Effects of the Smawell Mobile App on Psychological and Biological Factors in the Middle Aged and Older Adults Living Alone / 정신간호학회지

Purpose@#This study examined the effect of the smartphone-based intervention program using laughter therapy on psychological and biological factors of the middle aged and older adults living alone. @*Methods@#Data collection was conducted by a structured questionnaire about depression, loneliness, life satisfaction, and biological factors including general characteristics for the subjects residing in Cheonan, Korea. The collected data were analyzed by x2 test, t-test using SPSS/WIN ver. 26.0. There were 28 experimental and 31 control subjects. @*Results@#The experimental group received laughter therapy for 4 weeks along with usual care. The control group received usual care only. After 4 weeks, there was a statistically significant difference in depression (t=-3.28, p=.002), life satisfaction (t=-2.89, p=.006), and Immunoglobulin M (IgM) (t=-2.36, p=.021) between the two groups. @*Conclusion@#This study presents growing evidence for the diverse applications and benefits of laughter and humor. When using laughter as a complementary method to enhance health, it will be more effective to tailor the program to the specific needs of the individual.

Factors Affecting the Depressive Mood Experience in University Students by Gender in COVID-19 Pandemic Situation: Using Community Health Survey Data for 2020 / 보건행정학회지

Background@#The purpose of this study is to identify the factors affecting the depressive mood experience in university students by gender. @*Methods@#This study is a descriptive survey that conducted a secondary analysis using data from the 2020 Community Health Survey, which is conducted annually in Korea. The study targets 8,928 college students, 4,682 male students and 4,246 female students. Data analysis was conducted after creating a composite sample plan file that reflected layering variables, colony variables, and weights. @*Results@#Factors affecting the depressive mood experience of both males and females were household income, smoking, subjective stress levels, changes in drinking and smoking, and the number of encounters caused by coronavirus disease 2019 (COVID-19). Factors influencing the depressive mood experience of females were the presence of breakfast, changes in physical activity due to COVID-19, and the presence of helpers in self-quarantine due to COVID-19 (p<0.05). @*Conclusion@#Psychological counseling programs should be promoted to actively utilize mental health in those in their 20s and 30s. Universities also need to detect depressed students early through screening and perform timely and appropriate interventions.

Factors Affecting the Depressive Mood Experience of Adults in Their 20s: Using Community Health Survey Data for 2017 / 보건행정학회지

Background@#The purpose of this study is to identify the factors affecting the depressive mood experience of adults in their 20s. @*Methods@#This study is a descriptive survey that conducted a secondary analysis using data from the 2017 Community Health Survey, which is conducted annually in Korea. The study targets 21,324 adults in their 20s. Data analysis was conducted after creating a composite sample plan file that reflected layering variables, colony variables, and weights. @*Results@#Factors affecting the depressive mood experience were suicide thought experience, subjective stress level, gender, monthly household income, smoking status, subjective health level, breakfast status, participation in social activities, and whether the Internet, games, and smartphone interfered with daily life (p<0.05). @*Conclusion@#It is necessary to establish and realize a system that enables early detection and support of depression and suicide high-risk groups at the individual, home, community, and national levels.

Development of the Nursing Practice Guideline for Pain Management according to the Guideline Adaptation Process / 임상간호연구

PURPOSE: This study was done to develop a evidence-based guideline for pain assessment and management in Korea by adapting previously developed pain guidelines. METHODS: The guideline adaptation process was conducted using 24 steps according to the guideline adaptation manual developed by Hospital Nurses Association in 2012. RESULTS: The newly developed pain management guideline consisted of 9 domains and 234 recommendations. The number of recommendations in each domain was: 13 general instruction items, 51 pain assessments, 14 pain interventions, 66 pharmacological interventions for acute pain, 41 pharmacological interventions for chronic cancer pain, 35 pharmacological interventions for chronic noncancer pain, 21 non-pharmacological interventions, 2 documentations, 10 nursing education items, for pain. CONCLUSION: The findings suggest that the new pain management guideline can be used to address pain in hospital settings.

