Long-term Intracellular Recording of Optogenetically-induced Electrical Activities using Vertical Nanowire Multi Electrode Array.

Continuous recording of intracellular activities in single cells is required for deciphering rare, dynamic and heterogeneous cell responses, which are missed by population or brief single-cell recording. Even if the field of intracellular recording is constantly proceeding, several technical challenges are still remained to conquer this important approach. Here, we demonstrate long-term intracellular recording by combining a vertical nanowire multi electrode array (VNMEA) with optogenetic stimulation to minimally disrupt cell survival and functions during intracellular access and measurement. We synthesized small-diameter and high-aspect-ratio silicon nanowires to spontaneously penetrate into single cells, and used light to modulate the cell's responsiveness. The light-induced intra- and extracellular activities of individual optogenetically-modified cells were measured simultaneously, and each cell showed distinctly different measurement characteristics according to the cell-electrode configuration. Intracellular recordings were achieved continuously and reliably without signal interference and attenuation over 24 hours. The integration of two controllable techniques, vertically grown nanowire electrodes and optogenetics, expands the strategies for discovering the mechanisms for crucial physiological and dynamic processes in various types of cells.

Performance of thyristor memory device formed by a wet etching process.

Thyristor random access memory without a capacitor has been highlighted for its significant potential to replace current dynamic random access memory. We fabricated a two-terminal (2-T) thyristor by wet chemical etching techniques on n+-p-n-p+ silicon epitaxial layers, which have the proper thicknesses and carrier concentrations, as provided by technology computer-aided design simulation. The etched features such as etch rate, surface roughness, and morphologies, in a potassium hydroxide (KOH) and an isotropic etchant, were compared. The type of silicon etchant strongly affected the etched shapes of the side wall and therefore critically influenced the device performance with varying turn-on voltages. The turn-on voltage of thyristor fabricated with a KOH solution showed a consistent tendency of operation voltage in the range of 2.2-2.5 V regardless of the cell size, while the thyristor formulated with isotropic etchant had an operation voltage which increased from about 2.3-4.4 V as the device dimension decreased from 200 µm to 10 µm. The optimized 2-T thyristor showed a memory window of about 2 V, a nearly zero-subthreshold swing, and a current on-off ratio of about 104-105.

Effect of a mind-body therapeutic program for infertile women repeating in vitro fertilization treatment on uncertainty, anxiety, and implantation rate.

PURPOSE: The study aimed to develop a mind-body therapeutic program and evaluate its effects on mitigating uncertainty, anxiety, and implantation rate of second-trial in vitro fertilization (IVF) women. METHODS: This study employed a nonequivalent control group nonsynchronized design. The conceptual framework and program content were developed from a preliminary survey of eight infertile women and the extensive review of the literature. Program focuses on three uncertainty-induced anxieties in infertile women: cognitive, emotional, and biological responses. To evaluate the effect of the intervention, the infertile women with unknown cause preparing for a second IVF treatment were sampled at convenience (26 experimental and 24 control). RESULTS: The experimental group in the study showed greater decrease in uncertainty and anxiety in premeasurements and postmeasurements than the control group did. However, no statistically significant differences in the implantation rate between groups were observed. CONCLUSION: This study is meaningful as the first intervention program for alleviating uncertainty and anxiety provided during the IVF treatment process. The positive effects of the mind-body therapeutic program in alleviating both uncertainty and anxiety have direct meaning for clinical applications.

[Comparison for risk estimate of aspiration between the revised dysphagia assessment tool and videofluoroscopy in post-stroke patients].

PURPOSE: The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool. METHODS: A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis. RESULTS: In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy. CONCLUSION: The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.

Integrating evidence-based practice into RN-to-BSN clinical nursing education.

