Clinical Work and Life of Mid-Career Male Nurses: A Qualitative Study.

In Korea, about 3000 qualified male nurses enter the clinical nursing field annually; however, they face challenges in long-term job retention in general hospitals. Therefore, this study characterized the work and life experiences of mid-career male nurses engaged in clinical nursing care. Participants were nine registered nurses with a minimum of five years' work experience in a general hospital in Korea. Data were collected through face-to-face, in-depth, semi-structured interviews. A phenomenological qualitative design was used with Colaizzi's data analysis method. Three categories, eight theme clusters, and seventeen themes were revealed. The three categories were "limitations and adaptation to work performance", "interpersonal difficulties and coping", and "facing reality and preparing for the future". Findings suggested that mid-career male nurses were considering transitioning to other job roles. These findings help clarify the clinical work experience of mid-career male nurses and their difficulties with job retention. The results provide basic data that may inform the design of policies to practically support male nurses in preserving their careers.

Effect of a Simulation-Based Handover Education Program for Nursing Students: A Quasi-Experimental Design.

Nursing handover facilitates the continuity of nursing and ensures patient safety and quality of care. This study aimed to evaluate the effectiveness of a handover education program by assessing handover knowledge, self-efficacy, and handover performance competency. A group pretest-post-test quasi-experimental design was used. Thirty 4th-year Korean nursing students participated in a handover education program comprising a lecture and simulation training using a high-fidelity simulator. The average level of handover knowledge was 4.63 ± 1.61 before the program and 5.83 ± 0.95 after (t = -3.71, p = 0.001). Meanwhile, the average self-efficacy score was 3.35 ± 0.57 before the program and 3.90 ± 0.60 after (t = -5.65, p < 0.001). Further, the average handover performance competency was 1.75 ± 0.25 before the program and 2.37 ± 0.21 after (t = -12.08, p < 0.001). The simulation-based handover education intervention was effective in improving knowledge, self-efficacy, and performance competency of nursing students. This intervention can provide an effective method of improving nursing students' handover skills prior to entering clinical practice.

The Impacts of Pilates and Yoga on Health-Promoting Behaviors and Subjective Health Status.

This study investigates whether Pilates and yoga lead people to adopt generally health-promoting lifestyle elements and feel better about their physical and mental fitness. To this end, we designed an 8 week exercise program of Pilates and yoga reviewed by veteran practitioners and conducted an experimental study through which we collected the data from 90 volunteered adult subjects between ages 30 and 49 (mean age = 35.47), equally represented by women and men without previous experience with Pilates or yoga. In the 8 week long experiment, we assigned the subjects to three groups, where subjects in the two exercise groups regularly took part in either Pilates or yoga classes, and the control group participated in neither exercise classes. All participants completed two surveys, the Health-Promoting Lifestyle Profile (HPLP II) and the Health Self-Rating Scale (HSRS), before and after their assigned program. In our analysis of pre- and post-treatment differences across the three groups, we ran ANOVA, ANCOVA, and Sheffé test, implemented using SPSS PASW Statistics 18.00. Our results indicate that Pilates and yoga groups exhibited a higher engagement in health-promoting behaviors than the control group after the program. Subjective health status, measured with HSRS, also improved significantly among Pilates and yoga participants compared to those in the control group after the program. The supplementary analysis finds no significant gender-based difference in these impacts. Overall, our results confirm that Pilates and yoga help recruit health-promoting behaviors in participants and engender positive beliefs about their subjective health status, thereby setting a positive reinforcement cycle in motion. By providing clear evidence that the promotion of Pilates or yoga can serve as an effective intervention strategy that helps individuals change behaviors adverse to their health, this study offers practical implications for healthcare professionals and public health officials alike.

Factors associated with posttraumatic growth in patients with severe burns by treatment phase.

Aim: This study aimed to identify differences in the level of depressive symptoms, social support and posttraumatic growth among patients with severe burns by treatment phase and the factors associated with posttraumatic growth in the acute and rehabilitation phases. Design: A cross-sectional descriptive design. Methods: The factors associated with posttraumatic growth in 179 patients with severe burns were assessed using regression analysis. Results: Compared with those in the acute phase (mild depression), those in the rehabilitation phase showed moderate depression and lower positive self-perception, resulting in a significant difference in the means. Social support was significantly correlated with posttraumatic growth and explained 14.9% of its variance in the acute phase. Depressive symptoms and social support were significantly associated with posttraumatic growth and explained 28.2% of its variance in the rehabilitation phase. Therefore, the need for counselling support and intervention for patients with severe burns is evident.

