Development and validation of the resident safety activity questionnaire for long-term care facility staff.

This study developed and tested a questionnaire to evaluate the safety activities supporting older adult residents' quality of care among long-term care facility staff. The process included item construction, expert review and pilot testing, testing of reliability and validation with 268 staff from 12 targeted facilities in South Korea. The final questionnaire yielded 28 items across six domains: proactive activities for emergency situations, comfort management, prevention of infections, staff training and communication, sufficient goods and equipment, and adequate personnel. These factors explained 73.48 % of the total variance. The fit indices in the confirmatory factor analysis were acceptable, and the total Cronbach's ⍺ was 0.952 (sub-domains: 0.823 - .895), indicating high reliability. The findings suggest the reliability and validity of the newly-developed Resident Safety Activity Questionnaire, enabling an accurate evaluation of the safety of long-term care facility residents and serving as an indicator for improving care quality in such establishments.

Development and Testing of the School Healthcare Partnership Scale for Parents.

BACKGROUND: Cooperation between parents and school nurses is essential for the successful completion of school courses and a healthy school life for children with long-term conditions. Therefore, this study aimed to develop and test a scale to measure parental perceptions of partnerships between school nurses and parents in the school health care (SHC) system for children with type 1 diabetes (T1D). METHODS: The content validity, factorial structure validity, convergent validity, discriminant validity, known-group validity, internal consistency reliability, and test-retest reliability of the School Healthcare Partnership Scale for Parents (SHCPS-P) were evaluated. Data were analyzed by performing exploratory factor analysis (EFA), Pearson's correlation, Cronbach's α, and independent t-tests. The total sample included 155 parents for the EFA and 49 parents for the stability test. Seventeen items, grouped into 3 dimensions, were extracted through principal axis factoring. RESULTS: The total variance explained by these factors was 53.57%. The scale demonstrated a high correlation with parental satisfaction regarding school nursing and a moderate correlation with diabetes-related safety, thereby showing convergent validity. A low correlation with empathy demonstrated discriminant validity. A significant difference existed in the partnership scores in known-group comparisons. Cronbach's α was 0.95, and the test-retest correlation coefficient was 0.95, which showed reliability. CONCLUSIONS: This study suggests that the SHCPS-P is a reliable and valid tool for measuring the perception of SHC partnership among parents of children with T1D and can be used as an indicator to measure parents' perspectives about SHC.

Patient Safety in Nursing Homes From an Ecological Perspective: An Integrated Review.

OBJECTIVES: The aims of the study were to identify the systemic factors affecting the characteristics and safety of older adults living in nursing homes and the resulting resident outcomes and to explore the relationship between them through an integrated literature review. METHODS: A literature search was conducted from April 22 to May 6, 2021, in the PubMed, Embase, Cochrane CENTRAL, CIHNAL, RISS, NDL, and KoreaMed databases. The following key words and MeSH terms were used for the search: "nursing home," "skilled nursing facility," "long-term care facility," and "patient safety" or "safety." RESULTS: Forty-seven qualifying articles were finally selected. Three domains were derived as personal factors, 12 as facility factors, and one as a policy factor. The interrelationships between them could result in positive or negative resident outcomes. The relationship between them was also reconstructed from an ecological perspective. CONCLUSIONS: The results demonstrated that the safety and quality of life of older adults living in nursing homes were affected by both individual and institutional factors.

Effects of an Orff Music Activity Intervention Program on the Ego-Resilience, Peer Relationships, Happiness, Interpersonal Care Awareness, Anxiety, and Stress of Children from Multicultural Families in Republic of Korea.

