Nutritional Risk, Depression, and Physical Function in Older People Living Alone.

This study investigated depression and physical function as factors associated with nutritional risk in older adults living alone. The study included 2896 people 65 years or older who lived alone. Data were collected in South Korea between September and November 2020. Descriptive statistics, a chi-squared test, independent samples t-test, weighted multiple regression analysis, and binary logistic regression analysis were performed using IBM SPSS for Windows ver. 23.0. In this study, 44.8% of participants were in the nutritional risk group. Furthermore, 60.9% of those at risk for depression, 75.1% of those with instrumental activities of daily living (IADLs) dependency, and 59.1% of those with chewing limitations were at nutritional risk. The factors that increased nutritional risk in the weighted multiple regression analysis were depression (ß = 0.27, p < 0.001), chewing limitations (ß = 0.12, p < 0.001), IADL dependency (ß = 0.09, p < 0.001), and basic physical movement (ß = 0.04, p = 0.020). Binary logistic regression analysis showed that those with IADL dependency had a 2.59 times higher nutritional risk than those with IADL non-dependency (p < 0.001). The nutritional risk group had a higher risk of depression (2.01 times higher [p < 0.001]), chewing limitations (1.76 times higher [p < 0.001]), and basic physical movement limitations (1.35 times higher [p = 0.009]) than the good nutritional group. Therefore, nutritional screening is required of older individuals living alone. To mitigate nutritional risks, it is necessary to assess depression and physical function, including IADL dependency.

Social Interaction and Life Satisfaction among Older Adults by Age Group.

This study examined the effect of social interaction on life satisfaction in older adults. A total of 8188 participants were selected according to the inclusion criteria. SPSS Windows software (version 23.0) was used for statistical analyses. Data were analyzed using the independent samples t-test, chi-squared test, and multiple regression analysis with weights based on two age groups: 65-74 and ≥75 years. The results showed that social interaction factors influenced the life satisfaction of older adults. In the 65-74 age group, factors that statistically significantly increased life satisfaction were meeting children (ß = 0.17, p < 0.001) and volunteer activities (ß = 0.04, p = 0.007). In the ≥75 age group, factors that significantly increased life satisfaction were talking with friends (ß = 0.11, p = 0.002), talking with children (ß = 0.07, p = 0.013), using senior citizen community centers (ß = 0.08, p = 0.001), and hobby club activities (ß = 0.07, p = 0.001). In order to increase the life satisfaction of older adults, different ways to support social interactions need to be explored.

The Effects of Manual Acupuncture on Mitochondrial Fusion and Fission Gene Expression in Rat Spleen.

Background: A significant amount of research has been conducted to establish the validity of acupuncture, and it has been demonstrated through animal disease model studies that acupuncture influences mitochondrial changes. However, to more accurately examine the mechanisms of acupuncture treatment effectiveness in pathological models, it is crucial to investigate changes in disease-free animals. Among various hypotheses regarding the effects of acupuncture on the body, we focused on the result that acupuncture stimulation is related to mitochondria. Objectives: We examined the effects of acupuncture mitochondrial fission and fusionrelated mediators in disease-free Sprague Dawley (SD) rats' spleen meridian acupoints. Methods: SD rats were divided into control, SP1, SP2, SP3, SP5, and SP9 acupuncture groups. Acupuncture was performed at each point for 10 minutes daily for four days. Peroxisome proliferator-activated receptor-gamma coactivator 1-α (PGC-1α) and fission protein 1 (Fis1) levels were evaluated using quantitative real-time polymerase chain reaction (qRT-PCR), while dynamin-related protein 1 (DRP1), optic atrophy-1 (OPA1), mitofusin-1 (MFN1), and mitofusin-2 (MFN2) levels were assessed via western blotting. Mitochondria protein concentrations and NADH dehydrogenase activity in spleen tissues were measured using enzyme-linked immunosorbent assay (ELISA). Results: PGC-1α expression decreased in the SP1 (p < 0.01), SP5 (p < 0.05), and SP9 (p < 0.05) groups, while Fis1 expression increased in the SP1 (p < 0.01), SP5 (p < 0.01), and SP9 (p < 0.05) groups. DRP1, OPA1, MFN1, and MFN2 levels exhibited no significant changes. Mitochondrial protein concentrations decreased in the SP2 (p < 0.01), SP3 (p < 0.01), SP5 (p < 0.01), and SP9 (p < 0.01) groups, while NADH dehydrogenase activity decreased in the SP2 (p < 0.05) and SP9 (p < 0.05) groups. Conclusion: Acupuncture at the SP9 acupoint influenced the mitochondrial fission pathway by modulating PGC-1α and Fis1 mediators in the rat spleen under non-disease conditions.