Effects of Academic Motivation on Clinical Practice-Related Post-Traumatic Growth among Nursing Students in South Korea: Mediating Effect of Resilience.

Post-traumatic growth (PTG) refers to personal growth that occurs after experiencing challenges. For many nursing students, PTG could occur during their clinical practice. Academic motivation and resilience could help students to overcome these traumatic clinical experiences and possibly achieve PTG. This study examined the relationships between nursing students' academic motivation and resilience leading to post-traumatic growth. A total of 291 nursing students from three South Korean nursing colleges participated in this cross-sectional study. Self-report questionnaire data were analyzed using t-tests, ANOVA, correlations, and hierarchical multiple linear regressions. Intrinsically motivated students' PTG scores were significantly higher compared to extrinsically motivated students (t = 4.62, p < 0.001). Resilience scores showed similar results (t = 3.81, p < 0.001). Significant total, direct, and indirect effects of academic motivation on resilience and PTG were found. In addition, resilience mediated 40.9% of the relationship between academic motivation and PTG. Nursing students with intrinsic academic motivation were more likely to achieve high PTG scores, and resilience mediated the relationship between academic motivation and PTG. It is suggested that the importance of academic motivation must be considered in the early stages of university-level nursing education to increase retention rates of nursing students.

Sex Differences in Factors Affecting Depressive Symptoms in Older People in the Prefrailty Phase.

Depressive symptoms experienced late in life have considerable effects on the prevalence of comorbidity with physical and cognitive disabilities. By identifying and intervening on modifiable indicators for depression in prefrail older individuals, progression to the frailty phase can be delayed, and physical, psychosocial, and cognitive health problems of older people can be reduced and prevented. This study assessed sex differences in factors affecting depressive symptoms in older people in the prefrailty phase in Korea. Data from the 2014 National Survey of Older Koreans revealed 1706 women and 662 men in the early stages of old age. Regression analysis showed that economic status, number of medications, social support, nutritional status, and fear of falling collectively accounted for 39.0% of the variance among older men. Using the same analysis method, economic status, number of chronic diseases, number of medications, chewing discomfort, regular exercise, social support, mobility, nutritional status, and fear of falling collectively accounted for 37.5% of the variance among older women. Based on differences in characteristics with respect to the sex of older people in the prefrailty phase, public health workers in the community should consider sex differences when planning a frailty management program.

The effects of Pilates and yoga participant's on engagement in functional movement and individual health level.

This study was conducted to investigate the effect of Pilates and yoga participating in their functional movement and individual health level. Ninety volunteers were randomly divided into three groups and evenly recruited female and male participants in each group through a reliable organization. Their age group was between the 30s and 40s. They were informed the research process and assigned to the consent form. Pilates group (n=30), yoga group (n=30), and control group (n=30) were assigned to fulfill short form of Rand 36-item health survey (SF-36) survey form based on self-administration method and were scored functional movement screen (FMS) test before the intervention. Pilates and yoga group were carried out certain exercise program 1-hr duration 3 times per week for 8 weeks. And control group did not perform any exercise during experimental period. After completion of the 8-week Pilates and yoga program, they recorded SF-36 and were scored FMS score for posttest in same way. When we compared the differences between pre- and posttreatment scores, we found that there was statistically significant difference among three groups on FMS (F [2,89]=15.56, P<0.001) and there was significant change in favor of Pilates group groups (F [2,89]=52.36, P<0.001) on SF-36. To conclude, Pilates group was more effective for improving functional movement and individual health level to assess quality of life than yoga group and control group.

Factors Influencing Mobility Relative to Nutritional Status among Elderly Women with Diabetes Mellitus.

BACKGROUND: The prevalence of functional disability is very high among elderly people. Malnourished individuals are less likely to recover from limited mobility and have higher risk of deterioration of functional disability. This study investigated factors influencing mobility relative to nutritional status in elderly women with diabetes mellitus. METHODS: We analyzed data of 464 elderly women with diabetes mellitus, obtained from the 2014 cross-sectional survey of the Korea Institute for Health and Social Affairs. RESULTS: In the well-nourished group, body mass index, difficulties in daily activities due to visual acuity loss, muscle strength, and depressive symptoms were significant predictors of mobility; the explanatory power of this model was 24.0% (F=12.905; P<0.001). In the malnourished group, muscle strength, depressive symptoms, and nutritional status were significant predictors of mobility; the explanatory power of this model was 40.5% (F=16.589; P<0.001). CONCLUSION: The level of mobility relative to nutritional status varied widely among elderly women with diabetes mellitus. Therefore, to improve mobility in malnourished elderly people, public health nurses must provide comprehensive nutrition management and a support system in addition to physical and psychological interventions.

