Thrombospondin-1 promotes fibro-adipogenic stromal expansion and contractile dysfunction of the diaphragm in obesity.

Pulmonary disorders affect 40%-80% of individuals with obesity. Respiratory muscle dysfunction is linked to these conditions; however, its pathophysiology remains largely undefined. Mice subjected to diet-induced obesity (DIO) develop diaphragm muscle weakness. Increased intradiaphragmatic adiposity and extracellular matrix (ECM) content correlate with reductions in contractile force. Thrombospondin-1 (THBS1) is an obesity-associated matricellular protein linked with muscular damage in genetic myopathies. THBS1 induces proliferation of fibro-adipogenic progenitors (FAPs) - mesenchymal cells that differentiate into adipocytes and fibroblasts. We hypothesized that THBS1 drives FAP-mediated diaphragm remodeling and contractile dysfunction in DIO. We tested this by comparing the effects of dietary challenge on diaphragms of wild-type (WT) and Thbs1-knockout (Thbs1-/-) mice. Bulk and single-cell transcriptomics demonstrated DIO-induced stromal expansion in WT diaphragms. Diaphragm FAPs displayed upregulation of ECM and TGF-ß-related expression signatures and augmentation of a Thy1-expressing subpopulation previously linked to type 2 diabetes. Despite similar weight gain, Thbs1-/- mice were protected from these transcriptomic changes and from obesity-induced increases in diaphragm adiposity and ECM deposition. Unlike WT controls, Thbs1-/- diaphragms maintained normal contractile force and motion after DIO challenge. THBS1 is therefore a necessary mediator of diaphragm stromal remodeling and contractile dysfunction in overnutrition and a potential therapeutic target in obesity-associated respiratory dysfunction.

Implication of TIPE2 Expression on the Malignant Transformation of Oral Leukoplakia.

BACKGROUND/AIM: Identification of biomarkers involved in the malignant transformation of oral leukoplakia (OL) is required for the early diagnosis and management of patients with OL. This study aimed to evaluate the functions of tumor necrosis factor-alpha-induced protein 8-like 2 (TIPE2) expression in the malignant transformation of OL. MATERIALS AND METHODS: The expression levels of TIPE2 and dormant cell markers phospho-ERK and phospho-p38 in a cohort containing 103 surgical specimens from patients with OL were evaluated using immunohistochemistry. The influence of TIPE2 expression on the biological behavior of the immortalized human oral keratinocyte (IHOK) line was investigated in vitro. RESULTS: Increased TIPE2 expression was detected in 40 (38.8%) patients with OL. In a multivariate analysis using clinicopathological variables and TIPE2 expression as cofactors, the presence of dysplasia (p=0.003) and TIPE2 abundance (p=0.019) were identified as independent risk factors for the malignant transformation of OL. Moreover, the in vitro analysis revealed that TIPE2 knockdown can promote the proliferating ability of IHOK; however, the number of apoptotic cells also increased after TIPE2 knockdown in IHOK. Furthermore, TIPE2 expression was significantly associated with phospho-p38 expression, a dormant cell marker, in our cohort (p=0.047). CONCLUSION: TIPE2 expression may contribute to the malignant transformation of OL, and its function may be related to cellular dormancy in OL pathogenesis.

Machine Learning-Based Prediction of Abdominal Subcutaneous Fat Thickness During Pregnancy.

Objective: Current evidence regarding the safety of abdominal subcutaneous injections in pregnant women is limited. In this study, we developed a predictive model for abdominal skin-subcutaneous fat thickness (S-ScFT) by gestational periods (GP) in pregnant women. Methods: A total of 354 cases were measured for S-ScFT. Three machine learning algorithms, namely deep learning, random forest, and support vector machine, were used for S-ScFT predictive modeling and factor analysis for each abdominal site. Data analysis was performed using SPSS and RapidMiner softwares. Results: The deep learning algorithm best predicted the abdominal S-ScFT. The common important variables in all three algorithms for the prediction of abdominal S-ScFT were menarcheal age, prepregnancy weight, prepregnancy body mass index (categorized), large fetus for gestational age, and alcohol consumption. Conclusion: Predicting the safety of subcutaneous injections during pregnancy could be beneficial for managing gestational diabetes mellitus in pregnant women.

