Is physical restraint unethical and illegal?: a qualitative analysis of Korean written judgments.

BACKGROUND: Physical restraint (PR) is used to ensure the safety of care recipients. However, this causes an ethical dilemma between the autonomy and dignity of the recipients and the provision of effective treatment by health workers. This study aimed to analyze legal and ethical situations related to the use of PR using written judgments. METHODS: This study uses a qualitative retrospective design. Qualitative content analysis was performed on South Korean written judgments. A total of 38 cases from 2015 to 2021 were categorized. The types of court decisions and ethical dilemma situations were examined according to the four principles of bioethics, and the courts' judgments were compared. RESULTS: Written judgments related to PR were classified into three types according to the appropriateness of PR use, the presence or absence of duty of care, and legal negligence. Ethical dilemmas were categorized into three situations depending on whether the four principles of bioethics were followed. The courts' decisions regarding the ethical dilemmas differed depending on the situational factors before and after the use of PR and the conflicting conditions of the ethical principles. CONCLUSIONS: Health workers should consider legal and ethical requirements when determining whether to use PR to provide the care recipient with the necessary treatment.

Factors Influencing Suicidal Ideation in Korean Youth: A Secondary Data Study Using Longitudinal Data from the Korean Youth Panel Survey.

Background: Suicide is one of the most serious social problems in Korea. We examined suicidal ideation factors among Korean youth. Methods: For risk factor identification, data from the 2008 and 2018 Korean Youth Panel Survey were analyzed (n =6,568) using univariate multiple logistic regression analysis. Negative life events, feelings of hopelessness, early-life adversity, alcohol consumption, smoking, counseling experience, perceived stress, and current health status were independent variables, whereas suicidal ideation was the dependent variable. Results: Proximal (negative life events and feelings of hopelessness), distal (early-life adversities significantly influenced suicidal ideation), and health-related (alcohol consumption, counseling experience, perceived stress, and current health status) factors significantly influenced suicidal ideation among Korean youth. Conclusion: Mental health professionals must include distal risk factors, along with the common proximal and health-related risk factors, to provide targeted interventions.

Education program promoting report of elder abuse by nursing students: a pilot study.

BACKGROUND: Elder abuse is an important public health concern that requires urgent attention. One main barrier to active responses to elder abuse in clinical settings is a low level of relevant knowledge among nurses. This study aims to develop an educational program to promote an intent to report elder abuse among nursing students and assess its effectiveness, with a focus on the rights of older adults. METHODS: A mixed method design was used with the Analyze, Design, Develop, Implement, and Evaluate model. Twenty-five nursing students from Chungbuk Province participated in the study. Attitude toward older adults and knowledge of, awareness of, attitude towards, and intent to report elder abuse were assessed quantitatively and analyzed using paired t-test. The feasibility of the program and feedback were collected qualitatively through group interviews and analyzed using content analysis. RESULTS: After the education program, attitude toward older adults (Cohen's d = 1.08), knowledge of (Cohen's d = 2.15), awareness of (Cohen's d = 1.56), attitude towards (Cohen's d = 1.85), and intent to report elder abuse (Cohen's d = 2.78) increased, confirming the positive effects of this program. Overall, all participants were satisfied with the contents and method of the program. CONCLUSIONS: The method of program delivery should be improved and tailored strategies to boost program engagement among nursing students should be explored to implement and disseminate the program.

Classification of monthly tidal envelopes in mixed tide regimes.

Coastal inundation is increasing globally. Changes in tidal water levels contribute to flood risk alongside rain and sea storm events. Unlike the latter, temporal variations in tides may be predicted and their patterns analyzed many years in advance. This paper explains two novel methods for characterizing monthly scale patterns in tidal water level variation: one simple qualitative method with restricted applicability; and another more complex quantitative method with global applicability to areas characterized by mixed, mainly semidiurnal and mixed, mainly diurnal tide regimes (~ 65% of global oceans). We reveal that in some areas tidal high and low waters are balanced in near symmetrical patterns, while elsewhere tides are skewed towards upper or lower tidal height envelopes. Areas characterized by tidal patterns skewed towards upper envelopes are at heightened risk of extreme event inundations during certain periods each year, event scale risks that will increase with climate changes. Those skewed towards lower tidal envelopes are prone to frequent flooding and are potentially at greater risk of chronic inundation with ongoing mean sea level rise. Our findings and the novel tidal pattern classification approaches offered contribute to understanding the time varying nature of tidal contributions to coastal inundation risks.

Surviving Child Abuse in People With Mental Illness: A Grounded Theory Approach.

