Understanding global research trends in the control and prevention of infectious diseases for children: Insights from text mining and topic modeling.

INTRODUCTION: The emergence of novel infectious diseases has amplified the urgent need for effective prevention strategies, especially ones targeting vulnerable populations such as children. Factors such as the high incidence of both emerging and existing infectious diseases, delays in vaccinations, and routine exposure in communal settings heighten children's susceptibility to infections. Despite this pressing need, a comprehensive exploration of research trends in this domain remains lacking. This study aims to address this gap by employing text mining and modeling techniques to conduct a comprehensive analysis of the existing literature, thereby identifying emerging research trends in infectious disease prevention among children. METHODS: A cross-sectional text mining approach was adopted, focusing on journal articles published between January 1, 2003, and August 31, 2022. These articles, related to infectious disease prevention in children, were sourced from databases such as PubMed, CINAHL, MEDLINE (Ovid), Scopus, and Korean RISS. The data underwent preprocessing using the Natural Language Toolkit (NLTK) in Python, with a semantic network analysis and topic modeling conducted using R software. RESULTS: The final dataset comprised 509 journal articles extracted from multiple databases. The study began with a word frequency analysis to pinpoint relevant themes, subsequently visualized through a word cloud. Dominant terms encompassed "vaccination," "adolescent," "infant," "parent," "family," "school," "country," "household," "community," "HIV," "HPV," "COVID-19," "influenza," and "diarrhea." The semantic analysis identified "age" as a key term across infection, control, and intervention discussions. Notably, the relationship between "hand" and "handwashing" was prominent, especially in educational contexts linked with "school" and "absence." Latent Dirichlet Allocation (LDA) topic modeling further delineated seven topics related to infectious disease prevention for children, encompassing (1) educational programs, (2) vaccination efforts, (3) family-level responses, (4) care for immunocompromised individuals, (5) country-specific responses, (6) school-based strategies, and (7) persistent threats from established infectious diseases. CONCLUSION: The study emphasizes the indispensable role of personalized interventions tailored for various child demographics, highlighting the pivotal contributions of both parental guidance and school participation. CLINICAL RELEVANCE: The study provides insights into the complex public health challenges associated with preventing and managing infectious diseases in children. The insights derived could inform the formulation of evidence-based public health policies, steering practical interventions and fostering interdisciplinary synergy for holistic prevention strategies.

Analyzing symptom experiences and pathways to enhancing quality of life in adolescents with Moyamoya disease.

PURPOSE: The psycho-emotional symptom experiences and health-related factors that influence the quality of life of adolescents with Moyamoya disease are still not fully understood. The aim of this study is to identify the daily physical and accompanying psychological symptom experiences of such adolescents, and to examine how health-related factors contribute to their quality of life. DESIGN AND METHOD: This study employed a descriptive cross-sectional research design. Data on a total of 134 adolescents with Moyamoya disease was analyzed in order to develop a path analysis. Data were collected from October 2019 to January 2021 in South Korea. The theory of salutogenesis was employed in order to develop a hypothetical model for this path analysis. Participants were given a self-reporting questionnaire. Descriptive analysis and path analysis were conducted based on the results. RESULTS: Adolescents with Moyamoya disease experienced several negative emotions simultaneously, regardless of the severity of their physical symptoms. The path analysis revealed that stress, a sense of coherence, behavior, and the support of friends were significant contributors to adolescents' quality of life. CONCLUSIONS: Adolescents with Moyamoya disease have multifaceted symptom experiences in their daily lives. To enhance their quality of life, it is crucial to provide support that can help strengthen their capacity for stress management and enhance their sense of coherence. PRACTICAL IMPLICATIONS: This study provides evidence that nurses should offer anticipatory information to adolescents with Moyamoya disease regarding the symptoms they will frequently encounter, and develop interventions to enhance their quality of life.

Triage-clinical reasoning on emergency nursing competency: a multiple linear mediation effect.

