Effects of registered nurses' staffing levels, work environment and education levels on nursing home residents' quality of life and nurse outcomes.

AIMS AND OBJECTIVES: To examine the effects of registered nurse staffing levels, work environment and education levels on the residents' quality of life and nurses' job dissatisfaction, burnout and turnover intention. BACKGROUND: Registered nurse staffing status and work environment are suboptimal in nursing homes worldwide. Nursing home care aims to maximise residents' quality of life. However, evidence on the impact of registered nurse staffing levels, work environment and education levels on the residents' quality of life and nurse outcomes in nursing homes is limited. DESIGN: This is a cross-sectional observational study. METHODS: A total of 513 residents and 117 registered nurses from 39 nursing homes in South Korea participated in surveys. The main measures included registered nurses' staffing levels, work environment, education levels, residents' quality of life, registered nurses' job dissatisfaction, burnout and turnover intention. We analysed data using the generalised estimating equations and reported the study using the STROBE checklist. RESULTS: Overall, the residents' quality-of-life score was 13.7 ± 2.6 (out of 17). Residents in nursing homes with a higher number of registered nurses or with work environment evaluated as 'mixed' or 'better' (compared with 'poor') had a higher quality of life. Regarding nurse outcomes, 74.4% of the registered nurses were dissatisfied with their current jobs, 12.0% had burnout and 18.8% had a turnover intention. Registered nurses working in 'mixed' or 'better' work environment were less likely to have job dissatisfaction. Registered nurses' education levels did not have a statistically significant effect on the resident and nurse outcomes. CONCLUSIONS: Registered nurse staffing levels and work environment should be considered important for improving residents' quality of life and nurses' job satisfaction. RELEVANCE TO CLINICAL PRACTICE: Regulation and policy reforms are needed to increase the registered nurse staffing levels and to create a good work environment in nursing homes. PATIENT OR PUBLIC CONTRIBUTION: Nursing home residents and registered nurses participated in the surveys of this study. Registered nurses facilitated resident recruitment by identifying and introducing the study to residents who were eligible for study participation. TRIAL REGISTRATION: Not applicable.

Neural Reinstatement of Overlapping Memories in Young and Older Adults.

When we update our episodic memories with new information, mnemonic competition between old and new memories may result because of the presence of shared features. Behavioral studies suggest that this competition can lead to proactive interference, resulting in unsuccessful memory updating, particularly for older adults. It is difficult with behavioral data alone to measure the reactivation of old, overlapping memories during retrieval and its impact on memory for new memories. Here, we applied encoding-retrieval representational similarity (ERS) analysis to EEG data to estimate event-specific encoding-related neural reinstatement of old associations during the retrieval of new ones and its impact on memory for new associations in young and older adults. Our results showed that older adults' new associative memory performance was more negatively impacted by proactive interference from old memories than that of young adults. In both age groups, ERS for old associative memories was greater for trials for which new associative memories were forgotten than remembered. In contrast, ERS for new associative memories was greater when they were remembered than forgotten. In addition, older adults showed relatively attenuated target (i.e., new associates) and lure (i.e., old associates) ERS effects compared to younger adults. Collectively, these results suggest that the neural reinstatement of interfering memories during retrieval contributes to proactive interference across age, whereas overall attenuated ERS effect in older adults might reflect their reduced memory fidelity.

Evaluating a theory-based intervention for improving eHealth literacy in older adults: a single group, pretest-posttest design.