This study developed an interpersonal care-based Orff music activity program for children from multicultural families in Republic of Korea. We measured its effects on ego-resilience, peer relationships, happiness, interpersonal care awareness, anxiety, and stress. The participants were 74 children from third to sixth grade attending 10 regional children's centers in Cheonan-si, Chungcheongnam-do Province, Republic of Korea. They were randomly assigned to 36 experimental groups and 38 control groups. The experimental program was developed based on investigations of human care theory, expressions of care, and Orff music activities. The experiment was conducted twice a week for five weeks in 45 min sessions. Data were collected from June to September 2020. We used questionnaires on ego-resilience, peer relationships, happiness, and interpersonal care awareness to measure the effects, which were analyzed through frequency and descriptive statistics. Anxiety, physiological anxiety, acculturation stress, and physiological stress were measured using Behavior Detection VibraImage System Version 8.1 PRO (VIBRASYSTEM Ltd., Co., Seoul, Republic of Korea). The homogeneity of the variables across groups was examined using the χ² test, t-test, and Fisher's exact test. The effects were examined using repeated measures variance analysis and independent t-tests. The results showed that the program had significant effects on ego-resilience, peer relationships, happiness, interpersonal care awareness, physiological anxiety, and physiological stress. The findings suggest that interpersonal care nursing can be effective for children from multicultural families, and the program can be used for intervention to improve children's mental health.

Boosting Charge Transfer Efficiency by Nanofragment MXene for Efficient Photoelectrochemical Water Splitting of NiFe(OH)x Co-Catalyzed Hematite.

The use of oxygen evolution co-catalysts (OECs) with hematite photoanodes has received much attention because of the potential to reduce surface charge recombination. However, the low surface charge transfer and bulk charge separation rate of hematite are not improved by decorating with OECs, and the intrinsic drawbacks of hematite still limit efficient photoelectrochemical (PEC) water splitting. Here, we successfully overcame the sluggish oxygen evolution reaction performance of hematite for water splitting by inserting zero-dimensional (0D) nanofragmented MXene (NFMX) as a hole transport material between the hematite and the OEC. The 0D NFMX was fabricated from two-dimensional (2D) MXene sheets and deposited onto the surface of a three-dimensional (3D) hematite photoanode via a centrifuge-assisted method without altering the inherent performance of the 2D MXene sheets. Among many OECs, NiFe(OH)x was selected as the OEC to improve hematite PEC performance in our system because of its efficient charge transport behavior and high stability. Because of the great synergy between NFMX and NiFe(OH)x, NiFe(OH)x/NFMX/Fe2O3 achieved a maximum photocurrent density of 3.09 mA cm-2 at 1.23 VRHE, which is 2.78-fold higher than that of α-Fe2O3 (1.11 mA cm-2). Furthermore, the poor stability of MXene in an aqueous solution for water splitting was resolved by uniformly coating it with NiFe(OH)x, after which it showed outstanding stability for 60 h at 1.23 VRHE. This study demonstrates the successful use of NFMX as a hole transport material combined with an OEC for highly efficient water splitting.

Peptoniphilus gorbachii alleviates collagen-induced arthritis in mice by improving intestinal homeostasis and immune regulation.

Introduction: The intricate connection between gut microbiota and rheumatoid arthritis (RA) pathogenesis has gained prominence, although the specific microbial species contributing to RA development remain largely unknown. Recent studies have sought to comprehensively explore alterations in the human microbiome, focusing on identifying disease-related microbial species through blood analysis. Consequently, this study aimed to identify RA-associated microbial species using a serum microbial array system and to investigate the efficacy and underlying mechanisms of potential microbial species for RA treatment. Methods: Serum immunoglobulin M levels against 384 intestinal microbial species were assessed using a microbial microarray in patients with RA and healthy individuals. We investigated the therapeutic potential of the identified microbial candidate regarding arthritis development, immune responses, gut barrier function, and gut microbiome using a collagen-induced arthritis (CIA) mouse model. Results: Our findings revealed significant alterations in antibody levels against 36 microbial species in patients with RA compared to healthy individuals. Notably, the antibody levels against Peptoniphilus gorbachii (PG) were decreased in patients with RA and exhibited an inverse correlation with RA disease activity. In vitro experiments demonstrated that PG produced acetate and butyrate, while exhibiting anti-inflammatory properties. In CIA mice, PG administration suppressed arthritis symptoms, reduced the accumulation of inflammatory monocytes in the mesenteric lymph nodes, and downregulated gene expression of pro-inflammatory cytokines in the ileum. Additionally, PG supplementation restored intestinal barrier integrity and partially resolved gut microbial dysbiosis in CIA mice. The fecal microbiota in PG-treated mice corresponded to improved intestinal barrier integrity and reduced inflammatory responses. Conclusion: This study highlights the potential of serum-based detection of anti-microbial antibodies to identify microbial targets at the species level for RA treatment. Moreover, our findings suggest that PG, identified through the microbial microarray analysis, holds therapeutic potential for RA by restoring intestinal barrier integrity and suppressing the immunologic response associated with RA.