Thrombospondin-1 promotes fibro-adipogenic stromal expansion and contractile dysfunction of the diaphragm in obesity.

Pulmonary disorders impact 40-80% of individuals with obesity. Respiratory muscle dysfunction is linked to these conditions; however, its pathophysiology remains largely undefined. Mice subjected to diet-induced obesity (DIO) develop diaphragmatic weakness. Increased intra-diaphragmatic adiposity and extracellular matrix (ECM) content correlate with reductions in contractile force. Thrombospondin-1 (THBS1) is an obesity-associated matricellular protein linked with muscular damage in genetic myopathies. THBS1 induces proliferation of fibro-adipogenic progenitors (FAPs)-mesenchymal cells that differentiate into adipocytes and fibroblasts. We hypothesized that THBS1 drives FAP-mediated diaphragm remodeling and contractile dysfunction in DIO. We tested this by comparing effects of dietary challenge on diaphragms of wild-type (WT) and Thbs1 knockout ( Thbs1 -/- ) mice. Bulk and single-cell transcriptomics demonstrated DIO-induced stromal expansion in WT diaphragms. Diaphragm FAPs displayed upregulation of ECM and TGFß-related expression signatures, and augmentation of a Thy1 -expressing sub-population previously linked to type 2 diabetes. Despite similar weight gain, Thbs1 -/- mice were protected from these transcriptomic changes, and from obesity-induced increases in diaphragm adiposity and ECM deposition. Unlike WT controls, Thbs1 -/- diaphragms maintained normal contractile force and motion after DIO challenge. These findings establish THBS1 as a necessary mediator of diaphragm stromal remodeling and contractile dysfunction in overnutrition, and potential therapeutic target in obesity-associated respiratory dysfunction.

High-Strength Epoxy Nanocomposites Reinforced with Photochemically Treated CNTs.

A carbon nanotube (CNT)/epoxy nanocomposite was prepared using a photochemical surface modification process of CNTs. The vacuum ultraviolet (VUV)-excimer lamp treatment created reactive sites on the CNT surface. Increasing the irradiation time increased the oxygen functional groups and changed the oxygen bonding state such as C=O, C-O, and -COOH. By the VUV-excimer irradiation on CNTs, the epoxy infiltrated well between the CNT bundles and formed a strong chemical bond between CNT and epoxy. The tensile strength and elastic modulus of the nanocomposites with VUV-excimer irradiated sample during 30 min (R30) were found to increase by 30 and 68% compared to using pristine CNT, respectively. R30 was not pulled out and remained embedded in the matrix until the fracture occurred. The VUV-excimer irradiation is an effective surface modification and functionalization method for improving the mechanical properties of CNT nanocomposite materials.

Oral Squamous Cell Carcinoma-Derived ANGPTL3 Induces Cancer Associated Fibroblastic Phenotypes in Surrounding Fibroblasts.

