The Influence of Role Conflict, Head Nurses' Super Leadership, and Nursing Organizational Culture on Organizational Commitment of Male Nurses / 간호행정학회지

Purpose@#This study aimed to investigate the influence of role conflict, head nurses’ super leadership and nursing organizational culture on organizational commitment among male nurses. @*Methods@#This cross-sectional study included 221 male nurses who had worked for more than six months in university hospitals, general hospitals, and clinics. Data were collected using structured, self-administered questionnaires on role conflict, head nurse super leadership, nursing organizational culture, and organizational commitment. The data obtained were analyzed using descriptive analysis, independent t-test, analysis of variance, Scheffé test, Pearson’s correlation coefficients, and regression analysis. @*Results@#Organizational commitment had a significant positive correlation with head nurse super leadership, innovation-oriented culture, and relation-oriented culture; however, it had a significant negative correlation with role conflict and task-oriented culture. Among the general characteristics, the significant factors influencing organizational commitment among male nurses were number of beds and departments. Furthermore, among the main variables, innovation-oriented culture, task-oriented culture, role conflict, and head nurse super leadership influenced organizational commitment. @*Conclusion@#To increase male nurses’ organizational commitment, it is necessary to create an innovative organizational culture, reduce role conflicts, and improve head nurse super leadership.

Symptom Clusters in Patients with Non-Hodgkin’s Lymphoma Receiving Chemotherapy

Purpose@#This study aimed to identify symptom clusters over time and examine the severity of each symptom cluster in patients with non-Hodgkin’s lymphoma receiving chemotherapy. @*Methods@#Data were collected from 110 patients using the Memorial Symptom Assessment Scale. The data were analyzed using factor analysis. @*Results@#Lack of energy was the most prevalent symptom on the Day 7 of chemotherapy (T1). On the day of chemotherapy of the next cycle (T2), drowsiness was the most prevalent symptom. For the timeline of T1 and T2, seven and six symptom clusters were identified, respectively. The psychological and nutrition clusters were common to both T1 and T2. The symptom scores of energy and nutrition clusters were the highest at T1, while those of the nutrition and psychological clusters were the highest at T2. Although symptom scores at T2 tended to be lower than those at T1, the symptom scores of the severe groups were still high in the nutrition, skin changes, and psychological clusters. @*Conclusion@#Some symptom clusters can either change or appear stable over time. Furthermore, the severity of some clusters was found to be relatively high. Development of stable symptom cluster-based interventions is necessary to improve the quality of life.

Analysis of Influencing Factors on the Outpatient Prescription of Antipsychotic Drugs in the Elderly Patients

Background@#Most antipsychotic drugs studies have been mainly conducted on side effects, randomized clinical trials, utilization rates, and trends. But there have been few studies on the influencing factors in elderly patients. The purpose of this study was to analyze the influencing factors on the outpatient prescription of antipsychotic drugs in the elderly patients. @*Methods@#Active ingredients of antipsychotic drugs in Korea were selected according to the Korean Pharmaceutical Information Center (KPIC)’s classification. Data source was Korean Health Insurance Review and Assessment Service (HIRA) claims data in 2020 and target patient group was the elderly patient group. We extracted patients who have been prescribed one or more antipsychotic drugs and visited only one medical institution. Data were analyzed using descriptive statistics, chi-square, t-test, negative binomial regression. @*Results@#A number of outpatients were 245,197 and prescriptions were 1,379,092. Most characteristics of patients were 75-85 year’s old, female, health insurance type, no disease (dementia, schizophrenia), atypical drugs, cci score (>2) and characteristics of medical institution were neurology in specialty, rural region, general hospitals. Results of regression showed that patient’s characteristics and medical center characteristics had significant effect on the outpatient prescription of antipsychotic drugs in the elderly patients. @*Conclusion@#This study suggests that national policy of antipsychotic drugs in the elderly patients, with the consideration of the patients’ and medical institutions’ characteristics, is needed.