Factors Related to Life Satisfaction of Older Adults at Home: A Focus on Residential Conditions.

This study examined which residential conditions increase older adults' life satisfaction at home. We used data from 8903 participants over 65 years old who did not need help in their daily lives from a 2020 survey of older adults conducted by the Korea Institute for Health and Social Affairs. Data analysis was conducted using descriptive statistics, independent sample t-test, Pearson correlation analysis, and hierarchical multiple regression with weights. The final model explained 34.2% of life satisfaction in old age. Residential conditions that increased life satisfaction the most in old age were the community environment (ß = 0.16, p < 0.001) and satisfaction with the house (ß = 0.15, p < 0.001). Other conditions that significantly affected life satisfaction were safety (ß = 0.08, p < 0.001), interaction with neighbors (ß = 0.08, p < 0.001), distance from children or relatives (ß = 0.08, p < 0.001), frequency and route of public transportation (ß = 0.05, p < 0.001), and abundance and distance of green spaces (ß = 0.02, p = 0.031). Housing welfare policies should consider these results to increase life satisfaction for an increasingly aging population. Moreover, these data can be used to design age-friendly community environments.

College Life Adjustment, Life Stress, Career Barriers, and Career Decision-Making Self-Efficacy of College Students Who Have Experienced COVID-19 in South Korea.

University life is challenging for students, given the college life adjustment, life stress, career barriers, and career decision-making self-efficacy required. COVID-19 has made this even more complex. This study investigated the relationships among these factors in college students who experienced COVID-19. Data were collected using an online cross-sectional structured survey of 1242 university students from December 2020 to January 2021. Data were analyzed via independent-sample t-tests, one-way ANOVAs, Pearson's correlation coefficient, multiple regression, and logistic regression, using SPSS. College life adjustment was significantly correlated with life stress (r = −0.255, p < 0.001), career barriers (r = −0.429, p < 0.001), and career decision-making self-efficacy (r = 0.531, p < 0.001). The regression analysis showed that career barriers, career decision-making self-efficacy, and grade level had a total explanatory power of 33.7% for college life adaptation. The logistic regression analysis showed that the odds ratio (OR) of career barriers being low in the group with a high college life adaptation score was 2.045 (p < 0.001), and the OR of career decision-making self-efficacy being high was 4.107 (p < 0.001), as compared to the group with a low score. To increase college students' adaptation to college life, career support programs that improve career barriers and career decision-making self-efficacy should be developed.

Nursing Students' Acceptance Intention of a Smart Device, Information Literacy, and Problem-Solving Confidence.

The purpose of this study was to investigate the relationship between nursing students' acceptance intention of a smart device, information literacy, and problem-solving confidence to explore the factors that may improve nursing students' problem-solving confidence. Data were collected from 450 nursing students between July and August 2019 in two cities in Korea. The results showed that there is a positive correlation between problem-solving confidence and acceptance intention (r = 0.353, p < 0.001) and between problem-solving confidence and information literacy (r = 0.501, p < 0.001). Further, participants with high acceptance intention of a smart device and information literacy scores had significantly higher problem-solving confidence (t = 5.447, p < 0.001; t = 10.072, p < 0.001) than participants with low acceptance intention. In addition, in the logistic regression the odds ratio between the acceptance intention of a smart device, information literacy, and problem-solving confidence groups was odds ratio 2.071 (p < 0.001, CI: 1.412-3.037) and odd ratio 4.966 (p < 0.001, CI: 3.298-7.477). To improve nursing students' problem-solving confidence, educational strategies should be developed to build information experience and information utilization capabilities.

Smartphone use patterns and problematic smartphone use among preschool children.

BACKGROUND: The purpose of the present study was to identify smartphone use patterns associated with problematic smartphone use (PSU) among preschool children. Little is known about PSU patterns in younger children, although the age for first smartphone use is decreasing. METHODS: We applied a cross-sectional study design to analyze data obtained from a nationwide survey on smartphone overdependence conducted in 2017 by the South Korean Ministry of Science and ICT and the National Information Society Agency. Data from 1,378 preschool children were analyzed using binomial logistic regression analysis. This study was conducted in compliance with STROBE (Strengthening the Reporting of Observational Studies in Epidemiology). RESULTS: Seventeen percent of the sample met the criteria for PSU. The odds of PSU significantly increased with frequent smartphone use and in children who used a smartphone for more than two hours per day. Using smartphones to watch TV shows or videos for entertainment or fun significantly increased the odds of PSU, whereas using smartphones for education, games, and social networking did not. CONCLUSIONS: The findings indicate that one of five preschool children using smartphones could experience PSU. Compared to other age groups, PSU in young children may be more associated with their caregivers. To prevent PSU in preschool children, caregivers need information about the total screen time recommended for children, smartphone use patterns associated with PSU, suggestions for other activities as possible alternatives to smartphone use, and strategies to strengthen children's self-regulation with regards to smartphone use.

