Infant sleep interventions with sleep measurements using actigraphy: A systematic review.

AIM: This review investigated the outcomes and methodological quality of infant sleep intervention studies utilizing actigraphy. BACKGROUND: Parents need appropriate support for infant sleep from nurses. There are few methodological reports of actigraphy in infant sleep intervention studies that objectively measure infant sleep in a natural setting. DESIGN: This was a systematic review study. DATA SOURCES: Ovid MEDLINE, Embase, Cochrane, CINAHL and PsycINFO were searched from database establishment to 30 December 2021. REVIEW METHODS: This systematic review utilized the Cochrane Collaboration review guidelines. RESULTS: Eleven sleep intervention studies were reviewed. Three used extinction-based behavioural interventions, and eight included parental education programs. The infant sleep interventions positively affected the sleep outcomes of both infants and parents. Fairly consistent effects were found on infants' number of awakenings and sleep onset latency. However, parental psychosocial outcomes were inconsistent. All studies reported device placement, the algorithm for analysis, the use of a sleep diary and number of days/nights, but external movements affecting infants' sleep records were insufficiently reported. Only two studies had a low risk of bias. CONCLUSIONS: The infant sleep interventions had positive effects on both infants and their parents. Comprehensive methodological considerations are required for more standardized assessments using actigraphy for infant sleep evaluation.

Exploring the potential use of the metaverse in nurse education through a mock trial.

BACKGROUND: The metaverse has been attracting attention as a space for the application of education, where integrating the real and virtual worlds offers immersive 3D experiences. Consequently, its potential for higher education, including nursing, is being explored as a dynamic alternative to traditional education. OBJECTIVES: This study explores the applicability of metaverse in nurse education. It was conducted to implement a mock court on the metaverse platform and explore the learning experiences of nursing students through mock trials. DESIGN: Qualitative study. SETTINGS: A virtual mock court in VRChat (a virtual reality space). PARTICIPANTS: Fourteen participants were divided into three groups. METHODS: An orientation was conducted to explain the virtual space before the mock trial. On the day of the mock trial, a health survey of study participants was conducted in advance. After the mock trial, questionnaires and reflective diaries were written. RESULTS: The experiences of nursing students were organized into eleven sub-themes and three themes: "core features of the metaverse platform," "participation in a mock trial in the VRChat virtual space," and "metaverse-based learning using a mock trial." CONCLUSIONS: Nursing students participated and immersed themselves in learning while accepting the characteristics of the metaverse platform, which differs from face-to-face classes or existing educational methods. The metaverse enables reflective learning based on experiential learning and strengthens awareness of diverse viewpoints.

Effectiveness of a Strength-Based Intervention into Nursing Education in South Korea.

Purpose: This study aimed to examine the effectiveness of strength-based interventions integrated into the nursing education. Materials and Methods: The participants were 259 baccalaureate nursing students in South Korea. Over 15 weeks, strength-based intervention was integrated into the regular nursing curriculum. Stress, resilience, and well-being of the participants were measured before and after the intervention. The data were analyzed using a linear mixed model via the SPSS statistics 21.0. program. Results: There was a negative weak association between stress and well-being and between stress and resilience (r = -0.164, p = 0.009 and r = -0.138, p = 0.029, respectively) and a positive moderate association between well-being and resilience (r = 0.561, p<0.001). After adjusting the covariates, the interaction of group*time for stress and resilience were significant after the intervention, reflecting a higher status of stress and improved resilience. (p= 0.046 and 0.030 respectively). Conclusion: Integrating strength-based interventions into the nursing curriculum was effective in improving the mental health of Korean nursing students. Future research is needed to identify various ways of applying positive psychology to the nursing education.

Nursing students' self-directed learning experiences in web-based virtual simulation: A qualitative study.

BACKGROUND: Since the start of the COVID-19 pandemic, virtual reality simulation, including web-based simulation, has increased in nursing education. This study explored nursing students' self-directed problem-solving in web-based virtual simulation experiences. METHOD: Convenience sampling yielded 16 Korean senior nursing students who had experienced clinical practice in the last semester. Data were collected from August 2020 to January 2021 through in-depth Zoom video interviews and organized using NVivo version 12.0. Thematic analysis was applied to analyze the data. RESULTS: The following four themes were identified from nursing students' learning experiences during the web-based virtual simulations: "self-awareness of a lack of nursing competency in virtual reality," "applying new learning strategies learned from failure," "voluntary learning behavior," and "cognitive shift toward a holistic understanding." Web-based virtual simulations activated various cognitive and metacognitive factors of self-directed learning, and the system's prompt feedback and students' reflections facilitated learning effects. Nursing students corrected their cognitive errors while learning from their failures and mistakes and gained a holistic view of nursing practice. CONCLUSION: In this study, web-based self-directed learning activated the metacognition of nursing students in a virtuous cycle. The virtual environment with no actual harm to the patient has become a space for learners to experience a sense of confidence, achievement, and satisfaction. Web-based virtual simulation can be an effective teaching method to improve nursing students' self-directed learning abilities and nursing competency.