Surface analysis of metal clips of ceramic self-ligating brackets / 대한치과교정학회지

OBJECTIVE: The aim of this study was to analyze the surface composition, roughness, and relative friction of metal clips from various ceramic self-ligating brackets. METHODS: Six kinds of brackets were examined. The control group (mC) consisted of interactive metal self-ligating brackets while the experimental group (CC, EC, MA, QK, and WA) consisted of interactive ceramic self-ligating brackets. Atomic force microscopy-lateral force microscopy and scanning electron microscopy-energy-dispersive X-ray spectroscopy were used to analyze the surface of each bracket clip. RESULTS: All the clips in the experimental groups were coated with rhodium except for the QK clip. The results showed that the QK clip had the lowest average roughness on the outer surface, followed by the MA, EC, WA, and CC clips. However, the CC clip had the lowest average roughness on the inner surface, followed by the QK, WA, MA, and EC clips. The QK clip also had the lowest relative friction on the outer surface, followed by the MA, EC, CC, and WA clips. Likewise, the CC clip had the lowest relative friction on the inner surface, followed by the QK, WA, MA, and EC clips. CONCLUSIONS: The surface roughness and relative friction of the rhodium-coated clips were generally higher than those of the uncoated clips.

Risk Factors for Cognitive Impairment in Patient with Parkinson's Disease Treated with Levodopa

BACKGROUND: Long-term levodopa therapy relieves the motor dysfunction associated with Parkinson's disease (PD), but has various effects on non-motor symptoms, including cognitive dysfunction, hallucinations, and affective disorders, and can exacerbate certain aspects of dementia-like cognitive dysfunction. Here, we investigated the relationship between levodopa treatment and development of dementia in patients with PD. METHODS: This retrospective study analyzed 76 consecutive patients with PD who had taken levodopa between 2011 and 2015. The participants were initially free of dementia and had initial daily levodopa doses of below 600 mg. Patients who did and did not develop comorbid dementia were compared in terms of potential predictor variables, including PD onset age, sex, levodopa doses, and non-dementia comorbidities. RESULTS: Of the 76 patients, 21 (27.6%) developed dementia, which was followed by hallucinations and insomnia. The independent predictors of incident dementia were PD onset age and second-year and third-year average levodopa doses that were higher than the first-year average levodopa dose. Patients who developed dementia had significantly higher average daily levodopa doses and levodopa dose increases over the 6-year treatment period than those who did not develop dementia. In addition, patients with higher levodopa doses were more likely to experience hallucinations. CONCLUSION: These results suggest that increases in levodopa doses may be associated with a greater risk of cognitive impairment in patients with PD. Therefore, motor and cognitive functions and levodopa dose increases should be evaluated regularly during long-term levodopa therapy in patients with PD.

Effects of the Health Status and Health Behavior on Health-related Quality of Life of the Elderly Living Alone and Living with Their Families: Using Data from the 2014 Community Health Survey

PURPOSE: The purpose of this study is to identify factors influencing the quality of life of the elderly living alone and living with their families with regard to their health statuses and health behavior experiences. METHODS: We used source data from the 2014 Community Health Survey. The subjects of this study included some elderly people aged 65 and over, and analyzed the data of 13,373 elders living alone and 13,322 elders living with family. RESULTS: Factors influencing the quality of life of the elderly living alone and living with their families include gender, age, education, household income, current occupation, subjective stress level, depression, number of diagnosed diseases, walking exercise, the experience of health screening, and the experience of not having necessary medical services (p<.001). Region was a significant variable influencing the quality of life of the elderly living with their families (p<.001). CONCLUSION: In order to improve the quality of life of the elderly, it is necessary to provide sound conditions for working, emotional support, walking exercise and promotion of health screening, and to supplement the environment and institution for them to receive necessary medical services.