Temporal Dynamics of Visually Induced Motion Perception and Neural Evidence of Alterations in the Motion Perception Process in an Immersive Virtual Reality Environment.

Even though reciprocal inhibitory vestibular interactions following visual stimulation have been understood as sensory-reweighting mechanisms to stabilize motion perception; this hypothesis has not been thoroughly investigated with temporal dynamic measurements. Recently, virtual reality technology has been implemented in different medical domains. However, exposure in virtual reality environments can cause discomfort, including nausea or headache, due to visual-vestibular conflicts. We speculated that self-motion perception could be altered by accelerative visual motion stimulation in the virtual reality situation because of the absence of vestibular signals (visual-vestibular sensory conflict), which could result in the sickness. The current study investigated spatio-temporal profiles for motion perception using immersive virtual reality. We demonstrated alterations in neural dynamics under the sensory mismatch condition (accelerative visual motion stimulation) and in participants with high levels of sickness after driving simulation. Additionally, an event-related potentials study revealed that the high-sickness group presented with higher P3 amplitudes in sensory mismatch conditions, suggesting that it would be a substantial demand of cognitive resources for motion perception on sensory mismatch conditions.

Smartphone Use Patterns of Smartphone-dependent Children.

PURPOSE: The purpose of this study was to identify the smartphone use patterns of smartphone-dependent children. METHODS: The study design was a cross-sectional descriptive study. The data were derived from the 2017 survey on smartphone overdependence conducted by the Ministry of Science and ICT and the National Information Society Agency. The study sample was 595 elementary school students identified as being smartphone-dependent. The data were analyzed by frequency, percentage, mean, standard deviation, the independent t-test, the χ 2 test, the Pearson correlation coefficient, and multiple regression analysis. RESULTS: The frequency of smartphone use was the factor strongly associated with more severe smartphone dependence in participants. Games were the most commonly used application type among participants, regardless of their degree of dependence. More severe smartphone dependence was associated with greater use of applications such as learning and television/video. CONCLUSION: As smartphone dependence becomes more severe, children tend to use their smartphones more frequently and to use applications that involve solitary play for the purposes of entertainment and pleasure. The findings suggest that the parents should attentively monitor their children's smartphone use patterns and provide consistent discipline in a way that ensures appropriate smartphone use.

Feasibility of Eye Tracking Assisted Vestibular Rehabilitation Strategy Using Immersive Virtual Reality.

OBJECTIVES: Even though vestibular rehabilitation therapy (VRT) using head-mounted display (HMD) has been highlighted recently as a popular virtual reality platform, we should consider that HMD itself do not provide interactive environment for VRT. This study aimed to test the feasibility of interactive components using eye tracking assisted strategy through neurophysiologic evidence. METHODS: HMD implemented with an infrared-based eye tracker was used to generate a virtual environment for VRT. Eighteen healthy subjects participated in our experiment, wherein they performed a saccadic eye exercise (SEE) under two conditions of feedback-on (F-on, visualization of eye position) and feedback-off (F-off, non-visualization of eye position). Eye position was continuously monitored in real time on those two conditions, but this information was not provided to the participants. Electroencephalogram recordings were used to estimate neural dynamics and attention during SEE, in which only valid trials (correct responses) were included in electroencephalogram analysis. RESULTS: SEE accuracy was higher in the F-on than F-off condition (P=0.039). The power spectral density of beta band was higher in the F-on condition on the frontal (P=0.047), central (P=0.042), and occipital areas (P=0.045). Beta-event-related desynchronization was significantly more pronounced in the F-on (-0.19 on frontal and -0.22 on central clusters) than in the F-off condition (0.23 on frontal and 0.05 on central) on preparatory phase (P=0.005 for frontal and P=0.024 for central). In addition, more abundant functional connectivity was revealed under the F-on condition. CONCLUSION: Considering substantial gain may come from goal directed attention and activation of brain-network while performing VRT, our preclinical study from SEE suggests that eye tracking algorithms may work efficiently in vestibular rehabilitation using HMD.

Developing a Diagnostic Decision Support System for Benign Paroxysmal Positional Vertigo Using a Deep-Learning Model.