This study examines the effects of integrating evidence-based practice (EBP) into clinical practicum on EBP efficacy and barriers to research utilization among Korean RN-to-BSN students. A one-group pretest-posttest design was used. Eighty-one students were recruited from a school of nursing in Korea. Evidence-based practice clinical practicum was composed of two consecutive programs during one semester. Lectures, individual mentoring on EBP practicum, small group, and wrap-up conferences were provided. Outcomes of EBP efficacy and barriers to research utilization were analyzed using paired t tests for 74 final participants. Evidence-based practice efficacy scores increased significantly (p < 0.05), and the barriers to research utilization scores decreased significantly after the EBP clinical practicum. The results highlight the effectiveness of EBP education among RN-to-BSN students. These results may help health educators develop effective educational strategies to integrate EBP concepts into a clinical practicum.

Development and validation of a scale for the end of life caregiving appraisal.

PURPOSE: End-of-life caregiving experiences can be complex. Family members experience physical and mental suffering as they anticipate their impending loss. Healthcare providers should be able to provide good quality of end-of-life (EOL) care and support for primary EOL caregivers. Studies have highlighted the role of healthcare providers providing information in the EOL situation to caregivers of chronic disease patients. This has resulted in the development of the End-of-life Caregiving Experience Appraisal Scale (EOLCAS) presented in this paper. The purposes of this study were to develop a scale that can evaluate the experiences of EOL caregivers, and to test the reliability and validity of this scale. METHODS: The scale domains were derived from systematic review of 35 relevant studies. We then examined its content validity with nurse scholars and clinicians using content validity index. To examine construct validity, a total of 175 caregivers from tertiary hospital setting in Korea participated in this study from December 2007 to May 2008. For the construct validity, factor analysis was utilized. RESULTS: The scale was composed of 32 items with four subscales: two negative appraisals (physical suffering and burden), one positive appraisal (maturation), and one neutral appraisal (social support pursuit). In this sample, the Cronbach's alpha for the entire scale was .84 indicating adequate reliability. However, Cronbach's alpha of subscales was varied. CONCLUSION: Nurses and other healthcare professionals could use the EOLCAS to assess the experiences of EOL caregivers to understand their experience in the EOL and enhance their quality of life although psychometrics of EOLCAS shows limited findings.

[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.

Evaluation of a complementary cyber education program for a pathophysiology class.

PURPOSE: The goal of this study was to develop and evaluate a complementary cyber education program for a required pathophysiology class for nursing students. METHODS: The cyber education program comprised electronic bulletin boards, correspondence material storage, an announcement section, a report submission section, reference sites, and statistics on learning rates. Twelve online lectures complemented five lectures in the classroom. To evaluate the course's educational effectiveness, we performed an online objective questionnaire and an open questionnaire survey anonymously, and compared the complementary cyber education program with traditional classroom education. RESULTS: The complementary cyber education program effected significant improvements in scores for importance with regard to major, clarity of goals and education plans for courses, professor readiness, preciseness and description of lectures, amount and efficiency of assignments, and fairness in appraisal standards compared with the traditional classroom education group. CONCLUSION: This study indicates that a complementary cyber education program provides nursing students with the flexibility of time and space, the newest information through updated lectures, efficient motivational aids through intimacy between the lecturer and students, and concrete and meaningful tasks. The complementary cyber education course also increased student effort toward studying and student satisfaction with the class.

Family Experiences in End-of-Life Care: A Literature Review.

PURPOSE: The purpose of this study was to summarize and analyze families' experiences of end-of-life care by conducting a systematic review of peer reviewed journals both in Korea and abroad. BACKGROUND: Families play an increasingly important role in care and medical treatment, acting as caregivers or decision makers rather than just being passive observers. It is necessary to understand the experiences of family members in order to provide appropriate care for them. METHODS: A systematic search of the literature was performed using the Cumulative Index for Nursing and Allied Health Literature (CINAHL) and the Korea Education & Research Information Service (KERIS) for the period of January 1990 through to December 2006. A total of 35 studies met the inclusion criteria. RESULTS: Seventeen studies used a quantitative design, while 18 studies used qualitative methods. Quantitative studies reported that the family's quality of life was relatively low when the patient was in need of high medical/nursing services. The perceived burden levels were moderately high, and depression levels were high among family caregivers. Various concepts emerged from the 18 qualitative studies, including psychological issues, physical problems, burdens, needs and interpersonal relationships. CONCLUSION: This study found that most previous research findings were focused on negative and neutral experiences. A few studies identified positive experiences. Based on the study results, we suggest that nurses need to be more aware of the experiences of patients' families and their potential needs.