BACKGROUND: Triage is the first step in providing prompt and appropriate emergency nursing and addressing diagnostic issues. Rapid clinical reasoning skills of emergency nurses are essential for prompt decision-making and emergency care. Nurses experience limitations in emergency nursing that begin with triage. This cross-sectional study explored the mediating effect of perceived triage competency and clinical reasoning skills on the association between Korean Triage and Acuity Scale (KTAS) proficiency and emergency nursing competency. METHODS: A web-based survey was conducted with 157 emergency nurses working in 20 hospitals in South Korea between mid-May and mid-July 2022. Data were collected utilizing self-administered questionnaires to measure KTAS proficiency (48 tasks), perceived triage competency (30 items), clinical reasoning skills (26 items), and emergency nursing competency (78 items). Data were analyzed using the PROCESS macro (Model 6). RESULTS: Perceived triage competency indirectly mediate the relationship between KTAS proficiency and emergency nursing competency. Perceived triage competency and clinical reasoning skills were significant predictors of emergency nursing competency with a multiple linear mediating effect. The model was found have a good fit (F = 8.990, P <.001) with, a statistical power of 15.0% (R² = 0.150). CONCLUSIONS: This study indicates that improving emergency nursing competency requires enhancing triage proficiency as well as perceived triage competency, which should be followed by developing clinical reasoning skills, starting with triage of emergency nurses.

Development of a mobile application based on the salutogenic model for self-management in adolescents with Moyamoya disease.

PURPOSE: Moyamoya disease (MMD) is a rare disease which has a high incidence of onset in adolescence. Disease self-management skills are imperative for adolescents with MMD. This study aimed to describe the systematic development, content, and usability of the Moyamoya Healthy Youth application (app), which was developed to enhance self-management skills for adolescents with MMD. DESIGN AND METHODS: The theoretical grounding for the app was salutogenic model and the development process of the app was guided by the intervention mapping (IM) protocol. Results of each IM step were applied to the next step leading to the design of the app. Additionally, a pilot test was conducted to determine the usability of the app. RESULTS: Following the salutogenic model, we identified the stressors, behaviors, and resources regarding managing symptoms of MMD by interviewing adolescents with MMD, their parents, and healthcare providers. Based on the findings of the interviews, we determined the program outcomes and performance objectives to improve the self-management of MMD in adolescents. The app was developed by translating the theoretical methods to achieve the performance objectives into practical strategies for delivering the program. A pilot test with eight participants showed satisfaction with the app in terms of its usefulness and ease of use. CONCLUSION: We delineated the development process of the Moyamoya Healthy Youth. Additionally, we presented the positive outcomes regarding the usability of the app. PRACTICE IMPLICATIONS: The Moyamoya Healthy Youth app could benefit adolescents with MMD, by improving their self-management skills which are crucial for their health.

Risk and protective factors for a salutogenic sense of health in adolescents with Moyamoya disease.

PURPOSE: To identify the risk and protective factors affecting a salutogenic sense of health in adolescents with Moyamoya disease based on Antonovsky's salutogenesis theory. METHODS: This study used a qualitative descriptive design. We interviewed adolescents diagnosed with Moyamoya disease and their parents and experts with experience in treating them from 4 July 2019 to 10 October 2019. Data analysis was performed according to the process of deductive content analysis based on Antonovsky's salutogenesis theory. RESULTS: This study identified risk and protective factors affecting a salutogenic sense of health in adolescents with Moyamoya disease. Risk factors were closely related to problems with friends, parent relationships and academic work. Protective factors were identified as emotional support through interpersonal relationships, positive attitudes to the disease situation, ability to understand and predict patterns of symptoms, increasing strength to resolve the state of tension and developing available resources. CONCLUSION: The factors affecting a salutogenic sense of health in adolescents were identified reflecting on the characteristics of the developmental stage of adolescents and the symptoms and situations that are unique to adolescents. It is important for adolescents with Moyamoya disease to recognize available resources and use them appropriately to successfully manage the state of tension caused by stress.

Effect of a Hospital-To-Home Transitional Intervention Based on an Interaction Model of Client Health Behavior for Adult Patients with Stroke.