Background: Diagnosis of benign paroxysmal positional vertigo (BPPV) depends on the accurate interpretation of nystagmus induced by positional tests. However, difficulties in interpreting eye-movement often can arise in primary care practice or emergency room. We hypothesized that the use of machine learning would be helpful for the interpretation. Methods: From our clinical data warehouse, 91,778 nystagmus videos from 3467 patients with dizziness were obtained, in which the three-dimensional movement of nystagmus was annotated by four otologic experts. From each labeled video, 30 features changed into 255 grid images fed into the input layer of the neural network for the training dataset. For the model validation, video dataset of 3566 horizontal, 2068 vertical, and 720 torsional movements from 1005 patients with BPPV were collected. Results: The model had a sensitivity and specificity of 0.910 ± 0.036 and 0.919 ± 0.032 for horizontal nystagmus; of 0.879 ± 0.029 and 0.894 ± 0.025 for vertical nystagmus; and of 0.783 ± 0.040 and 0.799 ± 0.038 for torsional nystagmus, respectively. The affected canal was predicted with a sensitivity of 0.806 ± 0.010 and a specificity of 0.971 ± 0.003. Conclusions: As our deep-learning model had high sensitivity and specificity for the classification of nystagmus and localization of affected canal in patients with BPPV, it may have wide clinical applicability.

Intention to leave among staff nurses in small- and medium-sized hospitals.

AIMS AND OBJECTIVES: To explore the factors associated with the intention to leave among nurses in small- and medium-sized hospitals and to determine the predictors about work environment and rewards. BACKGROUND: Compared with large hospitals, insight into the working conditions, rewards and turnover of nurses working for these hospitals is lacking internationally. DESIGN: Cross-sectional study design. METHODS: Data were obtained from the Korean Nurses Association's 2016 Welfare Policy and System Improvement Survey. Of the participants, data from 951 staff nurses working three shifts were analysed using hierarchical multiple regression to explore the predictors of nurses' turnover intention. This study complied with the Strengthening the Reporting of Observational studies in Epidemiology. RESULTS: The perceived pay level satisfaction was the most obvious and persistent predictor of the intention to leave. Living benefits were shown to be scarcely satisfied, rendering considerable influence on turnover intention. Concerning aspects related to the working environment, the implementation of contract-abiding working hours and nurse-friendly night shift schedules reduced the turnover intention of nurses. CONCLUSIONS: Nurses in small- and medium-sized hospitals are likely to have particular challenges in terms of professional growth. When fundamental rewards and basic working conditions are acceptable to nurses, their turnover can be reduced, and the professional growth can also be expected. Hospitals with a high nurse turnover rate need to preferentially verify these factors perceived by their nurses and to improve to increase nurses' retention. RELEVANCE TO CLINICAL PRACTICE: Understanding the determinants of intention to leave can lead to the development of strategies that persuade nurses to remain employed. These findings inform policymakers, nurse managers and hospital managers of the causes of nurses' intentions to leave in small- and medium-sized hospitals. Our findings also provide empirical data on the working conditions and rewards of these nurses and suggest strategies for their retention.

Synergistic Effect between Cryptotanshinone and Antibiotics against Clinic Methicillin and Vancomycin-Resistant Staphylococcus aureus.

Cryptotanshinone (CT), a major tanshinone of medicinal plant Salvia miltiorrhiza Bunge, demonstrated strong antibacterial activity against clinic isolated methicillin and vancomycin-resistant Staphylococcus aureus (MRSA and VRSA) in this experiment. The CT was determined against clinic isolated MRSA 1-16 with MIC and MBC values ranging from 4 to 32 and 8 to 128 µ g/mL; for MSSA 1-2 from 16 to 32 µ g/mL and 64 to 128 µ g/mL; for VRSA 1-2 from 2 to 4 µ g/mL and 4 to 16 µ g/mL, respectively. The range of MIC50 and MIC90 of CT was 0.5-8 µ g/mL and 4-64 µ g/mL, respectively. The combination effects of CT with antibiotics were synergistic (FIC index <0.5) against most of tested clinic isolated MRSA, MSSA, and VRSA except additive, MRSA 4 and 16 in oxacillin, MRSA 6, 12, and 15 in ampicillin, and MRSA 6, 11, and 15 in vancomycin (FIC index < 0.75-1.0). Furthermore, a time-kill study showed that the growth of the tested bacteria was completely attenuated after 2-6 h of treatment with the 1/2 MIC of CT, regardless of whether it was administered alone or with ampicillin, oxacillin, or vancomycin. The results suggest that CT could be employed as a natural antibacterial agent against multidrug-resistant pathogens infection.