Effect of the fragrance inhalation of essential oil from Asarum heterotropoides on depression-like behaviors in mice.

BACKGROUND: Psychological stressors may cause affective disorders, such as depression and anxiety, by altering expressions of corticotropin releasing factor (CRF), serotonin (5-HT), and tyrosine hydroxylase (TH) in the brain. This study investigated the effects of essential oil from Asarum heterotropoides (EOAH) on depression-like behaviors and brain expressions of CRF, 5-HT, and TH in mice challenged with stress. METHODS: Male ICR mice received fragrance inhalation of EOAH (0.25, 0.5, 1.0, and 2.0 g) for 3 h in the special cage capped with a filter paper before start of the forced swimming test (FST) and tail suspension test (TST). The duration of immobility was measured for the determination of depression-like behavior in the FST and TST. The selective serotonin reuptake inhibitor fluoxetine as positive control was administered at a dose of 15 mg/kg (i.p.) 30 min before start of behavioral testing. Immunoreactivities of CRF, 5-HT, and TH in the brain were also measured using separate groups of mice subjected to the FST. RESULTS: EOAH at higher doses (1.0 and 2.0 g) reduced immobility time in the FST and TST. In addition, EOAH at a dose of 1.0 g significantly reduced the expected increases in the expression of CRF positive neurons in the paraventricular nucleus and the expression of TH positive neurons in the locus coeruleus, and the expected decreases of the 5-HT positive neurons in the dorsal raphe nucleus. CONCLUSION: These results provide strong evidence that EOAH effectively inhibits depression-like behavioral responses, brain CRF and TH expression increases, and brain 5-HT expression decreases in mice challenged with stress.

Pre-course simulation as a predictor of satisfaction with an emergency nursing clinical course.

Recent research suggests that simulation education can effectively improve nursing students' practical competence and can enhance educational outcomes. But very few studies have identified the relationships between pre-course simulation and course satisfaction. The purpose of this study was to determine whether pre-course simulations and other advanced learning modalities (i.e. pre-course e-learning, observation, and clinical placement skill performance) predicted students' satisfaction with an emergency nursing clinical course. Second-year Korean nursing students (N = 284) participated in an integrated clinical course consisting of self-directed pre-course e-learning, a 2-hour pre-course simulation, and an 80-hour emergency room clinical placement with observation. Multiple regression analyses found that pre-course simulation, clinical placement skill performance, observation during the clinical placement, and pre-course e-learning accounted for 47.2% of the variance in course satisfaction. Notably, pre-course simulation made the largest contribution to course satisfaction, accounting for 29.1% of the variance. Pre-course simulation, skill performance, observation, and pre-course e-learning all significantly influenced learner satisfaction. Findings suggest that integrating simulation into the clinical curriculum may enhance clinical course satisfaction.

Gender differences in the relationship between physical functioning and depressive symptoms in low-income older adults living alone.

This study examined gender differences in the relationship between physical functioning and depressive symptoms in low-income older adults living alone in Korea, and the variables influencing these symptoms. Data from a total of 317 older adults in the 2011 Korean National Survey were used. Upper limb mobility, lower limb mobility, activities of daily living, instrumental activities of daily living, and depressive symptoms were measured. Data were analyzed using multiple regression analysis. Low-income older men and women living alone experienced depressive symptoms. Regression analysis showed that lower limb mobility and age together explained 35.4% of the variance in depressive symptoms in men. Subjective health status explained 16.7% of the same in women. These findings suggest that low-income older adults living alone should be carefully monitored by public healthcare managers to improve their physical and mental health, considering gender-specific elements.

Factors influencing quality of chest compression depth in nursing students.

The purpose of the study was to identify factors influencing quality of chest compression depth in nursing students. A convenience sample of 102 female nursing students enrolled in a cardiopulmonary resuscitation skills training session. Each student performed 3 min of chest compression skills on a Resusci Anne SkillReporter manikin for measurements of both depth and rate. Nursing students with correct compression depth (50-60 mm) had higher body weight (t = -2.02, P = 0.046) and body mass index (t = -2.19, P = 0.031) compared with students in the incorrect depth group. Mean chest compression depth was shallower in underweight nursing students compared with normal weight or overweight students (F = 8.89, P < 0.001). Body weight was a significant factor influencing quality of chest compression depth (F = 4.25, P = 0.003). Educational intervention targeting underweight nursing students might need to enhance the quality of chest compression skills.