To develop and identify the effectiveness of a hospital-to-home transitional intervention based on an interaction model of client health behavior in adult patients with stroke. A non-equivalent control group pretest-posttest. Thirty-eight patients participated (18=intervention, 20=control); the intervention group received 12 weeks of the intervention. The intervention influenced anxiety, disease severity, health behavior adherence, patient satisfaction, and quality of life in adult patients with stroke. Transitional programs have potential to improve the health behaviors of subjects, and community health nurses can assist in the implementation of these programs. Health behaviors and quality of life scores were significantly higher in the intervention group than in the control group; these findings support the need for continuity of nursing care during the transitional period for patients with stroke. Given the challenges faced by adult stroke patients after stroke, community nurses should pay attention to patients' transitional experiences.

Resilience in Multicultural Families of Children With Disabilities in Korea: A Path Analysis Using National Data.

PURPOSE: The number of multicultural families has increased globally, and Korea has also witnessed a surge. Along with the various challenges experienced by these families, a child with a disability can pose additional challenges. In-depth knowledge about resilience factors among multicultural families of children with disabilities is important. The aim of this study was to examine relationships between family demands, family appraisals, family problem solving and coping, family resources, and family adaptation in multicultural families of children with disabilities in Korea as perceived by married immigrants. DESIGN: This study was based on a secondary analysis of national survey data in 2015 and 2018 in Korea. METHODS: A total of 256 multicultural families who have children with disabilities participated. Family demands were identified by examining marital conflict, cultural differences, marital status, and public assistance recipient households. Family appraisal was assessed by how the family perceived the married immigrant's culture. Family problem solving and coping were examined by how actively a married immigrant participated in social activities. Family resources were assessed by examining Korean language competency and the health status of immigrants. Family adaptation was identified by how immigrants perceived their life satisfaction. Path analysis was used to assess the factors. FINDINGS: Family demands had a direct impact on family resources and family adaptation. Family appraisal had a direct impact on family adaptation. Family resources mediated the effect of family demands on family adaptation. CONCLUSIONS: This study demonstrated that although a multicultural family of a child with a disability struggles with family demands, if the family receives positive resources from family members, they can adapt well. Current findings can be used to develop interventions that can foster greater resilience among families. CLINICAL RELEVANCE: This study provides evidence that nurses can target modifiable family aspects, including immigrants' health and family perceptions of immigrants' cultures identified in this study to enhance the immigrant and family adaptation.

Effectiveness of mHealth-Safe Kids Hospital for the prevention of hospitalized children safety incidents: A randomized controlled trial.

BACKGROUND: Preschool-age children in hospitals are at a high risk of unexpected incidents. Safety incidents in hospitals can cause serious damage to the children. OBJECTIVE: To determine the effectiveness of the mobile-type mHealth Safe Kids Hospital (SKH) application (app) for the prevention of hospitalized child safety incidents. DESIGN: This study used a three-group, randomized controlled trial pre-post design. SETTING(S): This study was conducted in the pediatric ward of three general hospitals in Korea. PARTICIPANTS: A total of 124 eligible hospitalized children and their caregivers were enrolled in the study from June to December 2018. Of these, 116 finally participated in the study, and 8 were excluded because they were discharged before the intervention. METHODS: Hospitalized preschool-age children and their caregivers were randomly allocated into three groups: experimental group I (n = 39), experimental group II (n = 39), and the control group (n = 38). Experimental group I received the SKH app intervention, the experimental group II received a paper-based intervention, whereas the control group received the usual intervention. Participants' outcomes of awareness, knowledge, and behavior related to hospital safety, were assessed at two time points: baseline and 24 h after the intervention. RESULTS: Hospital safety awareness had a higher increase after intervention in experimental groups I and II than in the control group. Among the four subdomains of hospital safety awareness, there was a significant increase in the scores of experimental group I on three subdomains after the intervention: falls (F = 8.19, p < 0.001), burns (F = 6.73, p = 0.002), and medical devices (F = 6.81, p = 0.002). In hospital safety knowledge and safety behavior, experimental group I had the highest average score after the intervention compared with experimental group II and the control group; however, there was no statistically significant difference in the average score of the three groups. CONCLUSIONS: Using the SKH app is easy to attract the interest of preschool-age children and is also easy for nurses to use in clinical trials; thus, it is considered to be a useful educational intervention to prevent safety incidents in clinical fields in future. CLINICAL RELEVANCE: It is thought to contribute to the prevention of preschool-age children's safety incidents in pediatric wards.