Applications of Microfluidic Devices for Urology / 대한배뇨장애요실금학회지

Microfluidics is considered an important technology that is suitable for numerous biomedical applications, including cancer diagnosis, metastasis, drug delivery, and tissue engineering. Although microfluidics is still considered to be a new approach in urological research, several pioneering studies have been reported in recent years. In this paper, we reviewed urological research works using microfluidic devices. Microfluidic devices were used for the detection of prostate and bladder cancer and the characterization of cancer microenvironments. The potential applications of microfluidics in urinary analysis and sperm sorting were demonstrated. The use of microfluidic devices in urology research can provide high-throughput, high-precision, and low-cost analyzing platforms.

Differentiation Potential of Mesenchymal Stem Cells Is Related to Their Intrinsic Mechanical Properties / 대한배뇨장애요실금학회지

PURPOSE: The differentiation properties of stem cells are not yet fully understood due to their close association with multiple environmental and extrinsic factors. This study investigates the differentiation properties of mesenchymal stem cells (MSCs) and correlates them with their intrinsic mechanical properties. METHODS: A total of 3 different types of MSCs, namely bone marrow-derived MSCs (BMSCs), umbilical cord-derived MSCs (UCSCs), and adipose-derived MSCs (ADSCs) were evaluated. These 3 MSCs were individually differentiated into adipocytes and osteoblasts for 3 weeks. The mechanical properties of the MSCs and differentiated cells were determined by atomic force microscopy. RESULTS: ADSCs showed the greatest ability to differentiate into adipocytes, followed by BMSCs and UCSCs. While UCSCs differentiated readily into osteoblasts, BMSCs and ADSCs were less likely to undergo this differentiation. UCSCs were the “hardest” cells, while ADSCs were the “softest.” The cells differentiated from “hard” MSCs were stiffer than the cells differentiated from “soft” MSCs, irrespective of lineage specification. CONCLUSIONS: The differentiation ability of MSCs and the mechanical properties of the differentiated cells were closely linked. However, there were no significant correlations regarding changes in the mechanical properties between the nuclear region and the cytoplasm during differentiation.

Effects of Gypenosides on Dopaminergic Neuronal Cell Death in 6-Hydroxydopamine-lesioned Rat Model of Parkinson's Disease with Long-term L-DOPA Treatment

The goal of this study was to determine whether gypenosides (GPS) exert protective effects against dopaminergic neuronal cell death in a 6-hydroxydopamine (OHDA)-lesioned rat model of Parkinson's disease (PD) with or without long-term 3,4-dihydroxyphenylalanine (L-DOPA) treatment. Rats were injected with 6-OHDA in the substantia nigra to induce PD-like symptoms; 14 days after injection, groups of 6-OHDA-lesioned animals were treated for 21 days with GPS (25 or 50 mg/kg) and/or L-DOPA (20 mg/kg). Dopaminergic neuronal cell death was assessed by counting tyrosine hydroxylase (TH)-immunopositive cells in the substantia nigra and measuring levels of dopamine, norepinephrine, 3,4-dihydroxyphenylacetic acid (DOPAC), and homovanillic acid (HVA) in the striatum. Dopaminergic neuronal cell death induced by 6-OHDA lesions was ameliorated by GPS treatment (50 mg/kg). L-DOPA treatment exacerbated 6-OHDA-induced dopaminergic neuronal cell death; however, these effects were partially reversed by GPS treatment (25 and 50 mg/kg). These results suggest that GPS treatment is protective against dopaminergic neuronal cell death in a 6-OHDA-lesioned rat model of PD with long-term L-DOPA treatment. Therefore, GPS may be useful as a phytotherapeutic agent for the treatment of PD.