A qualitative study of the sleep ecology of infants under 2 years old and their mothers in South Korea.

OBJECTIVES/DESIGN: Infancy is a crucial period for establishing an individual's sleep pattern, and it is a common period during which infants and mothers experience sleep problems. The aim of this qualitative study was to explore the sleep ecology of infants under 2 years of age and their mothers. SETTING/PARTICIPANTS: The study participants were 20 mothers with infants aged 3-19 months living in South Korea. METHODS: Data were collected through in-depth interviews and analyzed using the thematic analysis. RESULTS: Five themes related to the sleep of infants and their mothers emerged from the data: (1) changes in sleep patterns, (2) room-sharing, (3) environmental factors affecting sleep, (4) efforts to improve sleep quality, and (5) infant sleep and the mother's health. The sleep patterns of infants and their mothers were mutually interrelated, and were strongly affected by various environmental factors, including infants' biological maturity (a microsystem) as well as cultural factors (a macrosystem). Culture had an especially profound effect on sleep patterns of infants, similar to the effects of microsystem-level factors. CONCLUSIONS: To improve the sleep quality of infants and mothers, an ecological approach considering the biological characteristics and cultural contexts of infants is required based on an understanding of sleep as a phenomenon that evolves in a relationship of mutual influence between infants and mothers.

Effects of school-based "We Fit" weight control programme in adolescents.

AIM: This study examined the effects of a 12-week school-based "We Fit" weight control programme. DESIGN: A nonequivalent control group was used, with a non-synchronized pretest-posttest design. METHODS: In total, 109 Korean high school adolescents participated. The programme comprised exergaming, diet diary and counselling, health education, and social networking service-based group discussions. Anthropometric factors, physiological factors and physical activity (daily steps and sitting time) were measured in the intervention and the control groups before and after the intervention. Programme satisfaction was assessed post-intervention. Data were analysed using descriptive statistics; the chi-square, Mann-Whitney U and t tests; and generalized estimating equations. RESULTS: The intervention group showed a significantly decreased waist circumference, increased skeletal muscle mass, increased high-density lipoprotein cholesterol, decreased low-density lipoprotein cholesterol and reduced weekend sitting time. CONCLUSION: This study adds to the evidence for the applicability and effectiveness of healthy weight control programmes using exergames for adolescents in school settings.

Association of Weight Control Behaviors with Body Mass Index in Korean Adolescents: A Quantile Regression Approach.

PURPOSE: Adolescents are interested in weight control but likely practice unhealthy weight control behaviors. This study aimed to examine weight control behaviors associated with body mass index (BMI) in Korean adolescents. DESIGN AND METHODS: In this descriptive cross-sectional study of 16- to 19-year-old adolescents (97 girls and 90 boys), analyses were conducted of physical activity, sedentary behaviors, dietary behaviors, and self-efficacy for physical activity and diet. Daily steps were measured using pedometers. Height and weight were self-reported. We conducted descriptive statistics and quantile regression analysis using STATA 14.0. RESULTS: About 10% were underweight, and 8.6% overweight and obese. Average weekday and weekend steps/day were <10,000. Only 4.3% reported performing moderate-to-vigorous physical activity (MVPA) daily. Less than half (42.5%) reported that they had three meals/day every day. Most (89.3%) had milk less than once/day. Quantile regression showed that, for the 5th BMI percentile group, (1) age (ß = 0.941) and milk consumption (ß = 2.148) were significantly positively associated with BMI, whereas (2) dietary self-efficacy (ß = -0.083) was significantly negatively associated with BMI. For the 95th percentile group, having three meals/day (ß = 2.558) was significantly positively associated with BMI, whereas MVPA (ß = -5.440) and muscle-strengthening exercise (ß = -3.392) were significantly negatively associated with BMI. CONCLUSIONS: Milk consumption was positively associated with BMI of underweight adolescents, whereas physical activities were negatively associated with BMI of overweight and obese adolescents. PRACTICE IMPLICATION: Weight control programs for adolescents may need to be tailored for differing BMI levels.

Weight Control in Adolescents: Focus Groups With Korean Adolescents and Their Teachers.