Features and diversity of symptoms of moyamoya disease in adolescents: A cluster analysis.

AIMS: The purpose of this study is to explore the symptoms experienced by adolescents with moyamoya disease and to identify the characteristics of each symptom cluster associated with moyamoya disease. DESIGN: A retrospective and descriptive design, which is a secondary data analysis study based on electronic medical record data from hospitals. METHODS: To assess the symptoms associated with moyamoya disease, a qualitative study was conducted on 12 adolescents, 12 caregivers and 12 experts on moyamoya disease. According to a qualitative study, 12 main symptoms (limb weakness, numbness, pins and needles, difficulty in speech, blurred vision, facial paralysis, hand tremors, involuntary movements, convulsions, dizziness, nausea/vomiting and headaches) were selected. Data were collected around these symptoms. The data collection was carried out through the Electronic Medical Record (EMR) data of 303 adolescents aged 13-19 who were diagnosed with moyamoya disease (ICD 10 Code: I67.5) between January 2010-December 2019 in a hospital in Seoul, South Korea. Cluster analysis was applied to identify symptom clusters with the hierarchical cluster agglomerative approach. We used the log-likelihood distance to measure the similarity of variables. Proximity between groups of variables was measured using the two-step method. RESULTS: The physical symptoms experienced by adolescents with moyamoya disease were 'limb weakness' - the most common - followed by a 'headache,' 'difficulty in speech,' and 'nausea/vomiting.' A total of five symptom clusters were derived: cluster 1 was characterized by 'limb weakness'; cluster 2 participants were asymptomatic or experienced 'convulsions'; cluster 3 experienced 'difficulty in speech' and 'facial paralysis'; cluster 4 is prone to 'dizziness' and 'pins and needles'; and cluster 5 displays 'headaches' and 'nausea/vomiting'. CONCLUSION: This study offers a multidimensional approach for identifying differences in clinical symptoms of moyamoya disease among adolescents. IMPACT: These results will help provide interventions concerning the characteristics of the symptoms of moyamoya disease among adolescents.

Validity and Reliability of the Sense of Coherence Scale among Korean Adolescents with Chronic Diseases.

BACKGROUND: This study adapted the Sense of Coherence (SOC) Scale for Korean adolescents with chronic diseases and evaluated its psychometric properties. PURPOSE: This study aimed to validate the Sense of Coherence Scale for Korean adolescents with Chronic Disease (SOC-AC). DESIGN AND METHODS: This study employed the cross-sectional design. In total, 144 adolescents with chronic diseases (age: 15.07 ± 1.62 years; 58% male) responded to the study questionnaire, which included the 13-item SOC scale (SOC-13) and the 10-item Children's Depression Inventory. The SOC-13 was shortened to create the 10-item SOC-AC. Through an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). RESULTS: Following the EFA, two items (Item 8 and 13) with low factor loadings were deleted. Further, following the CFA, one item (Item 2) with a high modification index was deleted. The resulting 10-item SOC-AC exhibited a 3-factor structure comprising the subscales of meaningfulness (Item 4, 7, and 12), comprehensibility-manageability (Item 3, 5, 9, and 11), and resilience (Item 1, 6, and 10). The internal consistency of the SOC-AC was 0.868; the Cronbach's alpha values were 0.765, 0.78, and 0.529 for the meaningfulness, comprehensibility-manageability, and resilience subscales. The Pearson's correlation coefficient for the association between the SOC-13 and depression showed acceptable criterion-related validity (r = -0.436, p < .0001). CONCLUSIONS: These findings indicate that the SOC-AC has satisfactory psychometric properties and that it is useful for assessing SOC in adolescents with chronic diseases. PRACTICE IMPLICATION: This study revealed the utility of the examined scale to measure SOC as a means of health promotion and care in adolescents with chronic diseases.

Development and Effects of a Mobile Application for Safety Incident Prevention among Hospitalized Korean Children: A pilot Study of Feasibility and Acceptability.