BACKGROUND: The Internet is considered an important channel for providing health information to older adults. We developed an intervention to improve eHealth literacy in older adults according to the information-motivation-behavioral skills (IMB) theory and Intervention Mapping. This study aimed to analyze the effect of a developed intervention on information, motivation, behavioral skills, and behaviors related to eHealth information in older adults. METHODS: Forty-six older adults over the age of 65 were recruited from two senior welfare centers in a city in South Korea. We divided the participants into four groups and conducted one intervention per group from March to December 2019. One intervention consisted of 5 sessions and was performed once a week (2 h/1 time) for 5 weeks, culminating in a total lecture time of 10 h. One lecture instructor and two assistant instructors supported the participants in the computer practices. RESULTS: Participants' computer/web knowledge, perceived ease of use, perceived enjoyment, and attitude toward eHealth information showed statistically significant increases. The eHealth literacy efficacy score, searching performance score, and understanding score were also significantly increased. However, there was no significant difference in perceived usefulness. CONCLUSION: The application of the current theory-based methodology can improve the quality of research in eHealth literacy. Additionally, various interventions should be developed and continuously applied to improve eHealth literacy among older adults.

Characterization and Health-Related Quality of Life in Older Adults With Disabilities According to Timing of Disability Onset.

The current study examined characteristics of early-onset and late-onset disability in older adults and identified predictors of health-related quality of life (HRQoL). This is a secondary data analysis of the 2017 national survey in South Korea. Participants were 4,014 older adults with disabilities, who were divided into an early-onset group (n = 2,229) and late-onset group (n = 1,785). Data were analyzed using complex sample analyses. Difficulties during outdoor activity and transportation use, self-rated health, and stress were common predictors in both groups. Comorbidity was a significant predictor only in the early-onset group. Use of information technology devices, household income, and perceived social discrimination were significant predictors in the late-onset group. Characteristics and predictors of HRQoL were different between groups, despite sharing common characteristics. It is necessary to improve support systems and health care services for older adults with disabilities. [Journal of Gerontological Nursing, 48(3), 37-47.].

Internet health information education for older adults: A pilot study.

This study aimed to develop internet health information education program, and to explore the program's feasibility and preliminary effects. We made use of an intervention mapping approach and adopted as conceptual framework the information-motivation-behavioral skills model to develop the program. We evaluated the feasibility and the impact of the education program using a single-group pretest-posttest design using generalized equation estimation. Eleven older adults participated in the classes from January 25 to February 22, 2019. Each outcome of the behavioral theory-based components of the program-computer/Web knowledge (p < .001), attitude toward internet-based health information (p = .002), eHealth literacy score (p < .001), searching performance scores (p < .001), and level of understanding of internet-based health information (p = .002)-showed significant improvement immediately after the intervention. This pilot study reveals that a behavior theory-based education program for utilizing internet-based health information is an effective way to increase older adults' eHealth literacy.

Avalanche size distribution of an integrate-and-fire neural model on complex networks.

We considered the neural avalanche dynamics of a modified integrate-and-fire model on complex networks, as well as the neural dynamics in a fully connected network, random network, small-world network, and scale-free network. We observed the self-organized criticality of the neural model on complex networks. The probability distribution of the avalanche size and lifetime follow the power law at the critical synaptic strength. Neuronal dynamics on a complex network are not universal. The critical exponents of the avalanche dynamics depend on the structure of the complex network. We observed that the critical exponents deviate from the mean-field value.

A Tailored Intervention for Improving Diabetes Self-care Among Adults With Visual Impairment: A Pilot Study.

OBJECTIVES: Our aim in this study was to develop and evaluate a tailored intervention for improving diabetes self-care among people with visual impairment (TID-VI) in South Korea. METHODS: The TID-VI program was designed around the barriers, resources, and perceptual factors to promote diabetes self-care in those with visual impairment (VI). A single-arm pilot study was conducted to evaluate the feasibility and preliminary effects of the intervention. Diabetes self-efficacy, self-care behaviours, depression, health-related quality of life, and clinical outcomes (fasting blood glucose, glycated hemoglobin [A1C], lipids, and blood pressure) were measured before and up to 2 months after the 12-week intervention. RESULTS: All 14 participants completed TID-VI. Diabetes self-efficacy, diabetes self-care behaviours, depression, and health-related quality of life showed improvement from baseline that was sustained at 2 months. Although high- and low-density lipoprotein also improved, there were no differences in blood glucose, A1C, total cholesterol, or blood pressure at 2 months. CONCLUSIONS: A theory-driven, tailored intervention specific to the needs of adults with VI can produce substantial improvements in patient-reported quality of life and health status outcomes, although the benefits are yet to be confirmed in a controlled study.