Promising Therapeutic Effects of Embryonic Stem Cells-Origin Mesenchymal Stem Cells in Experimental Pulmonary Fibrosis Models: Immunomodulatory and Anti-Apoptotic Mechanisms.

Interstitial lung disease (ILD) involves persistent inflammation and fibrosis, leading to respiratory failure and even death. Adult tissue-derived mesenchymal stem cells (MSCs) show potential in ILD therapeutics but obtaining an adequate quantity of cells for drug application is difficult. Daewoong Pharmaceutical's MSCs (DW-MSCs) derived from embryonic stem cells sustain a high proliferative capacity following long-term culture and expansion. The aim of this study was to investigate the therapeutic potential of DW-MSCs in experimental mouse models of ILD. DW-MSCs were expanded up to 12 passages for in vivo application in bleomycin-induced pulmonary fibrosis and collagen-induced connective tissue disease-ILD mouse models. We assessed lung inflammation and fibrosis, lung tissue immune cells, fibrosis-related gene/protein expression, apoptosis and mitochondrial function of alveolar epithelial cells, and mitochondrial transfer ability. Intravenous administration of DW-MSCs consistently improved lung fibrosis and reduced inflammatory and fibrotic markers expression in both models across various disease stages. The therapeutic effect of DW-MSCs was comparable to that following daily oral administration of nintedanib or pirfenidone. Mechanistically, DW-MSCs exhibited immunomodulatory effects by reducing the number of B cells during the early phase and increasing the ratio of Tregs to Th17 cells during the late phase of bleomycin-induced pulmonary fibrosis. Furthermore, DW-MSCs exhibited anti-apoptotic effects, increased cell viability, and improved mitochondrial respiration in alveolar epithelial cells by transferring their mitochondria to alveolar epithelial cells. Our findings indicate the strong potential of DW-MSCs in the treatment of ILD owing to their high efficacy and immunomodulatory and anti-apoptotic effects.

The Microbiome in Systemic Sclerosis: Pathophysiology and Therapeutic Potential.

Systemic sclerosis (SSc), also known as scleroderma, is an autoimmune disease with unknown etiology characterized by multi-organ fibrosis. Despite substantial investigation on SSc-related cellular and molecular mechanisms, effective therapies are still lacking. The skin, lungs, and gut are the most affected organs in SSc, which act as physical barriers and constantly communicate with colonized microbiota. Recent reports have documented a unique microbiome signature, which may be the pathogenic trigger or driver of SSc. Since gut microbiota influences the efficacy and toxicity of oral drugs, evaluating drug-microbiota interactions has become an area of interest in disease treatment. The existing evidence highlights the potential of the microbial challenge as a novel therapeutic option in SSc. In this review, we have summarized the current knowledge about molecular mechanisms of SSc and highlighted the underlying role of the microbiome in SSc pathogenesis. We have also discussed the latest therapeutic interventions using microbiomes in SSc, including drug-microbiota interactions and animal disease models. This review aims to elucidate the pathophysiological connection and therapeutic potential of the microbiome in SSc. Insights into the microbiome will significantly improve our understanding of etiopathogenesis and developing therapeutics for SSc.

Monitoring of characteristics of the patients visiting an emergency center in Cameroon through the development of hospital patient database.

Most countries in Sub-Saharan Africa have struggled to utilize health information technology and thus lack in accurate patient data. This paper describes the method of collecting patient data and patient characteristics in an emergency centre in Yaoundé, Cameroon. We developed an Epi InfoTM-based data entry form to collect data of the patients who visited the Centre des Urgences de Yaoundé (CURY) from January 2016 to June 2018. Demographic, clinical symptoms, treatments and outcome data were collected. Additional data on the patients with multiple trauma, chest pain, sepsis/septic shock, and stroke were also collected. During the study period, a total of 18,875 patients' data were collected (44.5% women, median age of 36). Of the total patients, 2.4% had chest pain, 2.7% had stroke, 1.9% had sepsis/septic shock, and 1.6% had multiple trauma. About 6.0% patients received operation and majority of patients were discharged either normally (48.2%) or with continuity of care (26.3%). About 5.0% of patients were transferred to other hospital and 5.2% of patients were dead. This study serves to broaden understanding of the emergency patients in Yaoundé, Cameroon.