Factors related to the initial stroke severity of posterior circulation ischemic stroke.

BACKGROUND: Posterior circulation (PC) stroke, which was previously less well known than anterior circulation (AC) stroke, has become more identified due to the development of imaging equipment. Recently, the initial stroke severity assessed by the NIH Stroke Scale (NIHSS) was reported as a useful measure for predicting the outcome of PC as well as AC stroke. The aim of our study was to investigate the factors related to the stroke severity of PC ischemic stroke as assessed by the baseline NIHSS and the predictors of progressive neurological deficit and 3-month outcome. METHODS: All patients with first-time PC stroke (onset ≤ 7 days), admitted for a 5-year period and given a complete evaluation including brain MRI and angiographic studies, were enrolled. Patients were divided into two groups by the baseline NIHSS: moderate-to-severe stroke (MTSS, NIHSS > 5) and mild stroke (MS, NIHSS ≤ 5). Baseline characteristics, symptoms and progression, etiological subtypes, lesion characteristics from imaging, and patient 3-month outcome assessed by the modified Rankin Scale (mRS) were compared between the two groups. RESULTS: Among 604 enrolled patients with PC ischemic stroke, 143 belonged to the MTSS group and 461 to the MS group. In logistic regression analysis, MTSS was independently associated with white blood cell count (odds ratio, OR = 1.00, p = 0.001), high sensitivity C-reactive protein level (OR = 1.23, p = 0.004), dysarthria (OR = 2.59, p = 0.013), weakness (OR = 6.43, p < 0.001), dysphagia (OR = 5.77, p < 0.001) and decreased consciousness (OR = 10.54, p < 0.001). The independent predictors associated with progressive neurological deficit were MTSS (OR = 3.82, p = 0.001), the distal territory classified by lesion location (OR = 0.09, p = 0.004) and dysphagia (OR = 2.38, p = 0.010). The independent predictors associated with a 3-month mRS of 3-6 were MTSS (OR = 7.69, p < 0.001), diplopia (OR = 0.26, p = 0.023), visual field defect (OR = 4.87, p = 0.014), dysphagia (OR = 3.15, p < 0.001) and progressive neurological deficit (OR = 4.27, p < 0.001). CONCLUSIONS: The initial severity categorization of PC ischemic stroke by the NIHSS has provided several distinctions and could help with the prediction of neurological deficit progression and 3-month clinical outcome.

Plasma B-type natriuretic peptide level in patients with acute cerebral infarction according to infarction subtype and infarction volume.

BACKGROUND: Plasma B-type natriuretic peptide (BNP) is used as a diagnostic marker of cardiovascular diseases. BNP is secreted mainly from the myocardium and has been detected by immunoreactivity in brain and cerebral arteries. The aim of our study was to investigate plasma BNP in patients with acute cerebral infarction according to infarction subtype and infarction volume. METHODS: We studied 141 patients with acute cerebral infarction, classified as large artery atherosclerosis (LAA), cardioembolism (CE), or small vessel disease (SA) according to the Trial of Org 10172 in Acute Stroke Treatment classification. Plasma BNP level was measured in patients and 61 healthy controls. We analyzed various clinical and laboratory variables of patients according to plasma BNP level. RESULTS: Compared to controls, the patients had higher plasma BNP (11.9 ± 11.7 pg/mL versus 124.6 ± 228.8 pg/mL, p <0.01). The highest quartile BNP group was associated with advanced age, female gender, current non-smoker, atrial fibrillation, heart failure, CE group, increased white blood cell counts, increased high sensitivity C-reactive protein, increased left atrium size, decreased left ventricular ejection fraction, increased initial National Institute of Health Stroke Scale, and increased infarction volume. According to multiple regression analysis, CE group, female gender, and infarction volume were independently associated with plasma BNP. Plasma BNP level showed statistically significant differences among LAA (n = 71), CE (n = 50), and SA (n = 20) groups (p <0.001), and the expression decreased in order of CE (253.8 ± 337.1 pg/mL), LAA (61.6 ± 78.8 pg/mL), and SA (25.3 ± 24.8 pg/mL). Increased plasma BNP correlated with increased infarction volume (r = 0.42, p <0.001). CONCLUSIONS: Plasma BNP may be helpful for prediction of etiologic classification of acute cerebral infarction and infarction volume.

Anti-angiogenic, anti-inflammatory and anti-nociceptive activity of 4-hydroxybenzyl alcohol.