Interfacial Modification of ZnO/ZnMgO Bilayer for Efficient and Stable InP Quantum Dot Light-Emitting Diodes via Ultraviolet Ozone Treatment.

The development of efficient charge transport layers is crucial for realizing high-performance and stable quantum dot light-emitting diodes (QD-LEDs). The use of a ZnO/ZnMgO bilayer as an electron transporting layer (ETL) has garnered considerable attention. This configuration leverages the high electron mobility of ZnO and the favorable surface state of ZnMgO. Furthermore, the versatility of this configuration extends to its wide range of thickness tunability, rendering it suitable for the construction of thick devices for top-emitting structures with microcavities. However, despite the promising attributes of this bilayer configuration, the impact of the ZnO/ZnMgO bilayer ETL interface on QD-LEDs performance remains largely unexplored. Thus, this study investigated the effect of ultraviolet ozone (UVO) treatment on the stabilization of the ZnO/ZnMgO interface. UVO treatment was found to significantly enhance luminance uniformity across the QD-LEDs emission area while improving operational stability by over 4-fold. Comprehensive analyses employing X-ray photoelectron spectroscopy and Fourier-transform infrared spectroscopy confirmed that UVO treatment significantly reduced the defect states of the hydroxyl groups and removed the insulating native ethanolamine ligands, thereby facilitating improved and uniform electron transport. Moreover, the effectiveness of UVO treatment in enhancing electron transport was supported by impedance analyses. Therefore, this paper presents an effective approach for enhancing the interface of a highly potent ZnO/ZnMgO bilayer ETL, which can ultimately improve the luminance uniformity and stability of QD-LEDs.

Silent struggles to self-manage high blood pressure among deaf sign language users: a qualitative study.

AIMS: Tailored self-management support of hypertension, considering language and communication, is important for minorities, specifically in the deaf community. However, little is known about the experiences of hypertension self-management in deaf individuals who use sign language. This study aimed to explore the factors and processes of self-management in deaf sign language users with hypertension. METHODS AND RESULTS: Ten men and women who used sign language participated in this study. Data were collected using in-depth personal interviews conducted in the presence of a sign language interpreter between November 2022 and February 2023. All interviews were recorded and transcribed for conventional content analysis. Qualitative analyses identified four categories related to the self-management of hypertension among participants: personal factors (chronic hand pain, unique language and communication, and efforts to turn crisis into opportunities), family and socioeconomic factors (family support and financial burden of living), challenges (limited health literacy and alienation from health education), and desire for health education considering the deaf community. CONCLUSION: The results of this study suggest that family support, socioeconomic status, hand pain, and health literacy should be considered for the planning and development of health education on self-management of hypertension in deaf individuals. In addition, this health education requires cooperation with qualified sign language interpreters in healthcare settings.

Utilizing a compact diamino-based ligand as a charge balancer in quantum dot light-emitting diodes.

Charge imbalance within the emissive layer (EML) has been identified as a major obstacle to achieving high-performance quantum dot light-emitting diodes (QD-LEDs). To address this issue, we propose the use of a compact diamino-based ligand as a universal approach to improve the charge balance within the QD EML. Specifically, we treat QDs symmetrically with 1,4-diaminobutane (DAB) on both the bottom and top sides. This treatment simultaneously modulates the injection properties of electrons and holes, effectively suppressing electron injection into QDs while facilitating hole injection. As a result, QD-LEDs with symmetrical DAB treatment exhibit a 1.5-fold increase in external quantum efficiency and a remarkable 4.5-fold increase in device lifetime. These results highlight the role of the compact diamine-based ligands as highly efficient charge balancers to realize high-performance and highly stable QD-LEDs.

Recent Progress on Quantum Dot Patterning Technologies for Commercialization of QD-LEDs: Current Status, Future Prospects, and Exploratory Approaches.