Machine Learning Approach for Active Vaccine Safety Monitoring

Background@#Vaccine safety surveillance is important because it is related to vaccine hesitancy, which affects vaccination rate. To increase confidence in vaccination, the active monitoring of vaccine adverse events is important. For effective active surveillance, we developed and verified a machine learning-based active surveillance system using national claim data. @*Methods@#We used two databases, one from the Korea Disease Control and Prevention Agency, which contains flu vaccination records for the elderly, and another from the National Health Insurance Service, which contains the claim data of vaccinated people. We developed a casecrossover design based machine learning model to predict the health outcome of interest events (anaphylaxis and agranulocytosis) using a random forest. Feature importance values were evaluated to determine candidate associations with each outcome. We investigated the relationship of the features to each event via a literature review, comparison with the Side Effect Resource, and using the Local Interpretable Model-agnostic Explanation method. @*Results@#The trained model predicted each health outcome of interest with a high accuracy (approximately 70%). We found literature supporting our results, and most of the important drug-related features were listed in the Side Effect Resource database as inducing the health outcome of interest. For anaphylaxis, flu vaccination ranked high in our feature importance analysis and had a positive association in Local Interpretable Model-Agnostic Explanation analysis. Although the feature importance of vaccination was lower for agranulocytosis, it also had a positive relationship in the Local Interpretable Model-Agnostic Explanation analysis. @*Conclusion@#We developed a machine learning-based active surveillance system for detecting possible factors that can induce adverse events using health claim and vaccination databases. The results of the study demonstrated a potentially useful application of two linked national health record databases. Our model can contribute to the establishment of a system for conducting active surveillance on vaccination.

Machine Learning Approach for Active Vaccine Safety Monitoring

Background@#Vaccine safety surveillance is important because it is related to vaccine hesitancy, which affects vaccination rate. To increase confidence in vaccination, the active monitoring of vaccine adverse events is important. For effective active surveillance, we developed and verified a machine learning-based active surveillance system using national claim data. @*Methods@#We used two databases, one from the Korea Disease Control and Prevention Agency, which contains flu vaccination records for the elderly, and another from the National Health Insurance Service, which contains the claim data of vaccinated people. We developed a casecrossover design based machine learning model to predict the health outcome of interest events (anaphylaxis and agranulocytosis) using a random forest. Feature importance values were evaluated to determine candidate associations with each outcome. We investigated the relationship of the features to each event via a literature review, comparison with the Side Effect Resource, and using the Local Interpretable Model-agnostic Explanation method. @*Results@#The trained model predicted each health outcome of interest with a high accuracy (approximately 70%). We found literature supporting our results, and most of the important drug-related features were listed in the Side Effect Resource database as inducing the health outcome of interest. For anaphylaxis, flu vaccination ranked high in our feature importance analysis and had a positive association in Local Interpretable Model-Agnostic Explanation analysis. Although the feature importance of vaccination was lower for agranulocytosis, it also had a positive relationship in the Local Interpretable Model-Agnostic Explanation analysis. @*Conclusion@#We developed a machine learning-based active surveillance system for detecting possible factors that can induce adverse events using health claim and vaccination databases. The results of the study demonstrated a potentially useful application of two linked national health record databases. Our model can contribute to the establishment of a system for conducting active surveillance on vaccination.

The Prevalence of Sjögren's Syndrome in Rheumatoid Arthritis Patients and Their Clinical Features

Background@#To estimate the prevalence of Sjögren's syndrome (SS) in patients with rheumatoid arthritis (RA) and to compare the clinical features of RA patients with and without SS. @*Methods@#We conducted a retrospective study of RA patients who visited a rheumatology clinic in a tertiary referral hospital in Korea between May 20 and July 22, 2016. All patients fulfilled the classification criteria for RA, and the diagnosis of SS was made clinically by rheumatologists and according to the 2002 American-European Consensus Group (AECG), 2012 American College of Rheumatology (ACR), and 2016 ACR/European League Against Rheumatism (EULAR) classification criteria. The prevalence was estimated as the number of SS patients within the total number of RA patients. The disease activity and treatment pattern of RA were compared between patients with and without SS. @*Results@#Among 827 RA patients, 72 patients (8.7%) were diagnosed with SS by a rheumatologist, though only 60 patients (7.3%) satisfied the 2002 AECG classification criteria for SS. Fifty-two patients (6.3%) and 56 patients (6.8%) fulfilled the 2012 ACR and 2016 ACR/EULAR classification criteria, respectively. The prevalence of SS in RA patients was 10.5%, 17.0%, and 67.6% in rheumatoid factor, antinuclear antibody (≥ 1:80), and anti-Ro antibody positive patients, respectively. @*Conclusion@#The prevalence of SS among RA patients was 8.7% according to rheumatologists' diagnosis. The presence of SS did not affect the treatment patterns of RA patients. However, the autoantibody profiles and demographics of RA patients with SS differed from those of patients without SS.