Factors Associated with Satisfaction as Surveyor and Reliability of Surveyors in Hospital Accreditation Program / 보건행정학회지

BACKGROUND: The hospital accreditation program in Korea has been conducted since 2011 in order to improve patient safety and healthcare service quality. This study was conducted to find factors associated with satisfaction as surveyor and reliability of surveyors in hospital accreditation program. METHODS: This study was performed targeting 217 responded to the survey among 412 surveyors who had participated in the accreditation survey for acute care hospitals from December 2010 to February 2014. RESULTS: The average number of survey per surveyor is 2.35. We divided surveyors into those who participated in the survey more than 3 times and less than 3 times in order to judge the professionalism of surveyors according to the number of survey participation. Those factors that have an influence on the satisfaction as surveyors include: activity period as surveyor, role in the survey team, experience of survey in other fields, experience as consultant and the useful education and proper composition of survey team (p<0.05). Those factors that have an influence on the reliability for fellow surveyors include: number of beds of hospitals they belong, experience of survey in other fields, useful education, proper composition of survey team and difficulty in leadership interview (p<0.05). CONCLUSION: It is important to provide useful education and proper composition of survey team to increase the satisfaction as surveyors and the reliability for fellow surveyors.

Factors associated with the bone mineral density in Korean adults: Data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES) V / 農村醫學 地域保健

OBJECTIVE: The purpose of this study was to identify the correlates of bone mineral density of Korean adults. METHODS: This study was based on the data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES, 2010-2011) V. Among 8,473 subjects of the survey, who were adults 19 years old or over with bone mineral density data, the current study excluded those whose data include a missing study variable or the response of 'I don't know', and finally analyzed the data of 5,986 subjects (2,692 males and 3,294 females). This study employed the following statistical methods of analysis: t-test, analysis of variance (ANOVA), and hierarchical multivariate linear regression analysis. RESULTS: In multivariate analysis, in the case of men, the significant associated factors in bone mineral density were age, education level, body mass index (BMI), waist circumference, total muscle mass, exercise, and weight control; in the case of women, the significant associated factors in bone mineral density were age, education level, economic activity, BMI, total muscle mass, exercise, weight control. fat intake, uptake female hormone, menopause, and age of menarche. CONCLUSION: For both sexes, the strongest modifiable factor in influencing bone mineral density was total muscle mass. Therefore, to prevent osteoporosis and promote health, active health education and interventions such as regular exercise for total muscle mass increase should be implemented from an early growth period.

Maternal Acculturation Process of Married Immigrant Women in Korea

PURPOSE: This study was done to explore and understand acculturation focusing on reproductive health of immigrant women. METHODS: For the research sixteen immigrant women were selected by snowball sampling. Qualitative data were accumulated by in-depth interviews and private document collection. Raw data was analyzed following Mandelbaum's conceptual framework. RESULTS: The dimensions of immigrant women consisted of existence: emerging from the new environment in which it was hard to communicate and to get acquainted with others, reproduction: in the absence of learning and experience, reproductive health crisis, parenting: unmanageable burden. Turnings of life involved 'Inconvenience in one's eyes, vent for conflict and tension: pregnancy', 'strange medical care: accoucheur, rapid medical service', 'pain of morning sickness: poor maternal nutrition', 'manifestation of protective instinct for life'. In adaptations, content was as follows. 1) Standing alone as a Korean housewife, 2) Becoming aware of Korean maternal instinct: thirst for education supporting, 3) Rediscovery of family: growing maternal sense of existence. CONCLUSION: The results of this study show the acculturation process and the meaning of events related to reproductive health in current lives and can contribute to an integrated understanding of married immigrant women in Korean culture.