PURPOSE: This qualitative descriptive study sought to identify perceptions about and status of weight control in adolescents from the perspective of adolescents and their teachers. METHODS: Focus groups were used with six separate groups, 20 adolescents divided into four groups and 14 teachers divided into two groups. The qualitative data were analyzed using a thematic analysis in NVivo 11.0. Consolidated criteria for reporting qualitative studies (COREQ) were followed. RESULTS: We extracted three themes and 12 sub-themes with 52 meaningful codes. Both adolescents and teachers stated that perceptions about weight control in adolescents were overly weighted toward management of one's appearance. The adolescents reported an increase in weight gained during adolescence, especially after entering high school, and they noted a lack of participation in physical activities and the presence of unhealthy dietary behaviors. However, adolescents perceived excessive weight gain during adolescence as natural, as long as they studied hard. Their teachers and parents were also permissive about weight gain resulted from study. The participants suggested that a weight control program for adolescents should be conducted in schools and should include every student in order to avoid discrimination. In addition, teacher involvement was emphasized to promote participation of adolescents in a school program. CONCLUSION: Our findings indicate that adolescents, especially those in a society emphasizing academics, need to practice healthy weight control behaviors. A school-based weight control program involving teachers and peers would be suitable and should be provided to all students regardless of weight classification.

Voluntary stand-up physical activity enhances endurance exercise capacity in rats.

Involuntary physical activity induced by the avoidance of electrical shock leads to improved endurance exercise capacity in animals. However, it remains unknown whether voluntary stand-up physical activity (SPA) without forced simulating factors improves endurance exercise capacity in animals. We examined the eff ects of SPA on body weight, cardiac function, and endurance exercise capacity for 12 weeks. Twelve male Sprague-Dawley rats (aged 8 weeks, n=6 per group) were randomly assigned to a control group (CON) or a voluntary SPA group. The rats were induced to perform voluntary SPA (lifting a load equal to their body weight), while the food height (18.0 cm) in cages was increased progressively by 3.5 every 4 weeks until it reached 28.5 cm for 12 weeks. The SPA group showed a lower body weight compared to the CON group, but voluntary SPA did not affect the skeletal muscle and heart weights, food intake, and echocardiography results. Although the SPA group showed higher grip strength, running time, and distance compared to the CON group, the level of irisin, corticosterone, genetic expression of mitochondrial biogenesis, and nuclei numbers were not affected. These findings show that voluntary SPA without any forced stimuli in rats can eff ectively reduce body weight and enhance endurance exercise capacity, suggesting that it may be an important alternative strategy to enhance endurance exercise capacity.

Factors Associated with Early Smoking Initiation among Korean Adolescents.

PURPOSE: The aim of this study was to identify factors associated with early initiation of cigarette smoking among Korean adolescents. METHODS: A secondary analysis was conducted on the 2012 Korea Youth Risk Behavior Web-based Survey data using Cox proportional hazards regression. RESULTS: Early smoking initiation was associated with being male, having a positive subjective health status, perceiving oneself as thin or average weight (body image), having an average happiness level, being stressed, consuming alcohol, having suicidal ideation, experiencing sexual intercourse, having low or average academic grades, having a parental education level of high school or below, not taking a family trip in the previous 12 months, and having a family that approves of smoking in the home. CONCLUSIONS: Interventions targeting the prevention of smoking initiation among adolescents should include individual factors such as health status, body weight, perceived mental health status, health-risk behaviors, and academic characteristics as well as family factors that reinforce family cohesion and home smoking bans. Moreover, male adolescents aged 12-13 years and their parents should be the main target of these interventions.

Antidiabetic effects of Vigna nakashimae extract in db/db mice.

The inhibitory activity of Vigna nakashimae extract against intestinal α-glucosidase was investigated in vitro and in vivo. The extract exerted a significant inhibitory effect against intestinal α-glucosidases. With sucrose-loading, it reduced the peak responses of blood glucose significantly in normal mice. Next, it was administrated to 8-week-old db/db mice for 2 weeks, and then plasma glucose, triglyceride, and total cholesterol levels were measured. The extract significantly suppressed postprandial hyperglycemia and blood glycated hemoglobin in the db/db mice. In addition, it lowered fasting glucose and improved glucose tolerance. Furthermore, it led to significant decreases in plasma triglyceride levels. It reduced endoplasmic reticulum stress in thapsigargin-induced HepG2 cells. Taken together, these results suggest that Vigna nakashimae extract has hypoglycemic and hypolipidemic effects that occur via inhibition of α-glucosidase activity and endoplasmic reticulum stress.