Colloidal quantum dots (QDs) are widely regarded as advanced emissive materials with significant potential for display applications owing to their excellent optical properties such as high color purity, near-unity photoluminescence quantum yield, and size-tunable emission color. Building upon these attractive attributes, QDs have successfully garnered attention in the display market as down-conversion luminophores and now venturing into the realm of self-emissive displays, exemplified by QD light-emitting diodes (QD-LEDs). However, despite these advancements, there remains a relatively limited body of research on QD patterning technologies, which are crucial prerequisites for the successful commercialization of QD-LEDs. Thus, in this review, an overview of the current status and prospects of QD patterning technologies to accelerate the commercialization of QD-LEDs is provided. Within this review, a comprehensive investigation of three prevailing patterning methods: optical lithography, transfer printing, and inkjet printing are conducted. Furthermore, several exploratory QD patterning techniques that offer distinct advantages are introduced. This study not only paves the way for successful commercialization but also extends the potential application of QD-LEDs into uncharted frontiers.

Experiences of peer support activities and the need for a metaverse-based program in young women with breast cancer: A qualitative study.

Objective: This study aimed to explore young breast cancer survivors' experiences of peer support activities and their need for a metaverse-based peer support program. Methods: This qualitative content analysis study involved 15 young women with breast cancer under the age of 40. Participants with diverse experiences in peer support activities were purposefully selected. Data were collected in March 2023 through three focus group interviews and three additional individual interviews. Saturation was reached when no new themes emerged from the interviews. The interviews were transcribed verbatim and analyzed using conventional content analysis. This study ensured the trustworthiness of the data based on criteria including truth value, applicability, consistency, and neutrality. Results: Four categories emerged: advantages, disadvantages, preferences for peer support activities, and the need for metaverse-based peer support programs. Participants valued peer support activities for exchanging information, nurturing empathy, and encouraging healthy behaviors. Challenges included information confusion, peer conflict, isolation, and stigma. Preferences for group composition, size, and medium varied; however, all participants agreed on the importance of operational guidelines. Participants expected a metaverse-based peer support program to provide safe and enjoyable experiences despite concerns about unfamiliar platforms. Conclusions: This study highlights the unique needs and preferences of young breast cancer survivors regarding peer support activities. Well-organized and tailored peer support can significantly enhance their quality of life. These findings provide valuable insights for developing effective metaverse-based peer support programs to meet the needs of young women with breast cancer.

A hermeneutic phenomenological study on the disease experience among young women with breast cancer.

Objective: Women diagnosed with breast cancer under the age of 40 face distinctive physical and psychosocial challenges resulting from the disease's pathological features and the developmental aspects associated with their youth. This study aims to investigate the lived experience of breast cancer among this group of young women. Methods: Participants were purposefully selected from online communities and chat rooms in South Korea. A total of 15 young women with breast cancer were included in this study, and data were gathered through three focus group interviews. The interviews were transcribed verbatim and analyzed using the hermeneutic phenomenology method. Results: Four essential themes emerged based on four lifeworld existentials: lived body, lived time, lived space, and lived others. These four essential themes were: a wounded and sick body, life robbed of youth and elderly years, crossroads of growth discovered at life's extremes, and a steadfast companion on a solitary journey. Conclusions: Young women with breast cancer face unique challenges due to the intersection of a severe illness and its impact during their formative years. This study offers valuable insights for crafting customized interventions that directly target the physical and psychosocial requirements of young breast cancer survivors, ultimately enhancing their quality of life.

Age-related reductions in arousal-enhanced memory are moderated by trait emotion regulation.

Emotional arousal is known to enhance episodic memory in young adults. However, compared to valence, little is known about how healthy aging impacts arousal-enhanced memory effects. Furthermore, while emotion regulation is believed to improve with age, it is unclear how individual differences in emotion regulation influence arousal-enhanced memory. In this large-scale online study, we investigated the impact of age and individual differences in emotion regulation on arousal-enhanced memory. During encoding, participants made arousal ratings about negative, neutral, and positive images, and we compared their subsequent memory of high and low-arousal images. We found the impact of emotional arousal on memory was reduced with age, especially for older adults who habitually suppress their emotions. Our findings show that arousal-related memory benefits are reduced with advancing age, and that individual differences in habitual usage of emotion regulation impact these age-related alterations.