PURPOSE: This study aimed to describe the development, feasibility, acceptability, and effectiveness of a safety incident prevention program using the Safe Kids Hospital (SKH) application (app) among hospitalized Korean children aged 3-6 years. DESIGN AND METHODS: Through a literature review of studies on the development of mobile apps for child safety education, reference to educational apps on YouTube, and discussions among the research team, the SKH, a 2D game-based learning app, was developed. The SKH makes use of hospital pictures from the Hospital Safe Scale-Kids (HSS-Kids) test, a structured pictorial questionnaire that measures hospitalized children's safety awareness. This study was a pilot test of the SKH app in an urban Korean medical center. A one-group pre-posttest design was used to evaluate the effect of the SKH app among 30 child-caregiver (parent or grandparent) pairs using the HSS-Kids. In addition, semi-structured interviews were conducted to explore participants' experiences related to using the app. Quantitative and qualitative data were analyzed with t-test and content analysis, respectively. RESULTS: The mean age of the children was 4.5 years. Their level of safety awareness increased after the safety incident prevention program using the SKH app (M = 17.80, 24.53; t = 6.275, p < 0.001). Participants considered the app easy to use and a fun way of learning, expressing overall satisfaction with the education program. CONCLUSIONS: The effectiveness, feasibility, and acceptability of the SKH app were established. PRACTICE IMPLICATIONS: The SKH app is a promising educational method in pediatric settings.

Developing a conceptual model of pediatric inpatient safety accidents: A mixed methods approach.

Given that injuries to children during periods of hospitalization can lead to more serious health conditions in vulnerable children, preventing pediatric inpatient injuries should be a priority for the pediatric health care profession. This study was conducted to develop a conceptual model of factors affecting pediatric inpatient safety, including all injuries, not just fall injuries, in pediatric units. An explorative sequential mixed methods design was used. Qualitative interviews were conducted with 13 nurses working in pediatrics units and 17 parents of hospitalized children, and then 200 nurses in pediatrics units and parents of hospitalized children completed a self-report questionnaire. Based on the integration of both qualitative and quantitative data using building and weaving narrative integration, the Pediatric Inpatient Safety Accidents (PISA) model was proposed. The PISA model contains two main domains, the immediate and mediating domain and encompasses the six factors explain of the elements affecting the occurrence and prevention of pediatric inpatient safety accidents. The PISA model can serve as a model to understand child accidents in hospitals as well as to plan customized nursing interventions to prevent child accidents.

Changes in the Reciprocal Relationship Between Parenting and Self-Awareness During Adolescence: A Longitudinal Analysis of National Big Data.

PURPOSE: This study aimed to identify the reciprocal relationship between parenting and self-awareness during adolescence. DESIGN AND METHODS: This study analyzed longitudinal data from the Korea Children and Youth Panel Survey at three time points over a four-year period. Individuals (n = 2092; mean age 12.95 years) in their first year of middle school participated at the beginning of the survey. Repeated measurements were performed for the same participants in their third year of middle school and first year of high school between 2010 and 2016. Participants completed 18 self-awareness (self-esteem and self-identity) items and 21 parenting (positive and negative) items at three different time points. The autoregressive cross-lagged model was used to examine the causal relationship between parenting and adolescents' self-awareness. RESULTS: Positive parenting and adolescents' self-awareness influenced each other. In terms of the magnitude of the effects of the two variables, the impact of adolescents' self-awareness on positive parenting was greater than that of positive parenting on adolescents' self-awareness. Adolescents' self-awareness at the previous time points negatively predicted negative parenting at the later time points. However, negative parenting at the previous time points was not a significant predictor of adolescents' self-awareness at the later time points. CONCLUSIONS: In this study, the impact of adolescents' self-awareness on parenting was greater than was the case vice versa. This result could be regarded as reflecting adolescents' developmental characteristics. PRACTICE IMPLICATIONS: Intervention programs directly focusing on improving adolescents' self-awareness may be more effective than parenting interventions to improve self-awareness in adolescents.

What is the concept of parental 'emotional transference' to children? A Walker and Avant concept analysis.