Factors Associated with Quality Control of Hemodialysis Treatment / 대한내과학회지

BACKGROUND/AIMS: The number of patients with end-stage renal disease in Korea is increasing annually with 63,341 patients in 2011 with 42,596 of these patients undergoing hemodialysis. The purpose of this study was to present a quality control plan for hemodialysis treatment. METHODS: We analyzed 616 hemodialysis units in 2010. The difference between hospitals was analyzed by one-way analysis of variance and the Kruskal-Wallis H test. The factors related to outcome indicators were subjected to multiple regression analysis. RESULTS: The average proportion of physicians with a specialty in hemodialysis was 71.3% and the proportion of nurses with > 2 years experience in hemodialysis units was 76.3%. The average number of hemodialysis sessions performed per day by a physician was 23 and that of a nurse was 4.5. The rate of specialist physicians was significantly related to adequate diastolic blood pressure, integrated outcome indicator, and Hb levels (p < 0.05). Hemodialysis sessions performed by a nurse were significantly related to Hb levels of patients and integrated outcome indicator (p < 0.05). The integrated outcome indicator was significantly related to specialist physicians, the number of hemodialysis sessions performed by a nurse, and compliance with a hemodialysis adequacy and water test cycles (p < 0.05). CONCLUSIONS: The appropriate rate of specialist physicians and nurses is important for quality control of hemodialysis treatment. Proper facilities and equipment, as well as regular monitoring of the patient's condition, are also critical. This will require improved indicators and assessment reliability.

Renal Expression of an Ammonia Transporter in Rats with a Unilateral Ureteral Obstruction / 대한내과학회지

BACKGROUND/AIMS: Urinary tract obstruction induces a form of renal tubular acidosis with a urinary acidification defect caused by decreasing net acid excretion, which is predominantly due to a decrease in urinary ammonia excretion. The present study examined whether this decrease is associated with changes in the renal expression of an ammonia transporter family member, Rh C glycoprotein (Rhcg), in rats with a unilateral ureteral obstruction. METHODS: Male Sprague-Dawley rats underwent a 24-h unilateral ureteral obstruction. Rhcg expression was then evaluated by immunoblotting and immunohistochemistry. Cell height, total cellular expression, expression in the apical 25% of the cell, and % of total expression in the apical region were quantified by immunohistochemistry with quantitative morphometric analysis. RESULTS: After 24 h of unilateral ureteral obstruction, the serum bicarbonate level and total urinary ammonia excretion were decreased. Both light microscopy and immunohistochemistry with quantitative morphometric analysis demonstrated that the total intensity of Rhcg expression was decreased in the obstructed kidneys, whereas Rhcg expression did not change in the cortical collecting duct (CCD) and outer medullary collecting duct (OMCD) of nonobstructed kidneys in rats with a 24-h unilateral ureteral obstruction. CONCLUSIONS: The rats with a unilateral ureteral obstruction showed decreased urinary ammonia excretion associated with decreased Rhcg expression in the CCD and OMCD. These changes suggest that the ammonia transporter Rhcg mediates a urinary acidification defect associated with unilateral ureteral obstruction.

A Study on Intention to Quit and Job Overload, Role Ambiguity, Burn out among Nurses in General Hospital / 한국직업건강간호학회지

PURPOSE: This study is designed to verify affecting variables to turnover intention of nurses in general hospital. METHODS: The data were from the self-reported questionnaire responses of 168 nurses in five general hospitals 300-400 beds in Seoul and Gyungi province and analyzed by frequency and percentage, t-test, ANOVA and Scheffe's test and stepwise multiple regression. RESULTS: The means of turnover intention were 3.14+/-0.87, job overload, 3.54+/-0.67, role ambiguity, 2.87+/-0.71 and burnout, 2.68+/-0.72. A significant correlation was found among turnover intention and job overload (r=.24, p<.001), role ambiguity (r=.30, p<.001), and burn out (r=.58, p<.001). The factors that affect turnover intention from the result of multiple regression by the stepwise selection, were burn out, role ambiguity. CONCLUSION: Based on the results, to reduce turnover intention of nurses, emotional support should be provided and also range of roles be clearly defined. In addition, it is needed to improve the working conditions for nurses to get a sense of accomplishment.

