Characteristics of the Gut Microbiome of Healthy Young Male Soldiers in South Korea: The Effects of Smoking

Background/Aims@#South Korean soldiers are exposed to similar environmental factors. In this study, we sought to evaluate the gut microbiome of healthy young male soldiers (HYMS) and to identify the primary factors influencing the microbiome composition. @*Methods@#We prospectively collected stool from 100 HYMS and performed next-generation sequencing of the 16S rRNA genes of fecal bacteria. Clinical data, including data relating to the diet, smoking, drinking, and exercise, were collected. @*Results@#The relative abundances of the bacterial phyla Firmicutes, Actinobacteria, Bacteroidetes, and Proteobacteria were 72.3%, 14.5%, 8.9%, and 4.0%, respectively. Fifteen species, most of which belonged to Firmicutes (87%), were detected in all examined subjects. Using cluster analysis, we found that the subjects could be divided into the two enterotypes based on the gut microbiome bacterial composition. Compared with enterotype 2 subjects, subjects classified as enterotype 1 tended to be characterized by higher frequencies of potentially harmful lifestyle habits (current smoker: 55.6% vs 36.6%, p=0.222; heavy drinker: 16.7% vs 3.7%, p=0.120; insufficient physical activity: 27.8% vs 14.6%, p=0.318). We identified a significant difference in the microbiome compositions of current and noncurrent smokers (p=0.008); the former differed from the latter mainly in a relatively lower abundance of Bifidobacterium species and a higher abundance of Negativicutes. @*Conclusions@#A high abundance of Actinobacteria and low abundance of Bacteroidetes

Validation of the Decisional Conflict Scale for Evaluating Advance Care Decision Conflict in Community-dwelling Older Adults

PURPOSE: Decisional conflict is a significant and important barrier in end-of-life care planning, and it is often encountered in health professionals' discussions with patients and their families. Little is known about the measurement of decisional conflict, and existing measures are not suitable for all contexts. In this study, psychometric properties of the Decisional Conflict Scale, which was translated for the first time into Korean [Korean version of DCS (K-DCS)], were examined. METHODS: A sample of 273 community-dwelling elders was surveyed (mean age: 77.26 years; 80.2% women). Internal consistency reliability and stability reliability were tested by calculating Cronbach α and Pearson's correlation coefficients. Exploratory factor analysis and logistic regression analyses were performed to test validity. RESULTS: Reliability of the K-DCS was acceptable with Cronbach α =.87; test-retest correlation r = .76. Factor analysis showed a two-factor structure with nine items: informed/values clarity and uncertainty. Concordance between K-DCS and the four treatment directives was significant (kappa values ≥.78). Controlling for age and gender, those with decision implementation were more likely to implement their decisions on tube feeding (odds ratio = 5.15, p = .033) and hospice care (odds ratio = 2.83, p = .017). CONCLUSION: The K-DCS appears to be a valid measure to evaluate decisional conflict about advance directives in community-dwelling Korean older adults. Further validation of the K-DCS is warranted, though caution should be exercised in using subscales because of differences in decisional contexts.

The Validity and Reliability of a Lifestyle Evaluation Tool for Patients with Metabolic Syndrome / 기본간호학회지

PURPOSE: This study examined the validity and reliability to develop a lifestyle evaluation tool for metabolic syndrome patients. METHODS: A methodological research design was used. The construct factors and preliminary items were identified by reviewing previous researches and tools related to lifestyle and reviewed by ten experts. It was tested with 195 patients with metabolic syndrome in a university hospital. The data were analyzed with SPSS/WIN 14.0. RESULTS: To test the validity, principal component analyses were used and resulted in the extraction of six components. The convergent validity resulted r=.72 (p<.001) with Health Promotion Lifestyle Profile. The discriminant validity with Center for Epidemiologic Studies Depression Scale resulted r=-.15 (p=.004). The Internal consistency of the tool had an Cronbach's alpha of .92. The self-report format Lifestyle Evaluation Tool for the patients with metabolic syndrome was developed with 36 items and four-rating scales: 'physical activity and weight control' eight items, 'dietary habits' sixteen items, 'drinking and smoking' three items, 'sleep and rest' two items, 'stress' three items, 'drug and health management' four items. CONCLUSION: This Tool will evaluate health behaviors in patients with metabolic syndrome. Also, it will contribute to the development of nursing intervention to improve the metabolic syndrome patients' lifestyle.