Predicting ketosis during the transition period in Holstein Friesian cows using hematological and serum biochemical parameters on the calving date.

Ketosis often occurs during the postpartum transition period in dairy cows, leading to economic and welfare problems. Previously, ketosis was reported to be associated with hematological and serum biochemical parameters. However, the association between the parameters on the calving date and ketosis during the postpartum transition period remains unclear. This study aimed to investigate this association. Blood samples were collected from the jugular vein of Holstein cows on the calving date and ß-hydroxybutyrate was tested once every 3 days (8 times in 21 days). The cows were divided into three groups: non-ketosis, subclinical ketosis, and clinical ketosis. The clinical ketosis group significantly had the highest values of mean corpuscular volume, mean corpuscular hemoglobin, ß-hydroxybutyrate, non-esterified fatty acids, and total bilirubin, but the lowest values of red cell distribution width, the counts of white blood cell, monocyte, and eosinophil, albumin, alanine transaminase, lactate dehydrogenase, and amylase. In contrast, the non-ketosis group showed the opposite results (p < 0.05). In conclusion, these parameters are associated with the development and severity of ketosis. Our findings suggest that these parameters on the calving date may be useful indicators to identify dairy Holstein cow susceptible to ketosis during the transition period.

Comparison of clinical and inflammatory parameters in dogs with pyometra before and after ovariohysterectomy.

This study aimed to identify potential biomarkers of canine pyometra and their correlations with clinical parameters. First, 90 dogs with pyometra and 26 healthy female dogs were compared. Then, paired samples (before and after ovariohysterectomy) from 22 dogs with pyometra and 9 healthy controls from the initial cohort were compared. Concentrations of acute inflammatory proteins, C-reactive protein (CRP) and serum amyloid A (SAA), and cell-free DNA (cfDNA), were significantly higher in dogs with pyometra than in clinically healthy dogs. Cell-free DNA was the most sensitive biomarker for systemic inflammation, based on the receiver operating characteristic curve analysis (area under the curve = 0.959). In addition, cfDNA and CRP were significantly associated with inflammation and organ injury-related clinical parameters. Following the surgical removal of the inflamed uterus, interleukin-6 (IL-6), high-mobility group box 1 (HMGB1), and procalcitonin (PCT) significantly decreased, whereas changes in CRP, SAA, and cfDNA were not significant. These findings indicate that cfDNA, CRP, and SAA are potential clinical biomarkers of systemic inflammation in dogs with pyometra and PCT, IL-6, and HMGB1 are potential biomarkers of clinical recovery.

Cette étude visait à identifier les biomarqueurs potentiels du pyomètre canin et leurs corrélations avec les paramètres cliniques. Tout d'abord, 90 chiens avec pyomètre et 26 chiennes en bonne santé ont été comparés. Ensuite, des échantillons appariés (avant et après ovariohystérectomie) de 22 chiens avec pyomètre et neuf témoins sains de la cohorte initiale, ont été comparés.Les concentrations des protéines inflammatoires aiguës, protéine C réactive (CRP) et amyloïde sérique A (SAA), et d'ADN acellulaire (cfDNA), étaient significativement plus élevées chez les chiens atteints de pyomètre que chez les chiens cliniquement sains. L'ADN acellulaire était le biomarqueur le plus sensible pour l'inflammation systémique, sur la base de l'analyse de la courbe caractéristique de fonctionnement du récepteur (aire sous la courbe = 0,959). De plus, le cfDNA et la CRP étaient significativement associés à l'inflammation et aux paramètres cliniques liés aux lésions aux organes.Après l'ablation chirurgicale de l'utérus enflammé, l'interleukine-6 (IL-6), la protéine HMGB1 (« high-mobility groupe box 1 ¼) et la procalcitonine (PCT) ont significativement diminué, alors que les changements de CRP, SAA et cfDNA n'étaient pas significatifs. Ces résultats indiquent que cfDNA, CRP et SAA sont des biomarqueurs cliniques potentiels de l'inflammation systémique chez les chiens avec pyomètre et PCT, IL-6 et HMGB1 sont des biomarqueurs potentiels de récupération clinique.(Traduit par Docteur Serge Messier).