4-Hydroxybenzyl alcohol (HBA), one of the well-known phenolic compounds in diverse plants, displayed a significant inhibition in the chick chorioallantoic membrane (CAM) angiogenesis assay. HBA was shown to contain an anti-inflammatory activity in carrageenan-induced air pouch model in rats and acetic acid-induced permeability model in mice. Anti-nociceptive activity of HBA was also assessed using the acetic acid-induced writhing test in mice. HBA was able to suppress production of nitric oxide (NO) and expression of inducible nitric oxide synthase (iNOS) in lipopolysaccharide (LPS)-activated RAW264.7 macrophages. In the macrophages, the level of reactive oxygen species (ROS) was diminished by HBA. Taken together, HBA possesses anti-angiogenic, anti-inflammatory and anti-nociceptive activity possibly via its down-regulating activity on NO production, which may be partly responsible for the pharmacological efficacy of several folkloric medicines.

Anti-angiogenic activity of the methanol extract and its fractions of Ulmus davidiana var. japonica.

This study aimed to elucidate anti-angiogenic activity of Ulmus davidiana var. japonica that has been widely used in folk medicine. The methanol extract (UDE) of Ulmus davidiana var. japonica concentration-dependently displayed a strong inhibition in the chick chorioallantoic membrane (CAM) angiogenesis. The n-butanol fraction of UDE and subsequent 30% MeOH subfraction were identified to be most responsible for the anti-angiogenic activity.

Anti-inflammatory and anti-angiogenic activities of Gastrodia elata Blume.

Gastrodia elata Blume rhizome has been traditionally used as a folk medicine for centuries in Oriental countries. Its ethanol extract (GEE) and subsequent fractions were used to evaluate anti-angiogenic, anti-inflammatory and related activities of Gastrodia elata. GEE potently inhibited angiogenesis in the chick chorioallantoic membrane assay, and its n-butanol fraction (BuOH) exerted the higher inhibitory effect. In a dose-dependent manner, GEE inhibited vascular permeability induced by acetic acid. GEE and its BuOH fraction exerted an inhibitory activity on exudate production, leukocyte migration and nitric oxide (NO) level in rat air-pouch model. GEE caused a dose-dependent inhibition of acetic acid-induced abdominal writhing in mice. In addition, GEE inhibited NO production and expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) upon stimulation by lipopolysaccharide (LPS) in RAW264.7 macrophages. In summary, we demonstrate some novel pharmacological activities of Gastrodia elata, such as anti-angiogenic, anti-inflammatory and analgesic activities, and in vivo and in vitro inhibitory activity on NO production.

[A case of iatrogenic tension pneumoperitoneum following colonoscopy in a patient with cytomegalovirus colitis].

Perforation of the colon occurs in 0.2 to 2% of all colonoscopic examinations. The most common sites of perforation are rectosigmoid junction and cecal area. Colonic perforation, leading to tension pneumoperitoneum in most cases, may be caused by direct trauma or pressurized air. It should be suspected in patients with hypotension, tachycardia and tachypnea during or after the colonoscopy. An 83-year-old woman was admitted due to pulmonary embolism and left cerebellar infarction. Colonoscopy was performed due to bloody diarrhea. She was diagnosed as cytomegalovirus (CMV) colitis. One week after the colonoscopy, colon perforation was incidentally found on ascending colon, and tension pneumoperitoneum occurred immediately after the procedure. The perforated site was primarily closed and the patient discharged 20 days later. Herein, we report a case of tension pneumoperitoneum following colonoscopy in a patient with CMV colitis.

[A case of peritoneal mesothelioma without a history of asbestos exposure].

Peritoneal mesothelioma is an unusual disease which diffusely involves the peritoneal surface. The incidence is approximately one per 1,000,000, and one fifth to one third of all mesothelioma are peritoneal in origin. Asbestos exposure is linked to the development of peritoneal mesothelioma as a significant etiology, but further investigation should be conducted. Abdominal sonography, abdominal CT and cytologic examination of ascitic fluid are used to confirm the diagnosis, but rarely provides proper diagnosis. Laparoscopy with biopsy is the most common diagnostic method for definite diagnosis of mesothelioma. Cytoreductive surgery and intraperitoneal chemotherapy have been suggested for better survival since the median survival after the initial diagnosis is near to 50 months. This report describes a case of 73-years-old male patient presented with abdominal pain and distension. This patient had not been exposed to asbestos. Abdominal sonography and CT showed massive ascites, multiple omental masses and peritoneal thickening. It was difficult to distinguish peritoneal mesothelioma from carcinomatosis. Laparoscopy and peritoneal biopsy was conducted and immunostaining examination confirmed the diagnosis of peritoneal mesothelioma.