Development of a Scenario and Evaluation for Simulation Learning of Care for Patients with Asthma in Emergency Units / 기본간호학회지

PURPOSE: The purpose of this study was to develop a scenario and evaluate students' performance in simulation learning of care for patients with asthma in emergency units. METHODS: Meetings of experts were used to develop a scenario based on actual patients and textbook material. An evaluation protocol was developed to evaluate the simulation learning. The scenario was used in 2006 with six groups of 26 senior nursing students who participated voluntarily. RESULTS: The scenario was developed according to the nursing process for 15 minutes of simulation learning. The nursing students were able to demonstrate their knowledge and skills. The results showed a need to improve problem solving ability. In the self-evaluation, the students reported that simulation learning helped them to integrate their knowledge to practice and recognize their weaknesses and strengths. However, the scores for self-confidence about patient care after the simulation learning were low (4.8/10). CONCLUSION: The scenario in this study gave the students the experience of providing qualified and secure nursing care under conditions similar to reality. Further development of a variety of scenarios for simulation learning is needed.

Construction of EST Database for Comparative Gene Studies of Acanthamoeba

The genus Acanthamoeba can cause severe infections such as granulomatous amebic encephalitis and amebic keratitis in humans. However, little genomic information of Acanthamoeba has been reported. Here, we constructed Acanthamoeba expressed sequence tags (EST) database (Acanthamoeba EST DB) derived from our 4 kinds of Acanthamoeba cDNA library. The Acanthamoeba EST DB contains 3,897 EST generated from amebae under various conditions of long term in vitro culture, mouse brain passage, or encystation, and downloaded data of Acanthamoeba from National Center for Biotechnology Information (NCBI) and Taxonomically Broad EST Database (TBestDB). The almost reported cDNA/genomic sequences of Acanthamoeba provide stand alone BLAST system with nucleotide (BLAST NT) and amino acid (BLAST AA) sequence database. In BLAST results, each gene links for the significant information including sequence data, gene orthology annotations, relevant references, and a BlastX result. This is the first attempt for construction of Acanthamoeba database with genes expressed in diverse conditions. These data were integrated into a database (http://www.amoeba.or.kr).

Impact of Life Style Characteristics on Prevalence Risk of Metabolic Syndrome

PURPOSE: The goal of this study was to evaluate the impact of life style characteristics on the prevalence risk of metabolic syndrome (MS). METHODS: A total of 581 adults were recruited from a cardiovascular outpatient clinic. A newly developed comprehensive life style evaluation tool for MS patients was used, and patient data related to the MS diagnosis were reviewed from the hospital records. RESULTS: The overall prevalence of MS was 53.2%, and the mean of MS score was 2.6 for patients at a cardiovascular outpatient clinic (78% of the patients had hypertension). Dietary habits among the life style characteristics had significant influence on the prevalence risk of MS and MS scores. And also interestingly, the classification and regression tree (CART) model suggested that the high prevalence risk groups for MS were older adults (61.5< or =age<79.4), and adults between 48.5 and 61.5 yr of age with bad dietary habits. CONCLUSION: This study indicates that nurses should focus on dietary habits of patients (especially patients classified as high prevalence risk for MS) for improvement and prevention of MS prevalence risk.

Expressed Sequence Tags of Trichinella spiralis Muscle Stage Larvae

In order to obtain greater insight into the relevant genomic expression patterns of Trichinella spiralis, 992 expressed sequence tags (ESTs) were collected from a cDNA library of T. spiralis muscle stage larvae and assembled into 60 clusters and 385 singletons. Of them, 445 (44.7%) ESTs were annotated to their homologous genes, and small fractions were matched to known genes of nematodes. The annotated ESTs were classified into 25 eukaryotic orthologous groups (KOG). Cytochrome C oxidase (34 clones) was found to be most frequent species.

Development of an Eye Care Protocol for ICU Patients / 기본간호학회지

PURPOSE: The purpose of this study was to develop an eye care protocol for intensive care unit (ICU) patients. METHOD: A systematic review was conducted to develop an eye care protocol for ICU patients. Searches were performed using computerized databases (CINAHL, MEDLINE, EBM Review) and citation search from 1996 to January 2007. For the keywords, "eye care", and "randomized controlled trial" were used to identify experimental studies regarding eye care for ICU patients. After reviewing the collected studies, a preliminary eye care protocol algorithm was created. Then, content validity was examined with ophthalmologists and ICU nurses. RESULTS: Six studies were included to serve as a basis for framing of the preliminary algorithm. The final eye care protocol was completed after verifying the preliminary algorithm's content validity. The final eye care protocol was organized in the following manner: 3 items in the assessment stage, 7 items in the no-risk stage, 4 items in the low-risk stage, and 5 items in the high-risk stage. CONCLUSION: The results indicate that, for ICU patients, nurses can broaden their knowledge regarding ocular diseases, as well as improve their practice-based eye care nursing performance.