Effects of Adolescents' Lifestyle Habits and Body Composition on Bone Mineral Density.

The incidence of osteoporosis is increasing as the population ages, as is the need to manage and prevent it. Adolescence is the period when the fastest development of bone mass takes place. Increasing adolescents' maximum bone mass and avoiding the risk factors for its loss are effective for preventing osteoporosis. This study investigated the factors influencing adolescents' bone mineral density (BMD). The participants were 126 middle- and high-school students from Gangwon-do; 47.6% (n = 60) were male, with an average age of 15 (range 12-18) years of age. It was found that age, carbonated beverages, snacks, and calcium supplements were variables that showed significant differences in adolescents' BMD. Additionally, through correlation analysis, it was found that height, weight, body mass index (BMI), body water, protein, minerals, body fat mass, and skeletal muscle mass were correlated with BMD. Multiple regression analysis identified age, calcium supplements, BMI, body fat mass, and skeletal muscle mass as BMD-associated factors. These results show that adolescents' BMD is higher with lower body fat mass, higher BMI and skeletal muscle mass, and a higher intake of calcium supplements.

Butyrate Improves Skin/Lung Fibrosis and Intestinal Dysbiosis in Bleomycin-Induced Mouse Models.

Systemic sclerosis (SSc) is an autoimmune disorder characterized by fibrosis of the skin and internal organs. Despite several studies on SSc treatments, effective treatments for SSc are still lacking. Since evidence suggests an association between intestinal microbiota and SSc, we focused on butyrate, which has beneficial effects in autoimmune diseases as a bacterial metabolite. Here, we investigated the therapeutic potential of sodium butyrate (SB) using a bleomycin-induced fibrosis mouse model of SSc and human dermal fibroblasts (HDFs). SB attenuated bleomycin-induced dermal and lung fibrosis in mice. SB influenced fecal microbiota composition (phyla Actinobacteria and Bacteroidetes, genera Bifidobacterium and Ruminococcus_g2). SB controlled macrophage differentiation in mesenteric lymph nodes, spleen, and bronchoalveolar lavage cells of mice with bleomycin-induced skin fibrosis. Profibrotic and proinflammatory gene expression was suppressed by SB administration in skin. Furthermore, SB inhibited transforming growth factor ß1-responsive proinflammatory expression with increased acetylation of histone 3 in HDFs. Subcutaneous SB application had antifibrogenic effects on the skin. Butyrate ameliorated skin and lung fibrosis by improving anti-inflammatory activity in a mouse model of SSc. Butyrate may exhibit indirect and direct anti-fibrogenic action on fibroblasts by regulating macrophage differentiation and inhibition of histone deacetylase 3. These findings suggest butyrate as an SSc treatment.

Face Mask Policies in South Korea in Response to COVID-19.

All over the world, the critical shortage of face masks has been evident during the COVID-19 outbreak. No specific policy to solve the shortage has been shared among public health scholars and practitioners. Recently, the Korean government implemented noteworthy policies to stabilize the face mask market. This article examines the three government initiatives (Emergency Stabilization Policies) using participant observation, and what the effects of the Emergency Stabilization Policies are.

Characterization of virulence genes in Escherichia coli strains isolated from pre-weaned calves in the Republic of Korea.

BACKGROUND: Escherichia coli is an important cause of diarrhea in calves and its diarrheagenic properties are related to presence of certain virulence genes. In this study, the prevalence of virulence genes F5, F17, F41, sta, stx1, stx2, eae, and saa in E. coli isolated from pre-weaned calves presenting with (n= 329) or without diarrhea (n= 360) was explored using multiplex polymerase chain reaction. We also evaluated the association between detection of E. coli and the presence of diarrhea. RESULTS: Escherichia coli was detected in 56.3% (388/689) of the fecal samples and showed the highest prevalence (66.5%) in 21-40-day-old calves and the lowest (46.3%) among those that were 1-20 days old. The prevalence of the enterotoxigenic E. coli (ETEC) and Shiga toxin-producing E. coli (STEC) pathotypes was detected in 73.9% and 15.9%, respectively. The results showed no association between diarrhea and the presence of E. coli in general, ETEC or STEC. The F17 gene was the most frequently detected virulence factor in E. coli of calves of all ages regardless of diarrhea. Interestingly, the results show that the calves aged 41-60 days with F17-positive E. coli are at a higher risk for production of Shiga toxin (Stx1; 95% confidence intervals: 1.86-31.95; P = 0.005) compared to calves aged 1-20 days; no association between this finding and diarrhea was observed among the calves of this age group. Moreover, the virulence genes associated with the ETEC and STEC strains were not significantly associated with pathogenicity in this study cohort. CONCLUSIONS: These results suggest that while the incidence of E. coli is age-related, there was no relationship linking E. coli virulence genes to calf age and diarrhea. Furthermore, the present study demonstrated that detection of E. coli strains either with or without virulence factors was not associated with diarrhea in pre-weaned calves.