OBJECTIVE: Angiopoietin-like proteins (ANGPTLs) have emerged as both important regulator of lipid and glucose metabolism as well as insulin sensitivity. In particular, ANGPTL3 activity is one of the most important factors in cancer growth and invasion. Although ANGPTL3 have been studied in OSCC, but the role of ANGPTL3 between OSCC and CAFs has yet to be clearly defined. Thus, this study aimed to investigate the roles of ANGPTL3 in the differentiation of CAFs. METHODS: For our study, we used hTERT-hNOFs to replace CAFs by coculturing them with oral squamous cell carcinoma (OSCC) cells. We did a microarray dataset analysis to investigate what factors secreted from OSCC cells can induce cancer associated fibroblastic phenotype in surrounding fibroblasts. The secreted factors were confirmed by RT-PCR, real-time PCR, and Western blot. RESULT: ANGPTL3 has the most secreted factor derived from various oral cancer cells. To investigate the role of ANGPTL3 in CAFs, we treated rhANGPTL3 in hTERT-hNOFs. The fibroblasts showed an increase of tumor-promoting cytokines (IL-6 and IL-8) and myofibroblastic markers, such as α-SMA and FAP. CONCLUSION: In conclusion, our study reports the first evidence that ANGPTL3 plays a crucial role in tumor microenvironments by inducing CAF. Therefore, targeting ANGPTL3 may be promising treatment strategy for CAF-targeted therapy in CAF-rich tumors.

[An Analysis of Tasks of Nurses Caring for Patients with COVID-19 in a Nationally-Designated Inpatient Treatment Unit].

PURPOSE: The purpose of this study was to provide foundational knowledge on nursing tasks performed on patients with COVID-19 in a nationally-designated inpatient treatment unit. METHODS: This study employs both quantitative and qualitative approaches. The quantitative method investigated the content and frequency of nursing tasks for 460 patients (age ≥ 18 y, 57.4% men) from January 20, 2020, to September 30, 2021, by analyzing hospital information system records. Qualitative data were collected via focus group interviews. The study involved interviews with three focus groups comprising 18 nurses overall to assess their experiences and perspectives on nursing care during the pandemic from February 3, 2022, to February 15, 2022. The data were examined with thematic analysis. RESULTS: Overall, 49 different areas of nursing tasks (n = 130,687) were identified based on the Korean Patient Classification System for nurses during the study period. Among the performed tasks, monitoring of oxygen saturation and measuring of vital signs were considered high-priority. From the focus group interview, three main themes and eleven sub-themes were generated. The three main themes are "Experiencing eventfulness in isolated settings," "All-around player," and "Reflections for solutions." CONCLUSION: During the COVID-19 pandemic, it is imperative to ensure adequate staffing levels, compensation, and educational support for nurses. The study further propose improving guidelines for emerging infectious diseases and patient classification systems to improve the overall quality of patient care.

High Purity Single Wall Carbon Nanotube by Oxygen-Containing Functional Group of Ferrocene-Derived Catalyst Precursor by Floating Catalyst Chemical Vapor Deposition.

Single wall carbon nanotubes (SWCNTs) were synthesized using oxygen-containing ferrocene derived catalysts. The mechanism of synthesizing carbon nanotubes was clarified by the catalyst's exothermic or endothermic decomposition processes. By monitoring the decomposition process of ferrocene-derived catalyst precursors with and without sulfur, we found that the types of oxygen function groups closely influence catalyst formation and nanotube growth. The ferrocene-derived catalyst precursors have a different oxygen containing groups, which are hydroxyl (−OH, ferrocenenemethanol) and carbonyl (C=O, acetylferrocene, and 1,1'-diacetylferrocene). The sulfur chemical state (S 2p) on synthesized catalyst particles using acetylferrocene and 1,1'-diacetylferrocene has more sulfate (SO42−) than others, and there also is a carbon state (C-S-C). The catalyst particle using ferrocenemethanol predominant formed metal−sulfur bonds (such as S2− and Sn2−). The hydroxyl group (−OH) of ferrocenemethanol enhanced the etching effect to remove amorphous carbon and prevented oxidation on the catalyst particle surfaces; however, the carbonyl group (C=O) of acetylferrocene reacted with the catalyst particles to cause partial oxidation and carbon dissociation on the surface of the catalyst particles. The partial oxidation and carbon contamination on catalyst particles controlled the activity of the catalyst. The DFT study revealed that the ferrocene-derived catalyst precursor was dissociated according to following process: the functional groups (such as CH3CO and COH) => first Cp ligands => second Cp ligands. The pyrolysis and release of Fe ions were delayed by the functional groups of ferrocene-derived precursors compared to ferrocene. The thermal-decomposition temperature of the catalyst precursor was high, the decomposition time was be delayed, affecting the formation of catalyst particles and thus making smaller catalyst particles. The size and composition of catalyst particles not only affect the nucleation of CNTs, but also affect physical properties. Therefore, the IG/ID ratio of the CNTs changed from 74 to 18 for acetylferrocene and ferrocene, respectively. The purity also increased from 79 to 90% using ferrocene-derived precursors.