The effect of a comprehensive lifestyle modification program on glycemic control and body composition in patients with type 2 diabetes.

PURPOSE: This paper describes the effects of a comprehensive lifestyle modification program (CLMP) on glycemic control and body composition in patients with type 2 diabetes. METHODS: This study was performed from October 2003 to April 2005, and used an experimental design with random assignment. The experimental group (n = 25) received CLMP for 4 months and follow-up sessions for 9 months. CLMP included nurse-led education on exercise and diet, and counseling on stress management and self-monitoring of their diabetic health. The control group (n = 23) received a 1-hour educational session on diabetic diet at the beginning of the study. Glucose level and body composition were measured in both groups a total of five times: at baseline (pre-intervention) and at 0, 3, 6 and 9 months post intervention. RESULTS: Repeated-measures ANOVA showed that there were statistically significant differences in fasting blood sugar and HbA1c levels between the two groups (both p < .05). Both groups demonstrated statistically significant changes in body composition over time, but there was no significant difference in the pattern of change between the two groups. CONCLUSION: CLMP is a useful program, and its multiple approaches by nurses as the leaders and coordinators appear to have positive and synergistic roles in improving and maintaining stable glucose level and body composition in patients with type 2 diabetes.

Parenting stress in mothers of children with congenital heart disease.

PURPOSE: The main purposes of this study were to examine the relationships among uncertainty, social support and parenting stress in mothers of children with congenital heart disease (CHD) and to identify the factors related to parenting stress. METHODS: This was a survey study using a questionnaire. Fifty-one mothers of children with CHD were recruited at the pediatric cardiac outpatient clinic at one university-affiliated hospital in Seoul between July 14th and September 25th, 2006. Abidin's Parenting Stress Index-Short Form, Mishel's Parents' Perception Uncertainty in Illness Scale, and Brandt and Weinert's Personal Resource Questionnaire were used to collect data. RESULTS: The results of bivariate analysis showed that parenting stress was significantly related to social support, ambiguity, lack of clarity, and lack of information, but was not related to unpredictability, one of the subconcepts of uncertainty. Multiple regression analysis showed that parenting stress was significantly related to social support and Internet information. CONCLUSION: Mothers who reported they had more social support and less uncertainty showed lower parenting stress. Also, the Internet could be an effective method to obtain information and to share child-rearing experiences with other mothers of children with CHD.

Development of a-health information website evaluation categories with items for diabetes mellitus.

As one of four major causes of death in Korea, diabetes mellitus has dramatically increased since the 1980s because of westernized lifestyles. Diabetes patients try to learn the knowledge and skills necessary for disease care since diabetes management is highly dependent on self- management. To do this, patients pursue more health information and proper sources for themselves. This study developed an evaluation tool including categories with items necessary for evaluation of Websites for health information on diabetes mellitus, as a method to offer consumers certified high quality health information on diabetes.

The impact of a stage-matched intervention to promote exercise behavior in participants with type 2 diabetes.

This study was designed to develop and evaluate a stage-matched intervention (SMI) in Korean participants with type 2 Diabetes. The SMI was based on main constructs derived from the Transtheoretical Model match to the individual's stages of readiness for exercise behavior. The SMI was developed according to the results of the content validity tested by an expert group (n = 9). A control group pre- and post-test design was used for evaluating the impact of the SMI: the intervention group (n = 22) participated in the SMI for 3 months, while the control group (n = 23) received usual educational advice. The intervention group, compared to the control group, showed significant improvements in stages of change for exercise behavior (p < 0.001), physical activity levels (p < 0.001), and reductions in FBS (p < 0.05) and HbA(1)c (p < 0.05). This study yielded evidence for the beneficial impact of the SMI in participants with type 2 Diabetes.