A Case of Anaphylaxis to Trimethoprim-Sulfamethoxazole / 대한내과학회지

Bactrim consists of the sulfonamides trimethoprim and sulfamethoxazole. These induce relatively frequent adverse drug reactions, including allergic reactions ranging from urticaria to anaphylaxis. Either component can be the causative allergen, so it is necessary to determine which has caused an allergic reaction to prevent further allergy. We report the case of a 46-year-old male with chronic renal failure who experienced anaphylactic shock twice after ingesting trimethoprim-sulfamethoxazole, as was proven by the medical history and skin prick testing. Enzyme-linked immunoassays and enzyme-linked allergen inhibition assays for allergen-specific IgE antibody for the five components of Bactrim showed that sulfamethoxazole was the causative allergen.

Development of a Resource-based Relative Value Scale and Its Conversion Factor for Advanced Nursing Practices in the National Health Insurance

PURPOSE: The purpose of this study was to develop a resource-based relative value scale (RBRVS) and its conversion factor for advanced nursing practices carried out by critical care nurse practitioners (CCNP) in intensive care units. METHODS: The methodology was developed by calculating CCNP's RBRVS for 32 advanced nursing services based on CCNP's workload and time spent in the context of national health insurance. A cost analysis was performed to estimate the conversion factor of CCNP's RBRVS. The share of CCNP's contribution to fee-for-service in intensive care units was also analyzed. RESULTS: Calculation of the RBRVS of 32 advanced nursing practices showed a range of points from 100.0 to 1,181.4 and an average of 296.1 points. The relevant conversion factor for advanced nursing practices in CCNP were estimated at 37.3-48.4 won. The contribution rate of CCNP's advanced nursing practices in the relative value scale of the national health insurance was estimated at 0.1-31.3%. CONCLUSION: Measuring the economic value of advanced nursing services will be a basis for esta-blishing a reimbursement system for CCNP's practices and thus encourage a social demand for advanced nurse practitioners.

Factors Affecting On Caregiving Self-efficacy among Dementia Caregivers

PURPOSE: The study evaluated the determinants of caregiving self-efficacy among dementia caregivers. METHODS: Data were collected through a structured questionnaire survey from dementia sufferers and caregivers by nurses or social workers caring for dementia sufferers at health centers during July to September 2007. Multiple stepwise regression analysis using SAS Version 9.1 was performed to examine the determinants of caregiving self-efficacy. RESULTS: Factors affecting caregiving self-efficacy were behavioral and psychological symptoms of dementia (BPSD), activities of daily living (ADL), and age of dementia sufferer. CONCLUSION: To increase dementia caregivers' self-efficacy, there is a need to reduce difficulties of dementia caregivers in caring BPSD and increasing the ADL level of dementia sufferers by providing guidelines of care and intervention programs for BPSD and ADL management.

Proximal caries detection using digital subtraction radiography in the artificial caries activity model / 대한구강악안면방사선학회지

PURPOSE: The purpose of the experiment was to evaluating the diagnostic ability of dental caries detection using digital subtraction in the artificial caries activity model. MATERIALS AND METHODS: Digital radiographies of five teeth with 8 proximal surfaces were obtained by CCD sensor (Kodak RVG 6100 using a size #2). The digital radiographic images and subtraction images from artificial proximal caries were examined and interpreted. In this study, we proposed novel caries detection method which could diagnose the dental proximal caries from single digital radiographic image. RESULTS: In artificial caries activity model, the range of lesional depth was 572-1,374 micrometer and the range of lesional area was 36.95-138.52mm2. The lesional depth and the area were significantly increased with demineralization time (p<0.001). Furthermore, the proximal caries detection using digital subtraction radiography showed high detection rate compared to the proximal caries examination using simple digital radiograph. CONCLUSION: The results demonstrated that the digital subtraction radiography from single radiographic image of artificial caries was highly efficient in the detection of dental caries compared to the data from simple digital radiograph.