Response to the coronavirus disease 2019 pandemic of dental hygienists in South Korea-Part â : Knowledge and practice of infection control.

OBJECTIVES: To evaluate infection control knowledge and its practice of clinical dental hygienists in response to Coronavirus Disease 2019 (COVID-19) in South Korea. METHODS: Nine questions (Q9-K) on the degree of knowledge acquisition of dental hygienists in response to COVID-19, and another 9 questions (Q9-P) on the practices for COVID-19 infection and spread prevention were prepared. From 500 clinical dental hygienists in South Korea, answers about their general characteristics, Q9-K, and Q9-P were collected. 1 point was given to each question based on the 'yes' answers from Q9-K and Q9-P, and Score-K and Score-P were calculated, respectively. To identify factors affecting Score-P, a multiple linear regression analysis was performed. In all analyses, p-values lower than 0.05 were considered statistically significant. RESULTS: Average scores of Score-K and Score-P were 7.36 ± 1.35 and 6.26 ± 2.07, respectively. The regression model of Score-P was significant (F = 20.788, p < 0.001). Concerning Score-P, Score-K (ß = 0.385), age (ß = 0.275), dental hospital (ß = 0.158), monthly income of $2,360~$2,730 (ß = 0.104) had a significantly positive correlation, and the total years of career (ß = -0.293) are found to have a significantly negative correlation. CONCLUSIONS: Infection control knowledge and practice of clinical dental hygienists in South Korea was found to be vulnerable in the group of hygienists who are younger than 27 years old, working in dental clinics, and whose monthly income is less than under $2,000. Also, the factor that influences infection control practice the most was the degree of knowledge. Therefore, continuous infection control education and supplement targeting these vulnerable groups are necessary.

Factors Related to Long-term Hospital Length of Stay and Opinions on Discharge-related Community-based Medical and Welfare Service on Elderly Patients with Chronic Diseases in Korean Veterans Hospitals

Purpose@#This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. @*Methods@#The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. @*Results@#The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion.These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). @*Conclusion@#In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.

[Effectiveness of Drinking Reduction Program Focused on Self-Determination Enhancement for College Students with Problematic Drinking].

PURPOSE: This study examined the impact of a drinking reduction program on drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors in college students with problematic drinking habits. METHODS: This study incorporated a non-equivalent control group prepost-test design. Study participants included 58 college students who scored 12 or more in the AUDIT-K test (Alcohol Use Disorders Identification Test-Korean version) (experimental group: 30; control group: 28). The intervention consisted of eight sessions and was conducted once a week. It was designed to promote autonomy, competence, and relatedness-the three elements of basic psychological needs in self-determination theory. The participants were assessed before the intervention, immediately after, and four weeks post intervention. Data were collected from October 12 to December 31, 2017. The analysis employed the chi-square test, Fisher's exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 22.0. RESULTS: The mean age of participants was 21.8 years. There were 30 men (51.7%) and 28 women (48.3%). The differences in drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors were statistically significant for the group by time interaction (F = 42.56, p < .001; F = 54.96, p < .001; F = 39.90, p < .001, respectively). CONCLUSION: The findings indicate that the intervention effectively decreases drinking motivation, increases drinking refusal self-efficacy, and decreases problematic drinking behaviors. It can be an efficient strategy for college students with problematic drinking habits to enhance their self-determination ability.