Health education interventions for individuals with hearing impairment: A systematic review.

OBJECTIVES: This study aims to systematically review health education interventions targeting individuals with hearing impairment. METHODS: A total of 18 studies were selected based on search results from five databases, and quality appraisal was conducted using an appropriate tool based on the study design. The extracted results were described using qualitative analysis. RESULTS: Among the selected studies, most interventions focused on specific cancers, and video materials were the most common delivery method. Various strategies were applied depending on the type of materials provided, in addition to sign language interpretation and the involvement of hearing-impaired related personnel. The interventions primarily resulted in a significant increase in knowledge. CONCLUSION: This study suggests several recommendations, including expanding the scope of interventions to cover various chronic diseases, actively utilizing the features of video materials, considering health literacy, using peer support groups, and measuring behavior-related factors alongside knowledge levels. PRACTICE IMPLICATIONS: This study makes a significant contribution to understanding the unique characteristics of the population with hearing impairment. Furthermore, it has the potential to facilitate the development of high-quality health education interventions for individuals with hearing impairment by providing insights into future research directions based on existing health education interventions.

Covid-19-Stress Associated With Worse Sleep Quality, Particularly With Increasing Age.

OBJECTIVES: Based on socioemotional selectivity theory, one might predict that older adults' well-being would be less negatively affected by coronavirus disease 2019 (Covid-19)-stress, as with other stressors, than younger people. However, whether sleep quality, which is negatively affected by aging, is similarly protected from the negative consequences of Covid-19-stress with age is unknown. Here, we examined the association between Covid-19-stress, above and beyond general-stress, and sleep quality and how it varies by age. METHOD: From December 2020 to April 2021, 386 adults reported their Covid-19-stress, sleep quality, and resilience in an online study. RESULTS: While older age was related to lower Covid-19-stress, Covid-19-stress was associated with worse sleep quality with greater age. DISCUSSION: These results suggest that at least some aspects of one's well-being may be more susceptible to the negative consequences of stress with increasing age. Our results might be better understood via the strength and vulnerability integration model, which posits that older adults have increased susceptibility to prolonged and unavoidable stress.

Factors Associated With Diabetes Self-Care Behaviors of People With Visual Impairment: A Cross-Sectional Study.

PURPOSE: The purpose of the study was to examine the factors associated with diabetes self-care behaviors (DSCB) in people with visual impairment (PVI), including demographics, disease-related characteristics, and psychosocial factors (self-efficacy, depression, and family support). METHODS: A descriptive cross-sectional study was conducted. Adults with visual impairment and diabetes were recruited online and through posting notices, and a total of 141 participants were included. Measurements were completed using email and telephone surveys. Multiple linear regression analysis was performed to examine the factors associated with DSCB. RESULTS: Higher self-efficacy and positive family support were significant predictors of better DSCB, whereas higher negative family support was a significant predictor of worse DSCB. Diabetes medication regimen was another major influencing factor on DSCB. However, depression was not associated with DSCB. CONCLUSION: Diabetes interventions for the visually impaired should have strategies to improve vulnerable areas of diabetes self-care, such as blood glucose monitoring. Health care providers are needed to consider diabetes education programs focused on improving self-efficacy or include family members in interventions to promote DSCB in PVI. Further studies are required to understand the problems and solutions for diabetes self-care in this population.

Comparative analysis of cancer gene mutations using targeted sequencing in matched primary and recurrent gastric cancers after chemotherapy.