The aim of this qualitative study was to examine the process of surviving child abuse in people with a mental illness in order to develop an explanatory theory. The study utilized the grounded theory approach. Seventeen community-dwelling adults with a mental illness who had experienced child abuse were interviewed. For the in-depth interview, the lifeline interview method was used. Data were collected from July 14, 2019, to February 28, 2020. The constant comparative method was used for analysis, to identify similarities and differences between different statements, and similar phenomena or theories were compared and analyzed continuously. The central phenomena were "losing oneself" and "in a precarious state." Participants used "expressing," "standing on one's own feet," and "avoiding" as coping strategies. Observed outcomes were "making life work for them" and "living with others." The core category was "losing myself, embracing myself as someone in a precarious state, and being reborn as the master of my life." Positive religious coping, having a supportive network, and emotional or physical distance from difficult situations played a major role in surviving participants' experiences of child abuse and being victimized because of their mental illness. Our findings provide a theoretical basis for understanding people with mental illness who have survived child abuse, and suggest that opportunities for sharing their stories, facilitating self-reliance, and avoiding the causes of their difficulties all play a role in their healing process. Based on this study, it is expected that clinical experts and policy developers will be able to formulate evidence-based interventions and policies.

Intermediate cells of in vitro cellular reprogramming and in vivo tissue regeneration require desmoplakin.

Amphibians and fish show considerable regeneration potential via dedifferentiation of somatic cells into blastemal cells. In terms of dedifferentiation, in vitro cellular reprogramming has been proposed to share common processes with in vivo tissue regeneration, although the details are elusive. Here, we identified the cytoskeletal linker protein desmoplakin (Dsp) as a common factor mediating both reprogramming and regeneration. Our analysis revealed that Dsp expression is elevated in distinct intermediate cells during in vitro reprogramming. Knockdown of Dsp impedes in vitro reprogramming into induced pluripotent stem cells and induced neural stem/progenitor cells as well as in vivo regeneration of zebrafish fins. Notably, reduced Dsp expression impairs formation of the intermediate cells during cellular reprogramming and tissue regeneration. These findings suggest that there is a Dsp-mediated evolutionary link between cellular reprogramming in mammals and tissue regeneration in lower vertebrates and that the intermediate cells may provide alternative approaches for mammalian regenerative therapy.

Suicidal ideation and suicide attempts among university students in South Korea during the COVID-19 pandemic: the application of interpersonal-psychological theory and early maladaptive schema.

Background: This study examined the application of interpersonal-psychological theory and early maladaptive schema of suicidal ideation and suicide attempts in South Korean university students. Methods: In this cross-sectional study, data from 367 university students were surveyed using the Interpersonal Needs Questionnaire, Early Maladaptive Schema, Suicide Ideation Scale, and the Acquired Capability for Suicide Scale. Data were collected between June 21 and July 21, 2021. Results: University students' interpersonal needs and early maladaptive schema were significantly associated with suicidal ideation, and influencing suicide attempts. The acquired capability for suicide moderated the relationship between suicidal ideation and attempts. Conclusions: In suicide prevention programs for university students, it is critical to consider their interpersonal needs and early maladaptive schema, and the acquired capability for suicide, to prevent suicidal ideation and attempts among them.

A Phenomenologic Study of the Experiences of Pediatric Cancer Survivors After Hematopoietic Stem Cell Transplantation.

PURPOSE: To explore the experiences of pediatric cancer survivors in South Korea after hematopoietic stem cell transplantation. PARTICIPANTS & SETTING: 14 survivors of childhood cancer who had undergone hematopoietic stem cell transplantation at a pediatric hematopoietic stem cell transplantation center. METHODOLOGIC APPROACH: Participants underwent in-depth face-to-face or online interviews from October 2020 to January 2021. Data were analyzed following Giorgi's descriptive phenomenologic research method. FINDINGS: The following four themes emerged: regaining physical strength, a wish to express the overwhelming burden, cultivating positive thinking through reflection, and living a self-directed life. Pediatric cancer survivors experienced deep appreciation toward surroundings and everyday life, engaged in broader and greater positive thinking, and strived to live a self-directed life despite physical limitations and negative emotions. IMPLICATIONS FOR NURSING: Interventions enabling pediatric cancer survivors to express challenges and help them recover physical fitness are needed to improve their post-transplantation quality of life. These results can inform healthcare providers, nurses, and the general community to provide high-quality care to cancer survivors.