Tunable Synthesis of Predominant Semi-Ionic and Covalent Fluorine Bonding States on a Graphene Surface.

In this study, fluorinated graphene (FG) was synthesized via a hydrothermal reaction. Graphene oxides (GOs) with different oxygen bonding states and oxygen contents (GO(F), GO(P), and GO(HU)) were used as starting materials. GO(F) and GO(P) are commercial-type GOs from Grapheneall. GO(HU) was prepared using a modified Hummers method. The synthesized FGs from GO(F), GO(P), and GO(HU) are denoted as FG(F), FG(P), and FG(HU), respectively. The F atoms were bound to the graphene surface with predominantly semi-ionic or covalent bonding depending on the GO oxygen state. FG(F) and FG(HU) exhibited less extensive fluorination than FG(P) despite the same or higher oxygen contents compared with that in FG(P). This difference was attributed to the difference in the C=O content of GOs because the C=O bonds in GO primarily produce covalent C-F bonds. Thus, FG(F) and FG(HU) mainly exhibited semi-ionic C-F bonds. The doped F atoms were used to tune the electronic properties and surface chemistry of graphene. The fluorination reaction also improved the extent of reduction of GO.

The Effect of a Non-Invasive Positive Pressure Ventilation Simulation Program on General Ward Nurses' Knowledge and Self-Efficacy.

The purpose of this study is to develop a simulation-based ventilator training program for general ward nurses and identify its effects. Quantitative data were collected from 29 nurses (intervention group: 15, control group: 14), of which seven were interviewed with focus groups to collect qualitative data. The quantitative results revealed significant differences in ventilator-related knowledge (p = 0.029) and self-efficacy (p = 0.026) between the intervention and control groups. Moreover, three themes were derived from meaningful statements in the qualitative data: understanding psychophysical discomfort of the patient while applying the ventilator; helping in ventilator care; and establishing a future ventilator training strategy. The findings confirmed that the non-invasive positive pressure ventilation (NPPV) simulation program is an effective method for improving the knowledge of ventilator nursing and self-efficacy and will be helpful in developing educational methods and strategies related to ventilator nursing for general ward nurses.

Risk Factors for Fall-Related Serious Injury among Korean Adults: A Cross-Sectional Retrospective Analysis.

The purpose of this study was to identify the risk factors of serious fall-related injuries by analyzing the differences between two fall groups: one with serious fall-related injuries and one without such injuries. Applying a retrospective, descriptive investigation study design, we analyzed the degree of fall-related injury and the risk factors related to serious falls by conducting a complete survey of the medical records of fall patients reported throughout one full year, 2017, at a tertiary hospital in Seoul, Korea. Among the patients with reported falls, 188 sustained no injury (63.1%), 72 sustained minor injury (24.2%), and 38 patients sustained serious injury (12.8%). The serious fall-related injuries included eight lacerations requiring suture (2.7%), 23 fractures (7.7%), five brain injuries (1.7%), and two deaths (0.7%). Analysis results indicated that taking anticoagulants/antiplatelet drugs (p = 0.016) and having a fall history (p = 0.038) were statistically significant in the differences between the group with serious injury related to falls and the group without serious injury. Logistic regression revealed that taking anticoagulant/antiplatelet drugs was the factor most significantly correlated with serious injuries related to falls (OR = 2.299, p = 0.022). Results show that it is necessary to develop a patient-tailored fall prevention activity program.

Abdominal skin subcutaneous fat thickness over the gestational period in Korean pregnant women: a descriptive observational study.