Sexual Double Standard, Dating Violence Recognition, and Sexual Assertiveness among University Students in South Korea

PURPOSE: This study aimed to examine the association among sexual double standard, dating violence recognition, and sexual assertiveness among Korean university students. METHODS: Using a cross-sectional survey study in January 2018, Korean university students (N = 322, years; 54.3% female) completed structured questionnaires with the double standard scale, dating violence recognition index, and sexual assertiveness index. The relationship among the variables was analyzed with Pearson's correlations and multiple regression analyses. RESULTS: There were significant correlations among sexual double standard, dating violence recognition, and sexual assertiveness. Sexual double standard (β = .12, p = .043) was determined to influence dating violence recognition. In addition, gender (β = .63, p < .001) and sexual double standard (β = .11, p = .015) were determined to influence dating violence recognition; the explanatory power was 43%. CONCLUSION: These findings will serve as a basis for the development of education programs that help university students to establish appropriate sexual values and enjoy a healthy sex life.

Social Interaction Test in Home Cage as a Novel and Ethological Measure of Social Behavior in Mice

Sociability is the disposition to interact with one another. Rodents have a rich repertoire of social behaviors and demonstrate strong sociability. Various methods have been established to measure the sociability of rodents in simple and direct ways, which includes reciprocal social interaction, juvenile social play, and three-chamber social tests. There are possible confounding factors while performing some of these tasks, such as aggression, avoidance of interaction by the stimulus mouse, exposure to a new environment, and lengthy procedures. The present study devised a method to complement these shortcomings and measure sociability as a group in the home cage setting, which prevents group-housed mice from isolation or exposure to a new environment. The home cage social test can allow high-throughput screening of social behaviors in a short amount of time. We developed two types of home cage setup: a home cage social target interaction test that measures sociability by putting the wire cage in the center area of the cage and a home cage two-choice sociability and social preference test that measures both sociability or social preference by putting cage racks at opposite sides of the cage. Interestingly, our results showed that the two types of home cage setup that we used in this study can extract abnormal social behaviors in various animal models, similar to the three-chamber assay. Thus, this study establishes a new and effective method to measure sociability or social preference that could be a complementary assay to evaluate the social behavior of mice in various setup conditions.

Tenovin-1 Induces Senescence and Decreases Wound-Healing Activity in Cultured Rat Primary Astrocytes

Brain aging induces neuropsychological changes, such as decreased memory capacity, language ability, and attention; and is also associated with neurodegenerative diseases. However, most of the studies on brain aging are focused on neurons, while senescence in astrocytes has received less attention. Astrocytes constitute the majority of cell types in the brain and perform various functions in the brain such as supporting brain structures, regulating blood-brain barrier permeability, transmitter uptake and regulation, and immunity modulation. Recent studies have shown that SIRT1 and SIRT2 play certain roles in cellular senescence in peripheral systems. Both SIRT1 and SIRT2 inhibitors delay tumor growth in vivo without significant general toxicity. In this study, we investigated the role of tenovin-1, an inhibitor of SIRT1 and SIRT2, on rat primary astrocytes where we observed senescence and other functional changes. Cellular senescence usually is characterized by irreversible cell cycle arrest and induces senescence-associated β-galactosidase (SA-β-gal) activity. Tenovin-1-treated astrocytes showed increased SA-β-gal-positive cell number, senescence-associated secretory phenotypes, including IL-6 and IL-1β, and cell cycle-related proteins like phospho-histone H3 and CDK2. Along with the molecular changes, tenovin-1 impaired the wound-healing activity of cultured primary astrocytes. These data suggest that tenovin-1 can induce cellular senescence in astrocytes possibly by inhibiting SIRT1 and SIRT2, which may play particular roles in brain aging and neurodegenerative conditions.