Factors associated with psychosocial problems in Korean nursing and non-nursing students during the COVID-19 pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has changed our lives in many ways, including school closures and social distancing practices. These abrupt life changes may have led to psychosocial problems in college students. This study aimed to identify the factors associated with psychosocial problems in South Korean nursing and non-nursing students. METHODS: This descriptive cross-sectional survey was conducted with 139 nursing and 147 non-nursing students (N = 286) between August 6 and October 30, 2020. We investigated participants' general characteristics (that is, sociodemographic and health-promoting behaviors), sensitivity to COVID-19 infection, COVID-19 pandemic response indicators, and psychosocial problems. The factors associated with psychosocial problems were determined using multiple regression analysis. RESULTS: Among the COVID-19 pandemic response indicators, perceived health status during the COVID-19 pandemic was verified as a factor associated with psychosocial problems in nursing (ß =  - 5.831, p < .001) and non-nursing students (ß =  - 8.513, p < .001). Perceived stress (ß = 1.263, p = .045), trust in policy (ß = .892, p < .001), and religion (ß =  - 1.424, p = .004) were verified as correlates of psychosocial problems in non-nursing students. CONCLUSION: As the COVID-19 pandemic continues, the stakeholders can use our study results to identify students experiencing psychosocial problems and subsequently as a theoretical background for developing intervention programs for those at a high risk of psychosocial problems. Additionally, it can be used as primary data for future research and practice regarding COVID-19 guidelines among students.

Development and validity of the Korea psychiatric triage algorithm.

BACKGROUND: Psychiatric emergencies require timely intervention because of the risk of harm to individuals and society, including others. The aim of the present study was to test the content validity of a psychiatric triage algorithm developed for use in South Korea. METHODS: The initial algorithm was developed through systematic literature review. Its validity was then verified by 10 experts. Based on results of expert validity, the algorithm was modified and the final algorithm was developed. RESULTS: Its clinical validity was then verified by 37 emergency room nurses who had used triage. Four questions of expert validity results with a CVI of 0.8 or less were revised to reflect expert opinion. The usefulness, adequacy, and convenience of the final modified algorithm was 2.98 ~ 3.53. CONCLUSION: After sufficiently validated by follow-up studies, it is expected that the use of psychiatric classification algorithms in emergency room nurses will not only improve the quality of care, but also can improve patient outcomes and experience.

Educational needs related to elder abuse among undergraduate nursing students in Korea: An importance-performance analysis.

BACKGROUND: Elder abuse is a prominent social issue and is a particularly grave problem in increasingly aging societies. Provision of appropriate elder abuse education programs for undergraduate nursing students, who are the future healthcare providers, can aid the detection of elder abuse by strengthening their practical knowledge. OBJECTIVES: The purpose of this study was to conduct an importance-performance analysis (IPA) on the educational content related to elder abuse among undergraduate nursing students in Korea. DESIGN: Cross-sectional design with a questionnaire survey. SETTING: Nursing department in the Chungcheong region of South Korea. PARTICIPANTS: A total of 324 undergraduate nursing students participated. METHODS: The IPA and Borich needs assessment of undergraduate nursing students' perceptions of elder abuse education were conducted. RESULTS: The IPA analysis indicated that quadrant I demonstrated high levels of both importance and performance. The results of the Borich needs assessment, which analyzed the order of priority of the educational needs, also indicated that the factors that ranked high in the order of priority belonged to quadrant 1 (strengthening maintenance) and quadrant 4 (concentrated investment), consistent with the IPA results. The results of the locus for focus model identified the elder abuse education topics' first and second priority groups. Educational themes such as "understanding of laws regarding elder abuse and ways of reporting it" were revealed to be the highest priority, and themes such as "human rights of the elderly" and "types and cases of elder abuse" received the second priority. CONCLUSIONS: Courses regrading elder abuse that include the educational needs, identified the by undergraduate nursing students, are required to improve the professional ability of nurses who care for the elderly.

The applicability of the interpersonal-psychological theory of suicide among community-dwelling older persons.

INTRODUCTION: This study examined the application of the interpersonal-psychological theory of suicide to community-dwelling older persons in South Korea. METHODS: A cross-sectional study design was used. The data were collected by surveying 200 older persons (117 female, 83 male) aged over 65 years at welfare centers for older persons. The Interpersonal Needs Questionnaire, the Suicidal Ideation Scale, and the Acquired Capability for Suicide Scale were used to assess participants' thwarted belongingness, perceived burdensomeness, suicidal ideation, attempts, and the capability for suicide. Structural equation modeling was used to examine the fitness of a model based on the interpersonal-psychological theory of suicide. This theory described that perceived burdensomeness and thwarted belongingness lead to suicidal ideation, which is transformed into suicide attempts through an acquired capability for suicide. RESULTS: Perceived burdensomeness was significantly associated with suicidal ideation among older persons, whereas thwarted belongingness was not. Furthermore, suicidal ideation influenced suicide attempts. The acquired capability for suicide moderated the relationship between suicidal ideation and suicide attempts. CONCLUSIONS: To prevent suicidal ideation and suicide attempts among older persons, it is important to prevent them from feeling that they are a burden.