Purpose: Although insulin is usually injected into the abdominal subcutaneous fat, in pregnancy women tend to avoid abdominal injections due to concern about fetal damage. Prior studies have been limited to only measuring skin-subcutaneous fat thickness (S-ScFT) at one site at specific pregnancy points. This study aimed to measure S-ScFT across several abdominal sites and over the gestational period in Korean pregnant women. This can identify which site would be relatively safe for subcutaneous injection during pregnancy. Methods: Healthy women over 24 weeks of pregnancy in Korea were invited to voluntarily participate in this descriptive study. For the 142 women, S-ScFT of 12 sites in the abdomen were measured by ultrasound, several times over the pregnancy. Each incidence was treated as a case and a total of 262 cases were analyzed. Results: The mean S-ScFT during pregnancy was 1.14±0.47 cm (1.25±0.54 cm at 24+0-27+6 weeks; 1.17±0.48 cm at 28+0-31+6 weeks; 1.09+0.40 cm at 32+0-35+6 weeks; and 1.06±0.47 cm at 36+0-40 weeks of pregnancy). Most S-ScFT were thicker than 10 mm. But S-ScFTs in the lateral abdomen and some sites were suboptimal (<6 mm), especially in the pre-pregnancy underweight body mass index group, who had a high rate of suboptimal thickness (27.1% overall and 33.9% in the lateral side). Conclusion: The whole abdomen seems to be appropriate for subcutaneous injection in most Korean women during pregnancy, with a 4 to 5-mm short needle. However, for the lateral abdomen, making the skin fold might be needed for fetal safety.

Factors Affecting Turnover Intention of Nurses Working in Neonatal Intensive Care Units / 임상간호연구

Purpose@#This study was conducted to assess the factors affecting turnover intention of the nurses working in neonatal intensive care units, including the extent of fatigue, work stresses, and work overload related to infection control. @*Methods@#This was a descriptive correlational study to test factors affecting the turnover intention of the nurses working in neonatal intensive care units. Data was analyzed utilizing descriptive statistics, t-test, One-way ANOVA, Pearsons’ Correlation Coefficient, and multiple regressions by using the IBM SPSS Statistics 23.0 Program(IBM Corp., Armonk, NY). @*Results@#The turnover intention of nurses had a positive correlation with the extent of fatigue (r=.54, p<.001), work stress (r=.40, p<.001), and with the work overload (r=.43, p<.001) related to infection control. In addition, factors affecting the turnover intention of nurses included the extent of fatigue (β=.52, p<.001) related to infection control and the number of pediatric patients assigned to each nurse (β=.26, p=.001) and the variances explained by the regression model was 37.0%. @*Conclusion@#It is necessary to establish and implement strategies to lower the extent of fatigue related to infection control by reducing the nurses’ workload. Securing additional nurses to ensure an appropriate number of pediatric patients assigned to each nurse, and providing efficient management and available resources to reduce the turnover intention of nurses working in neonatal intensive care units are suggested.

Effectiveness of Drinking Reduction Program Focused on Self-Determination Enhancement for College Students with Problematic Drinking

Purpose@#This study examined the impact of a drinking reduction program on drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors in college students with problematic drinking habits. @*Methods@#This study incorporated a non-equivalent control group prepost-test design. Study participants included 58 college students who scored 12 or more in the AUDIT-K test (Alcohol Use Disorders Identification Test-Korean version) (experimental group: 30; control group: 28). The intervention consisted of eight sessions and was conducted once a week.It was designed to promote autonomy, competence, and relatedness-the three elements of basic psychological needs in self-determination theory. The participants were assessed before the intervention, immediately after, and four weeks post intervention. Data were collected from October 12 to December 31, 2017. The analysis employed the chi-square test, Fisher’s exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 22.0. @*Results@#The mean age of participants was 21.8 years. There were 30 men (51.7%) and 28 women (48.3%). The differences in drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors were statistically significant for the group by time interaction (F = 42.56, p < .001; F = 54.96, p < .001; F = 39.90, p < .001, respectively). Conclusion: The findings indicate that the intervention effectively decreases drinking motivation, increases drinking refusal self-efficacy, and decreases problematic drinking behaviors. It can be an efficient strategy for college students with problematic drinking habits to enhance their self-determination ability.

