronchopulmonary dysplasia (P=0.056) and intraventricular hemorrhage grade I (P=0.079) were marginally associated with cognition delay. Higher paternal educational level (P<0.05) was significantly associated with the language outcome. Birth weight (P<0.05) and head circumference at discharge (P<0.05) were the major predictors of motor delay. @*Conclusion@#The population-based nationwide cohort study shows that approximately 20% of VLBW infants without major brain injury have developmental delay. Several factors that are not directly associated with major brain injury were significantly associated with poor neurodevelopmental outcome.

Cognitive Outcomes of Children with Very Low Birth Weight at 3 to 5 Years of Age

BACKGROUND@#The cognitive consequences and risk factors based long-term outcome of very-low-birth-weight (VLBW; < 1,500 g) infants in Korea has not been studied. The aim of this study was to determine the influence of perinatal and neonatal risk factors on the cognitive performance of VLBW children at 3 to 5 years of age.@*METHODS@#We enrolled 88 VLBW infants without cystic periventricular leukomalacia for the assessment of their demographic data, cognitive performance, and development of cerebral palsy (CP) at 3 to 5 years of age. Cognitive performance was assessed using the Korean version of the Wechsler Preschool and Primary Scale of Intelligence IV. Growth data were assessed with measurements of weight, height, and head circumference (HC) at the corrected ages of 6, 12, and 18 months, and 3 to 5 years of age.@*RESULTS@#In the VLBW group, the full-scale intelligence quotient (FSIQ) was 96.1 ± 15.2 at the mean age of 4.5 years. The incidence rate of CP was 3.4%. Overall, 17% (15/88) of the VLBW children had a below-average FSIQ (< 85). We divided the VLBW children into the abnormal FSIQ group (< 85, n = 15) and the normal FSIQ group (≥ 85, n = 73). VLBW children with intrauterine growth retardation (IUGR) was associated with a below-average FSIQ at the mean age of 4.5 years (< 85, 8/15, 53.3% vs. ≥ 85, 5/73, 6.8%; P < 0.001). After controlling for associated clinical factors, IUGR in the VLBW children was found to be associated with an abnormal FSIQ at the mean age of 4.5 years (P = 0.025). The weight, height, and HC obtained for both groups showed that normal growth was maintained at the mean age of 4.5 years with no significant difference between abnormal and normal FSIQ groups.@*CONCLUSION@#Fifteen of 88 (17%) of the VLBW children had a below-average FSIQ (< 85). VLBW with IUGR is associated with poor cognitive outcomes at the mean age of 4.5 years.

The Effect of the Education Applying Havruta's Method on Communication Competency, Critical Thinking Competency, and Self-leadership of Nursing Students

Purpose@#The purpose of this study was to construct the education applying Havruta's method for nursing students and to examine its effect on the communication competency, critical thinking competency, and self-leadership. @*Methods@#A non-equivalent control group pretest-posttest design was used. The participants were 138 nursing students at two universities. The experimental group (n=70) received the education applying Havruta's method for six weeks. The study was carried out from September 23 to November 8, 2019. Data were analyzed using IBM SPSS/WIN 22.0 for the x 2 test, Fisher's exact test, and independent t-test. @*Results@#The experimental group had a significant increase in communication competency (t=2.44, p=.016). However, there was no significant difference in critical thinking competency (t=1.85, p=.067), and self-leadership (t=1.78, p=.077) between the two groups. @*Conclusion@#The education applying Havruta's method is an effective nursing education for communication competency. The result of this study could be a guide for nursing professors at the nursing education field when developing education programs that apply Habruta’s method. Based on these results, future studies should be conducted to apply Habruta’s teaching method to various nursing majors.