The Werther effect of celebrity suicides: Evidence from South Korea.

Since 2003 Korea has experienced the highest suicide rate among OECD countries. One of the societal risk factors that triggers suicide is the contagious nature of suicide. This paper empirically examines the effect of celebrity suicide reports on subsequent copycat suicides, using daily suicide data and information of highly publicized suicide stories in Korea from 2005 to 2018. The findings from the Poisson regression model suggest that the number of public suicides soars after media reports on celebrity suicides. On average, the number of suicides in the population increased by 16.4% within just one day after the reports. Further analysis reveals that female and younger subgroups are more likely to be affected by celebrity suicides. Moreover, the public reacts more strongly to suicide incidents of celebrities of the same gender and even imitates the methods of suicide used by celebrities. This paper highlights the significance of careful and responsible media coverage of suicide stories to prevent copycat suicide. For policymakers, it is crucial to implement regulations not only for traditional media but also for new media where younger people can freely access unfiltered information.

Risk factors for self-harm in psychiatric wards: A judicial case analysis.

Patients hospitalized in a psychiatric ward may engage in self-injurious behavior secretly, leading to fatal consequences. This study aimed to identify risk factors for self-harm in psychiatric wards. In this review, the framework of Taylor and Hignett's medical malpractice analysis was utilized. In the search conducted from March to April 2020, keywords were used to collect relevant judgments and previous studies. The final assessment comprised of 5 cases and 13 previous studies. The results of this study emphasize the creation of a ward environment where inpatients can feel secure, and the staff can actively engage in therapeutic communication.

Intimate Partner Violence Victimization Influences Suicidal Ideation via Interpersonal Dependency and Anger.

BACKGROUND: Intimate partner violence is a serious global social problem. While intimate partner violence is highly prevalent, few studies have examined its negative outcomes among victims in South Korea. The aim was to clarify the mediating roles of interpersonal dependency and anger on the relationship between intimate partner violence victimization and suicidal ideation. METHODS: In this descriptive, cross-sectional study, 301 participants (203 women and 98 men) aged 18-65 yr completed an online questionnaire on a social networking site. Data were collected between Feb and Mar 2017 in South Korea. Structural equation modeling was used to test the fitness of the conceptual model of this study. RESULTS: We found significant correlations between intimate partner violence victimization, interpersonal dependency, state-trait anger, and suicidal ideation. Intimate partner violence victimization influenced anger and suicidal ideation only when the victims had high interpersonal dependency. CONCLUSION: It is necessary to develop programs for reducing interpersonal dependency and improving anger management that are specifically targeted at intimate partner violence victims to prevent suicidal ideation.

Simplified Brain Organoids for Rapid and Robust Modeling of Brain Disease.

Although brain organoids are an innovative technique for studying human brain development and disease by replicating the structural and functional properties of the developing human brain, some limitations such as heterogeneity and long-term differentiation (over 2 months) impede their application in disease modeling and drug discovery. In this study, we established simplified brain organoids (simBOs), composed of mature neurons and astroglial cells from expandable hPSC-derived primitive neural stem cells (pNSCs). simBOs can be rapidly generated in 2 weeks and have more homogeneous properties. Transcriptome analysis revealed that three-dimensional (3D) environment of simBOs facilitates the conversion of pNSCs to mature neuronal systems compared to a two-dimensional environment in the context of neurotransmitter release, synaptic vesicle formation, ion channels, calcium signaling, axonal guidance, extracellular matrix organization, and cell cycle. This result was correlated with the translocation of YAP1 into the cytoplasm by sensing matrix stiffness on the 3D models. Furthermore, we demonstrated that simBOs could easily be specified into midbrain-like simBOs by treatment with Shh and FGF8. Midbrain-like simBOs from a Parkinson's disease patient (LRRK2 G2019S)-derived pNSCs and gene-corrected (LRRK2 WT ) control pNSCs represented disease-associated phenotypes in terms of increased LRRK2 activity, decreased dopaminergic neurons, and increased autophagy. Treatment with the LRRK2 inhibitor, PFE-360, relieved the phenotype of Parkinson's disease in midbrain-like simBOs. Taken together, these approaches could be applied to large-scale disease models and alternative drug-testing platforms.

Comparison of COVID-19 and MERS Risk Communication in Korea: A Case Study of TV Public Service Advertisements.