[The effects of a physical activity reinforcement program on exercise compliance, depression, and anxiety in continuous ambulatory peritoneal dialysis patients].

PURPOSE: This study was to evaluate the effects of a physical activity reinforcement program on exercise compliance, depression, and anxiety in continuous ambulatory peritoneal dialysis(CAPD) patients. METHOD: A nonequivalent control group with a pre-post test was designed. Data collection was done from December, 2002 to June, 2003 at a hospital. The degree of depression and anxiety of the patients was assessed by the score of SCL-90-R, and exercise compliance was measured by exercise period, frequency, time and intensity. The experimental group was composed of 19 participants who were educated based on an exercise education protocol and carried out walking exercises two to four times a week after hearing verbal persuasion biweekly through the telephone or a face-to-face interview for 12 weeks, while 17 participants in control group received no intervention. RESULT: 1. The experimental group showed significant improvement in self-efficacy of exercise compliance (U=79.00, p=.01), exercise period (chi2=20.84, p=.00), exercise frequency (chi2=9.03, p=.01), exercise time (chi2=9.03, p=.01) and exercise intensity (chi2=11.09, p=.00) compared to those of the control group. 2. The experimental group showed a lower depression score (U=84.50, p=.01) than the results of the control group. 3. However, there were no changes in anxiety level compared to the control group. CONCLUSION: The physical activity reinforcement program was found to have an effect on exercise compliance and the depression score of CAPD patients. The results provided evidence for the importance of physical activity and verbal persuasion in CAPD patients.

Development and validation of a computerized exercise intervention program for patients with type 2 diabetes mellitus in Korea.

This study was designed to develop and validate a computerized exercise intervention program using the transtheoretical model (TTM) for Korean patients with type 2 diabetes mellitus (DM). This computerized program was web-based and developed by designing a flow chart. An expert group (n=24), who validated the content of the computerized program, produced a mean score for the evaluation scale of 4.25 (SD.56). Of the patients (n=28) with type 2 DM who participated in clinical validity testing of the program, the mean score for the satisfaction scale was 4.82 (SD.12). In the validation of the program, significant differences between baseline and after-intervention were observed in the stage of readiness for exercise (Z=-3.78, p < 0.001), physical activity (Z=-2.33, p < 0.05), blood glucose profiles [FBS (Z=-2.84, p < 0.01), pc 2 hr. glucose (Z=-2.33, p < 0.05), HbA1c (Z=-2.77, p < 0.01)], and VO2max (Z=-2.52, p < 0.01). The study confirmed that the computerized program could be used to construct a database and continue to provide follow-up intervention for patients in all stages.

Priorities for nursing research in Korea.

PURPOSE: To identify priorities for nursing research in Korea. METHODS: A national sample of nurses in academic and clinical settings, representing varied clinical specialties, participated in two rounds of a Delphi survey. Participants listed five most important nursing research problems rated on three dimensions: the degree of nurses' lead role, contribution to nursing profession, and nurses' contribution to health and welfare of patients and clients. A total of 29 research areas were derived from 1,013 research problems identified from the Delphi surveys, and 26 expert panel members who participated in a 1-day workshop to determine the priority of these areas. Key words of 706 research articles published in the major nursing research journals in Korea were analyzed to identify priorities. RESULTS: In the two rounds of Delphi surveys 347 of 1,047 nurses participated (31%-33% response rates respectively). To three research areas common to both Delphi survey and literature analysis were: clinical nursing practice, nursing education, and nursing research. Cultural nursing was rated the lowest in the Delphi survey but was rated third by the expert panel members. CONCLUSIONS: In the clinical practice area, research on the advanced practice nursing system was the first priority research problem followed by development of nursing interventions, clinical competency, quality and effectiveness of nursing care, and standardized nursing tasks. Research on home health care, nursing education, utilization of nursing research, and geriatric nursing were other areas of priority. Nurses around the world are encouraged to develop collaborative research projects based on common priority areas.