PROBLEM: Human emotions come from relationships with others, and emotional states can be transferred to others through emotional transfer, leading people to experience identical emotions unconsciously. Emotional transference is not a new concept; however, no concept analysis has been performed on emotional transference from parents to children. ELIGIBILITY CRITERIA: A literature search was conducted of terms related to 'emotional transference', (e.g. 'emotional transfer' and 'affective transference') in the following databases: PubMed, CINAHL, ProQuest, RISS and DBPIA published between 1987 and 2016; documents were published in English or Korean. SAMPLE: Forty-four studies met review criteria. RESULTS: This review highlighted analysis of the concept of emotional transference from parent to child, a unidirectional process. The apparent attributes which are of importance to the child during parental interaction consist of parental expression (facial, voice, postural), child's interpretation of parental emotional expression and child's emotional formation. CONCLUSIONS: Understanding parental emotional transference to children is very important in effecting positive outcomes in the nursing environment. IMPLICATIONS: Nurses need to be aware that parental emotional transference to children and its attributes essential to assessment and intervention. Further study and education are needed to develop nursing care for children.

Predictors of Posttraumatic Growth Among University Students Who Experienced a Recent Earthquake.

A 5.8 magnitude earthquake hit Gyeongju City, South Korea, in 2016, traumatising and psychologically panicking residents. The purpose of this study was to identify predictive factors for posttraumatic growth (PTG) among university students who experienced South Korea's largest earthquake. A cross-sectional descriptive survey was distributed to a convenience sample of 493 university students in Gyeongju City. Data were collected via 5 self-report questionnaires. PTG was found to be positively correlated with posttraumatic stress disorder (PTSD), resilience and social support. Multiple regression analysis showed that PTSD (ß = 0.519, p < .001), resilience (ß = 0.213, p < .001), religion (ß = 0.125, p = .001) and sex (female; ß = 0.090, p = .010) were identified as predictive factors of PTG. These results illustrate a need for health care providers to include individual internal resources such as resilience in intervention strategies to promote PTG and decrease posttraumatic experiences in those who have experienced traumatic events such as earthquakes. A longitudinal study is needed to obtain more definitive evidence of PTSD progression and PTG over time.

Effect of Unshaven Hair with Absorbable Sutures and Early Postoperative Shampoo on Cranial Surgery Site Infection.

BACKGROUND: Cranial surgical site infection is a significant cause of morbidity and mortality in hospitals. Preoperative hair shaving for cranial neurosurgical procedures is performed traditionally in an attempt to protect patients against complications from infections at cranial surgical sites. However, preoperative shaving of surgical incision sites using traditional surgical blades without properly washing the head after surgery can cause infections at surgical sites. Therefore, a rapid protocol in which the scalp remains unshaven and absorbable sutures are used for scalp closure with early postoperative shampooing is examined in this study. METHODS: A retrospective comparative study was conducted from January 2008 to December 2012. A total of 2,641 patients who underwent unshaven cranial surgery with absorbable sutures for scalp closure were enrolled in this study. Data of 1,882 patients who underwent surgery with the traditional protocol from January 2005 to December 2007 were also analyzed for comparison. RESULTS: Of 2,641 patients who underwent cranial surgery with the rapid protocol, all but 2 (0.07%) patients experienced satisfactory wound healing. Of 1,882 patients who underwent cranial surgery with the traditional protocol, 3 patients (0.15%) had infections. Each infection occurred at the superficial incisional surgical site. CONCLUSION: Unshaven cranial surgery using absorbable sutures for scalp closure with early postoperative shampooing is safe and effective in the cranial neurosurgery setting. This protocol has a positive psychological effect. It can help patients accept neurosurgical procedures and improve their self-image after the operation.

Factors affecting the cultural competence of visiting nurses for rural multicultural family support in South Korea.