PURPOSE: In recent years, the world has been under threat of novel infectious diseases such as Middle East respiratory syndrome (MERS) and coronavirus disease 2019 (COVID-19). Governmental risk communication plays a key role in overcoming the public health crises caused by the emergence of these infectious diseases. The purpose of this study was to identify the focus of Korean public service advertisements (PSAs) in response to the MERS and COVID-19 outbreaks, along with the differences between them. METHODS: A total of five MERS and 17 COVID-19 TV PSAs were analyzed using Lasswell's Sender, Message, Channel, Receiver, and Effect model and the responses of the Korean government were compared between the MERS and COVID-19 outbreaks. RESULTS: During the MERS outbreak, the Korean government failed to gain the public's trust through its PSAs. Despite its best efforts, it provided opaque and selective information on the crisis. Conversely, in the case of COVID-19, the Korean government has successfully worked to strengthen community awareness by supporting and encouraging the public. CONCLUSION: Despite the Korean government's improved communication in the COVID-19 crisis, there has been an insufficient response to the needs of vulnerable groups that could be placed in at-risk situations as a result of domestic violence or mental health problems during outbreaks of novel infectious diseases that require aggressive management.

Post-translational regulation of the major drug transporters in the families of organic anion transporters and organic anion-transporting polypeptides.

The organic anion transporters (OATs) and organic anion-transporting polypeptides (OATPs) belong to the solute carrier (SLC) transporter superfamily and play important roles in handling various endogenous and exogenous compounds of anionic charge. The OATs and OATPs are often implicated in drug therapy by impacting the pharmacokinetics of clinically important drugs and, thereby, drug exposure in the target organs or cells. Various mechanisms (e.g. genetic, environmental, and disease-related factors, drug-drug interactions, and food-drug interactions) can lead to variations in the expression and activity of the anion drug-transporting proteins of OATs and OATPs, possibly impacting the therapeutic outcomes. Previous investigations mainly focused on the regulation at the transcriptional level and drug-drug interactions as competing substrates or inhibitors. Recently, evidence has accumulated that cellular trafficking, post-translational modification, and degradation mechanisms serve as another important layer for the mechanisms underlying the variations in the OATs and OATPs. This review will provide a brief overview of the major OATs and OATPs implicated in drug therapy and summarize recent progress in our understanding of the post-translational modifications, in particular ubiquitination and degradation pathways of the individual OATs and OATPs implicated in drug therapy.

Direct Reprogramming to Human Induced Neuronal Progenitors from Fibroblasts of Familial and Sporadic Parkinson's Disease Patients.

In Parkinson's disease (PD) research, human neuroblastoma and immortalized neural cell lines have been widely used as in vitro models. The advancement in the field of reprogramming technology has provided tools for generating patient-specific induced pluripotent stem cells (hiPSCs) as well as human induced neuronal progenitor cells (hiNPCs). These cells have revolutionized the field of disease modeling, especially in neural diseases. Although the direct reprogramming to hiNPCs has several advantages over differentiation after hiPSC reprogramming, such as the time required and the simple procedure, relatively few studies have utilized hiNPCs. Here, we optimized the protocol for hiNPC reprogramming using pluripotency factors and Sendai virus. In addition, we generated hiNPCs of two healthy donors, a sporadic PD patient, and a familial patient with the LRRK2 G2019S mutation (L2GS). The four hiNPC cell lines are highly proliferative, expressed NPC markers, maintained the normal karyotype, and have the differentiation potential of dopaminergic neurons. Importantly, the patient hiNPCs show different apoptotic marker expression. Thus, these hiNPCs, in addition to hiPSCs, are a favorable option to study PD pathology.

Efficient exogenous DNA-free reprogramming with suicide gene vectors.

Reprogramming with episomal vectors is an easy, safe, and cost-effective method to generate exogenous DNA-free (exogene-free) induced pluripotent stem cells (iPSCs). However, the genomic integration of exogenes is observed occasionally. Additionally, the removal of episomal DNA takes more than 70 days in established iPSCs. Here, we inserted the cytosine deaminase (CD) gene from yeast into episomal vectors and used them to reprogram human fibroblasts into iPSCs. These new episomal vectors (CD episomal vectors) were eliminated from the generated iPSCs as early as seven days after 5-fluorocytosine (5-FC) treatment. We also found that cells with the integration of the CD gene perished within two days of 5-FC treatment. In addition, we generated exogene-free induced neural stem cells after one passage by direct reprogramming with CD episomal vectors combined with 5-FC treatment. Conclusively, our novel method allows the rapid and easy isolation of exogene-free reprogrammed cells and can be applied to disease modeling and clinical applications.