Development of video-based educational materials for kidney-transplant patients.

INTRODUCTION: Treatment adherence has been evaluated as a major predictor of long-term outcome, and education has been suggested to improve adherence. Considering the characteristics of adult learners, it is necessary to implement educational programs that meet the needs of transplant patients. Multimedia education may be well-suited for this. This study aims to develop video education materials in accordance with transplant patients' self-care needs. METHODS: This study includes a literature review and patient interviews aimed at developing video education materials for the self-care needs of patients who underwent renal transplant surgery at a university hospital in Seoul. Ten patients were interviewed about the desired educational content, accessibility, and other preferences. After verifying the validity of the data, the video scenarios were produced and satisfaction surveys were conducted. RESULTS: Eleven self-care education items were identified through interviews with 10 kidney transplant patients. The expert validation of video-based educational content result was high (mean CVI = 0.94). The mean score of the patients' satisfaction evaluation of the completed 7-minute video instructional materials was also high (4.55 on a 5-point Likert scale). CONCLUSION: Findings indicate that the video education materials will meet the needs of adult learners and mitigate the limitations of the existing education programs by increasing interest and motivation and may contribute to increased treatment adherence and ultimately, positively effect self-care for new transplant patients.

Parental Factors Associated with Obesity in Korean Adolescents.

Parental characteristics can influence adolescent obesity. However, the influence of parental characteristics on obesity may differ depending on the adolescent's sex. This study evaluated parental characteristics that were associated with obesity in male and female adolescents. This study involved the secondary data analysis of cross-sectional survey data that were collected from June to September 2015. The study subjects included 1621 eighth-grade students. The study variables included sex, age, body mass index, household income, parental weight, parental perceptions of the child's body, parental lifestyle, and parental social support for healthy eating and physical activity. The association between parental factors and adolescent obesity was analyzed via logistic regression analysis for each sex. Among male students, the fathers' and mothers' overweight status, fathers' underestimation and overestimation of male adolescent weight, mothers' dietary habits, and the mothers' physical activity level were identified as obesity-associated factors. Among female students, the mothers' overweight status, underestimation of female adolescent weight by fathers, dietary habits, and the physical activity level of fathers were significantly associated with adolescent obesity. The mothers' overweight status and the underestimation of weight by fathers were strongly associated with obesity in male and female adolescents. Parental involvement in obesity-intervention programs could help prevent adolescent obesity.

A sampling and estimation method for monitoring poultry red mite (Dermanyssus gallinae) infestation on caged-layer poultry farms.

BACKGROUND: The poultry red mite, Dermanyssus gallinae, is a serious problem in the laying hen industry worldwide. Currently, the foremost control method for D. gallinae is the implementation of integrated pest management, the effective application of which necessitates a precise monitoring method. OBJECTIVES: The aim of the study was to propose an accurate monitoring method with a reliable protocol for caged-layer poultry farms, and to suggest an objective classification for assessing D. gallinae infestation on caged-layer poultry farms according to the number of mites collected using the developed monitoring method. METHODS: We compared the numbers of mites collected from corrugated cardboard traps, regarding with length of sampling periods, sampling sites on cage, and sampling positions in farm buildings. The study also compared the mean numbers of mites collected by the developed method with the infestation levels using by the conventional monitoring methods in 37 caged-layer farm buildings. RESULTS: The statistical validation provided the suitable monitoring method that the traps were installed for 2 days on feed boxes at 27 sampling points which included three vertical levels across nine equally divided zones of farms. Using this monitoring method, the D. gallinae infestation level can be assessed objectively on caged-layer poultry farms. Moreover, the method is more sensitive than the conventional method in detecting very small populations of mites. CONCLUSIONS: This method can be used to identify the initial stages of D. gallinae infestation in the caged-layer poultry farms, and therefore, will contribute to establishment of effective control strategies for this mite.