Knowledge, Perception & Practice of Eye Care Nursing among Nurses in Intensive Care Units / 기본간호학회지

PURPOSE: The purpose of this study was to identify levels of knowledge, perception, and practice of eye care as part of nursing care in the ICU. METHOD: A descriptive, cross-sectional study design was used. The participants in this study were 269 registered nurses working in the ICUs of five university hospitals in Seoul, Korea. Between November 2005 and December 2005, data were collected using a semi-structured questionnaire developed by the researchers, and analyzed using the SPSS Program. RESULTS: In general, levels of knowledge of nursing care for the eyes were moderate among ICU nurses, but levels of perception of nursing care for the eyes were very high. Of the respondents, 61.7% reported that they would consult a doctor whenever they found an eye problem. Only 42.4% nurses answered that they provide eye care as part of the daily routine and 43.9% nurses responded that they cleanse the eye lids with wet saline gauze. In regression analysis, the practice of eye care as part of nursing was significantly influenced by perception of nursing care for the eyes, and knowledge of interventions for nursing care for the eyes. CONCLUSION: These results suggest that education on care of the eyes for ICU nurses and the development of a standardized eye care protocol should be done to improve quality of nursing care in the ICU.

Development of a Health Information Web Site Evaluation Categories with Items for Diabetes Mellitus / 대한의료정보학회지

OBJECTIVE: The purpose of this study was to develop a health information web site evaluation categories with items for diabetes mellitus in order to offer verified health information, and to propose directions for development of web sites. METHODS: A preliminary evaluation categories with items was developed using domestic and foreign web site evaluation standards for health information and through a review of the literature. The evaluation categories with items was composed of 'evaluation for web site attributes' and 'evaluation for content information on diabetes mellitus'. Through expert validity tests and a feasibility test of the preliminary tool, the health information Web site evaluation tool for diabetes mellitus was finalized. RESULTS: This evaluation categories with items included 'evaluation for web site attributes' and 'evaluation for content information on diabetes mellitus'. 'Evaluation for web site attributes' included 8 categories with 28 items. The 'evaluation for content information on diabetes mellitus' included 7 categories with 40 items. 'Evaluation component for content' and 'evaluation of category content' included 4 items on 'accuracy', 6 on 'harmfulness' and 3 on 'comprehensibility'. CONCLUSION: From this study guidelines are propose for providing health information for diabetes mellitus, so that health information providers will be able to offer consumers verified good quality health information themselves.

An Analysis of Trends in Exercise-Related Studies in Nursing and Non-Nursing Fields in Korea / 기본간호학회지

PURPOSE: This study was done to analyze the trends in excercise-related research in nursing and non nursing research studies published in Korea. METHOD: Two hundred and ten research studies published in Korea between January, 1990 and December, 2002 were analyzed according to the criteria of methological characteristics, pattern of excercise-related program, and measurement index of exercise effect. RESULTS: There were twice many papers from nursing compared to other fields, and many experimental studies in nursing were done with more variety than in non nursing fields. Aspects of exercise pattern, such as excercise type, duration, and frequency, exercise-intervention pattern, and applying theory were especially included. When patterns of excercise therapy and index of exercise effect were analyzed, each researcher used their own unique excercise contents and intervention patterns(excercise time per week, exercise duration at each time period, excercise, intervention time, and etc). CONCLUSION: For the importance of exercise therapy to health improvement and the proper suggestion of exercise therapy on the basis of this research, meta-analysis of exercise effect are needed, and with this analysis, intervention patterns of exercise, development of standard exercise therapy, and identification of exercise effects are required.

Immunomodulatory Effects of Vitamin D Analogues in Psoriatic Skin

Psoriasis is an inflammatory skin disease characterized by hyperproliferation and incomplete differentiation of keratinocytes. Mounting scientific evidence suggests that this epidermal alteration occurs as a response to an immunologic injury, giving rise to the concept that psoriasis is a skin-specific autoimmune disease. Indeed, many effective therapeutic agents for psoriasis are immunosuppressive in nature, lending further support to this view. The well known ability of calcipotriene and 1,25(OH)2D3 to inhibit keratinocyte proliferation and to induce its differentiation is certainly compatible with their antipsoriatic actions. In addition, topical calcipotriene has been shown to correct, at least in part, the local cytokine imbalance observed in psoriatic lesions. Interleukin (IL)-8 is a proinflammatory cytokine that is chemotactic for polymorphonuclear cells and T lymphocytes. It also promotes proliferation of keratinocytes and endothelial cells. In lesional psoriatic skin, IL-8 and its receptor levels are markedly elevated. IL-10 is an immunosuppressive cytokine, which as a type2 (T2) cytokine antagonizes cell-mediated immunity. Indeed, IL-10 administration has been shown to improve psoriasis. Topical calcipotriene markedly reduces elevated levels of IL-8 while simultaneously increasing IL-10 levels in lesional skin of psoriasis. These changes occur very early, within the first three days of therapy, prior to significant clinical improvement of psoriasis, indicating that the cytokine alterations are not simply secondary to resolution of psoriatic plaques. Therefore, elaboration of the immunosuppressive cytokine IL-10 and a concomitant reduction in the proinflammatory cytokine IL-8 may mediate the immunopharmacological improvementin psoriasis by calcipotriene.