Effectiveness of Drinking Reduction Program Focused on Self-Determination Enhancement for College Students with Problematic Drinking

Purpose@#This study examined the impact of a drinking reduction program on drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors in college students with problematic drinking habits. @*Methods@#This study incorporated a non-equivalent control group prepost-test design. Study participants included 58 college students who scored 12 or more in the AUDIT-K test (Alcohol Use Disorders Identification Test-Korean version) (experimental group: 30; control group: 28). The intervention consisted of eight sessions and was conducted once a week.It was designed to promote autonomy, competence, and relatedness-the three elements of basic psychological needs in self-determination theory. The participants were assessed before the intervention, immediately after, and four weeks post intervention. Data were collected from October 12 to December 31, 2017. The analysis employed the chi-square test, Fisher’s exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 22.0. @*Results@#The mean age of participants was 21.8 years. There were 30 men (51.7%) and 28 women (48.3%). The differences in drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors were statistically significant for the group by time interaction (F = 42.56, p < .001; F = 54.96, p < .001; F = 39.90, p < .001, respectively). Conclusion: The findings indicate that the intervention effectively decreases drinking motivation, increases drinking refusal self-efficacy, and decreases problematic drinking behaviors. It can be an efficient strategy for college students with problematic drinking habits to enhance their self-determination ability.

Factors Affecting Turnover Intention of Nurses Working in Neonatal Intensive Care Units / 임상간호연구

Purpose@#This study was conducted to assess the factors affecting turnover intention of the nurses working in neonatal intensive care units, including the extent of fatigue, work stresses, and work overload related to infection control. @*Methods@#This was a descriptive correlational study to test factors affecting the turnover intention of the nurses working in neonatal intensive care units. Data was analyzed utilizing descriptive statistics, t-test, One-way ANOVA, Pearsons’ Correlation Coefficient, and multiple regressions by using the IBM SPSS Statistics 23.0 Program(IBM Corp., Armonk, NY). @*Results@#The turnover intention of nurses had a positive correlation with the extent of fatigue (r=.54, p<.001), work stress (r=.40, p<.001), and with the work overload (r=.43, p<.001) related to infection control. In addition, factors affecting the turnover intention of nurses included the extent of fatigue (β=.52, p<.001) related to infection control and the number of pediatric patients assigned to each nurse (β=.26, p=.001) and the variances explained by the regression model was 37.0%. @*Conclusion@#It is necessary to establish and implement strategies to lower the extent of fatigue related to infection control by reducing the nurses’ workload. Securing additional nurses to ensure an appropriate number of pediatric patients assigned to each nurse, and providing efficient management and available resources to reduce the turnover intention of nurses working in neonatal intensive care units are suggested.

How to Improve Patient Safety Literacy?

The aim of this comparative study involving pre- and post-tests was to analyze the effectiveness of patient safety educational materials developed for the Comprehensive Plans for Patient Safety in Korea (2018-2022), and to suggest how to improve patient safety literacy. A face-to-face survey interview comprising items related to general information and patient safety literacy was completed by 217 patients and their families who visited three general hospitals in Seoul and one general hospital in Gyeonggi-do for treatment between 25 October and 15 November 2019. In the interview, the patients were asked questions about whether the patient safety educational materials were "easy to understand," provided "help in safe hospitalization," and enabled patients to practice patient safety independently ("do it yourself"). The literacy of the patient safety educational materials was analyzed using a paired t-test with a p value of 0.05. The comparison between patient safety literacy on pre- and post-tests revealed that among all participants, there were significant differences in "easy to understand," "help in safe hospitalization," and "do it yourself" scores. To improve patient safety literacy, patient education materials need to optimize communication by improving patients' knowledge, skills, and attitudes for maintaining and promoting healthy living.