BACKGROUND: With the recent growth of multicultural families in the Korean society, the importance of the role of qualified visiting nurses in the delivery of culturally sensitive health care has grown dramatically. As the primary health care provider for multicultural families enrolled in public community-based health care centers, the cultural competence of visiting nurses is an essential qualification for the provision of quality health care for multicultural families, especially in rural areas. Cultural competence of visiting nurses is based on their cultural awareness and empathetic attitude toward multicultural families. This study aimed to examine the levels of cultural competence, empowerment, and empathy in visiting nurses, and to verify the factors that affect the cultural competence of visiting nurses working with rural multicultural families in South Korea. METHODS: Employing a cross-sectional descriptive study design, data from 143 visiting nurses working in rural areas were obtained. Data collection took place between November 2011 and August 2012. The measurement tools included the modified Korean version of the Cultural Awareness Scale, the Text of Items Measuring Empowerment, and the Interpersonal Reactivity Index to measure the level of empathy of visiting nurses. Analyses included descriptive statistics, a t-test, an ANOVA, a Pearson correlation coefficient analysis, and a multiple linear regression analysis. RESULTS: The cultural competence score of the visiting nurses was 3.07 on a 5-point Likert scale (SD = 0.30). The multiple regression analysis revealed that the cultural competence of visiting nurses was significantly influenced by experience of cultural education, empathy, and scores on the meaning subscale of the empowerment tool (R2 = 10.2%). CONCLUSIONS: Institutional support to enhance visiting nurses' empowerment by assuring the significance of their job and specific strategies to enhance their empathy would be helpful to improve the cultural competence of visiting nurses. Additionally, regular systematic education on culturally sensitive care would be helpful to enable visiting nurses to provide culturally sensitive care for multicultural families.

Risk Factors for Suicide Ideation Among Adolescents: Five-Year National Data Analysis.

This study identified risk factors for suicide ideation among adolescents through a secondary analysis using data collected over five years from the 5th-9th Korea Youth Risk Behavior Survey. We analyzed 370,568 students' responses to questions about suicidality. The risk factors for suicide ideation included demographic characteristics, such as gender (girls), low grades, low economic status, and not living with one or both parents. Behavioral and mental health risk factors affecting suicide ideation were depression, low sleep satisfaction, high stress, alcohol consumption, smoking, and sexual activity. Health care providers should particularly target adolescents manifesting the above risk factors when developing suicide prevention programs for them.

Effects of transglutaminase 2 inhibition on ventilator-induced lung injury.

This study was performed to examine the role of transglutaminase 2 (TG2) in ventilator-induced lung injury (VILI). C57BL/6 mice were divided into six experimental groups: 1) control group; 2) lipopolysaccharide (LPS) group; 3) lung protective ventilation (LPV) group; 4) VILI group; 5) VILI with cystamine, a TG2 inhibitor, pretreatment (Cyst+VILI) group; and 6) LPV with cystamine pretreatment (Cyst+LPV) group. Acute lung injury (ALI) score, TG2 activity and gene expression, inflammatory cytokines, and nuclear factor-κB (NF-κB) activity were measured. TG2 activity and gene expression were significantly increased in the VILI group (P < 0.05). Cystamine pretreatment significantly decreased TG2 activity and gene expression in the Cyst+VILI group (P < 0.05). Inflammatory cytokines were higher in the VILI group than in the LPS and LPV groups (P < 0.05), and significantly lower in the Cyst+VILI group than the VILI group (P < 0.05). NF-κB activity was increased in the VILI group compared with the LPS and LPV groups (P < 0.05), and significantly decreased in the Cyst+VILI group compared to the VILI group (P = 0.029). The ALI score of the Cyst+VILI group was lower than the VILI group, but the difference was not statistically significant (P = 0.105). These results suggest potential roles of TG2 in the pathogenesis of VILI.

Exploring the Link Between Smartphone Overdependence, Depression, and Suicidal Behaviors Through the Mediating Effect of Lifestyle Risk Behaviors Among South Korean Adolescents: A Cross-sectional Study Using National Big Data.

INTRODUCTION: This study examined how lifestyle risk behaviors mediate the relationship between smartphone overdependence, depressive symptoms, and suicidal behavior in adolescents. METHOD: Based on a secondary analysis of national survey data obtained in 2020 in South Korea, this study had 54,948 participating adolescents. Multiple logistic regression and mediating effect analyses were used to assess the relationships between the study variables. RESULTS: Adolescents' lifestyle risk behaviors partially mediated the link between smartphone overdependence and depression (Z = 6.86, p < .001), suicidal ideation (Z = 7.04, p < .001), and suicidal planning (Z = 4.59, p < .001). DISCUSSION: This is the first study to examine the mediating role of comprehensive lifestyle behaviors, not single habits, in the relationship between smartphone overdependence, depression, and suicidal behaviors. Encouraging healthy lifestyle behaviors in adolescents can help alleviate the link between smartphone overdependence and mental health problems.