BACKGROUND: Investigation of responsiveness-associated genes using longitudinal mutation analyses after standard treatments in recurrent gastric cancer (GC) is limited. OBJECTIVE: To evaluate the somatic mutations associated with resistance to combined treatment involving fluorouracil (FU) or platinum (PL) in advanced GC. METHODS: Samples from patients with advanced GC treated with FU or PL alone, or surgery plus FU/PL, were studied. GC patients who relapsed after standard chemotherapy (FU/PL) and with presence of tumor samples from initial diagnosis and recurrence were included. Targeted sequencing analysis of 143 cancer-related genes was performed using an Oncomine Comprehensive Cancer Panel. RESULTS: Matched samples of primary and recurrent lesions were analyzed in sixteen patients with GC. When genes with recurrent mutations in two or more patients were used as specific findings, a total of 26 genes were found. TP53 was the most predominantly increased allele frequency (AF) in recurrent GCs after standard treatment. The mutational AF of ERBB2, PTEN, and BRCA2 also commonly increased, suggesting the role of these mutations in treatment resistance, whereas the mutational AF of VLH, NF1, and STK11 frequently decreased in recurrent tumors, suggesting the role of these mutations in increasing sensitivity to treatment. TCGA gastric cancer data (n = 436) were analyzed, and mutation sites detected in 16 GC patients in this study were in agreement with TCGA cohort with some exceptions. Overall survival according to gene expression associated with chemotherapy responsiveness exhibited compatible patterns with gain or loss-of-function mutations of each gene. CONCLUSIONS: Mutations in TP53, ERBB2, PTEN, BRCA2, VHL, NF1, and STK11 are candidate somatic alterations related to chemoresistance in GC.

Spatial Movement Patterns and Local Co-Occurrence of Nutria Individuals in Association with Habitats Using Geo-Self-Organizing Map (Geo-SOM).

Nutrias (Myocastor coypus) were imported to South Korea for farming in 1985; individuals escaped captivity and established wild populations in natural ecosystems in the late 1990s. Numerous studies have focused on their monitoring and management; however, information on the continuous movement of individuals is not available. In this study, telemetry data from field conditions were used to identify the nearest-neighbor distances of individuals in association with environmental factors, including plant type, land cover, and biological parameters. The minimum nearest-neighbor distances for the different sexes were, overall, according to the minimum distances for the same sex. Local co-occurrences of individuals, either of the same or different sex, were seasonal. Tall grasslands, followed by herbaceous vegetation, were associated with the co-occurrence of different sexes. Conversely, floating-leaved hydrophytes, followed by xeric herbaceous vegetation, were correlated with the co-occurrence of the same sex. Local female-male co-occurrences were negatively associated with male-male co-occurrences but not with female-female co-occurrences, suggesting male dominance in group formations. Movement and co-occurrence information extracted using Geo-self-organizing maps furthers our understanding of population dispersal and helps formulate management strategies for nutria populations.

The Effect of Pain Catastrophizing on Depression among Older Korean Adults with Chronic Pain: The Mediating Role of Chronic Pain Interference and Sleep Quality.

Pain catastrophizing is a notable concept associated with change in chronic pain interference and depression. Sleep quality is also one of the important factors affecting geriatric depression. This study examined the mediating effects of chronic pain interference and sleep quality on the relationship between pain catastrophizing and depression. This study is a secondary data analysis that analyzed a total of 138 older Korean adults with chronic pain. The participants were selected from a single elderly daycare center in a city in South Korea. Also, the multiple regression analysis and PROCESS macro with bootstrapping were used. The results revealed that chronic pain interference and sleep quality mediated the relationship between pain catastrophizing and depression, respectively. Furthermore, chronic pain interference and sleep quality sequentially and dually mediated the effect of pain catastrophizing on depression. In the management of depression in the elderly, persistent complaints of pain should not be disregarded, irrespective of the intensity of their chronic pain. Psychological intervention is needed to alleviate negative thoughts about chronic pain and to increase the ability to cope with chronic pain. In addition, it is important to assess sleep patterns and to develop interventions to improve sleep quality, because depression in the elderly could appear as a symptom of a sleep problems.