Zoonotic potential of Enterocytozoon bieneusi in pre-weaned Korean native calves.

BACKGROUND: Enterocytozoon bieneusi is the most common microsporidian species infecting humans and various animals worldwide. To date, there has been limited information on the prevalence of infection and genotypes of E. bieneusi in cattle in the Republic of Korea. Therefore, this study investigated the prevalence and genotypes of E. bieneusi circulating in pre-weaned Korean native calves and determined the age pattern of E. bieneusi infection and the relationship between E. bieneusi infection and diarrhea. METHODS: The prevalence of E. bieneusi infection in pre-weaned Korean native calves was screened by polymerase chain reaction. PCR-positive products were sequenced to determine the genotype of E. bieneusi. A Chi-square analysis was used to compare the association between diarrhea and the infection rate of E. bieneusi in each age range or for all ages. RESULTS: PCR and sequencing analysis revealed an overall prevalence (16.9%, 53/314) of E. bieneusi in pre-weaned calves. The prevalence of E. bieneusi was highest in September (36.2%), followed by March (28.3%). Enterocytozoon bieneusi infection was associated with diarrhea in calves (χ2 = 5.82, P = 0.016). Our results also indicated that E. bieneusi infection was significantly associated with calf age (χ2 = 11.61, P = 0.003), and the prevalence of E. bieneusi infection was significantly higher in calves aged 21-40 days-old (odds ratio: 2.90, 95% confidence interval: 1.54-5.45; P = 0.001) than in those aged 1-20 days-old. Interestingly, the association between E. bieneusi infection and diarrhea was observed only in calves aged 1-20 days-old (χ2 = 5.82, P = 0.010). We identified three known genotypes, BEB4 (n = 12), BEB8 (n = 21) and J (n = 16), and three novel genotypes, BEB8-like (n = 21), KCALF1 (n = 1) and KCALF2 (n = 1). The genotype BEB8 was the most prevalent among all age groups. All genotypes identified in this study exhibited zoonotic potential. CONCLUSIONS: To our knowledge, this is the first report of the genotype BEB4 in pre-weaned Korean native calves. Zoonotic E. bieneusi infection was prevalent in pre-weaned calves, indicating that cattle may play an important role as a reservoir host for E. bieneusi transmission to humans.

Effectiveness of cultural competence educational interventions on health professionals and patient outcomes: A systematic review.

PURPOSE: This systematic review aimed to identify, appraise, and synthesize the best available evidence for the effectiveness of cultural competence educational interventions on health professional and patient outcomes. METHODS: We conducted a systematic review of randomized and non-randomized controlled trials. We searched seven electronic databases including MEDLINE, EMBASE, Cochrane Library, and four Korean databases in June 2018. Studies that provided cultural competence educational interventions for health professionals and measured the impact on health professional outcomes, patient outcomes, or both were included. A narrative synthesis of study findings was performed. RESULTS: Eleven studies met the inclusion criteria. Studies used a randomized (n = 5) and a non-randomized controlled trial (n = 6) design and were conducted in the USA (n = 7), South Korea (n = 3), and Sweden (n = 1). Cultural competence education was provided mostly to those of single occupations, nurses (n = 5) or physicians (n = 4). The delivery mode was classroom (n = 7), online (n = 3), or blended learning (n = 1), using mainly lectures, discussions, and case studies as teaching and learning methods. Education duration ranged from less than 1 hr to 3 days. Nine studies reported significantly improved health professional outcomes compared to the control group. Patient outcomes were reported in three studies. Only one study reported significant effect on patient satisfaction (d = 0.94) and trust (d = 0.71). There was no significant effect on patient physiological outcomes. CONCLUSIONS: Cultural competence educational interventions had a positive effect on health professional outcomes. There is a considerable lack of research assessing patient outcomes, and there is limited evidence on whether interventions can change patient outcomes.