Sex-specific Behavioral Features of Rodent Models of Autism Spectrum Disorder

Sex is an important factor in understanding the clinical presentation, management, and developmental trajectory of children with neuropsychiatric disorders. While much is known about the clinical and neurobehavioral profiles of males with neuropsychiatric disorders, surprisingly little is known about females in this respect. Animal models may provide detailed mechanistic information about sex differences in autism spectrum disorder (ASD) in terms of manifestation, disease progression, and development of therapeutic options. This review aims to widen our understanding of the role of sex in autism spectrum disorder, by summarizing and comparing behavioral characteristics of animal models. Our current understanding of how differences emerge in boys and girls with neuropsychiatric disorders is limited: Information derived from animal studies will stimulate future research on the role of biological maturation rates, sex hormones, sex-selective protective (or aggravating) factors and psychosocial factors, which are essential to devise sex precision medicine and to improve diagnostic accuracy. Moreover, there is a strong need of novel strategies to elucidate the major mechanisms leading to sex-specific autism features, as well as novel models or methods to examine these sex differences.

Clinical analysis of single filtration plasmapheresis using continuous renal replacement therapy machines in kidney transplantation

BACKGROUND: Plasmapheresis has become an essential element of kidney transplantation (KT). In the present study, we report clinical outcomes of filtration plasmapheresis using continuous renal replacement therapy machines with a single filter for the first time in Korea. METHODS: We retrospectively analyzed six patients who underwent filtration plasmapheresis for KT in our center; plasmapheresis was performed using the Plasmaflex (Baxter®) with a TPE 2000 filter set (Baxter®) in our hemodialysis unit. Five percent albumin was used as the replacement fluid, and intravenous immunoglobulin G was administered after each plasmapheresis session. The target preoperative ABO isoagglutinin titer was less than 1:8. RESULTS: Filtration plasmapheresis was performed in four patients for ABO-incompatible KT, one for antibody-mediated rejection after KT, and the last one for positive T cell crossmatch. Altogether, 46 sessions of plasmapheresis were performed. ABO isoagglutinin titers successfully declined to or below the target level in all patients, and all patients successfully received KT with no significant antibody titer rebound. Acute antibody-mediated rejection and positive T cell crossmatch were well treated with filtration plasmapheresis, and no patient required fresh frozen plasma infusion for coagulopathy. There were one episode of hypotension and three of hypocalcemia. No patients experienced bleeding, infection, or allergic reaction. CONCLUSION: Filtration plasmapheresis was effective and safe. Although our result is from a single center, our protocol appears to be promising.

Correlation between attention deficit hyperactivity disorder and sugar consumption, quality of diet, and dietary behavior in school children

This study investigated the correlation between consumption of sugar intake by fifth grade students in primary schools and development of Attention Deficit Hyperactivity Disorder (ADHD). A total of 107 students participated, and eight boys and one girl (8.4% of the total) categorized as high risk for ADHD according to diagnostic criteria. There were significant differences in the occupations and drinking habits of the respondents' fathers between the normal group and risk group. In a comparison of students' nutrition intake status with daily nutrition intake standards for Koreans, students consumed twice as much protein as the recommended level, whereas their calcium intake was only 60% of the recommended DRI (dietary reference intake). Regarding intake volume of vitamin C, the normal group posted 143.9% of the recommended DRI, whereas the risk group showed only 65.5% of the recommended DRI. In terms of simple sugar intake from snacks, students in the normal group consumed 58.4 g while the risk group consumed 50.2 g. These levels constituted 12.5% of their total daily volume of sugar intake from snacks, which is higher than the 10% standard recommended by the WHO. In conclusion, children who consumed less sugar from fruit snacks or whose vitamin C intake was less than RI was at increased risks for ADHD (P < 0.05). However, no significant association was observed between total volume of simple sugar intake from snacks and ADHD development.