Effects of a Nursing Simulation Learning Module on Clinical Reasoning Competence, Clinical Competence, Performance Confidence, and Anxiety in COVID-19 Patient-Care for Nursing Students

Purpose@#This study aimed to develop a nursing simulation learning module for coronavirus disease 2019 (COVID-19) patient-care and examine its effects on clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient care for nursing students. @*Methods@#A non-equivalent control group pre- and post-test design was employed. The study participants included 47 nursing students (23 in the experimental group and 24 in the control group) from G City. A simulation learning module for COVID-19 patient-care was developed based on the Jeffries simulation model. The module consisted of a briefing, simulation practice, and debriefing. The effects of the simulation module were measured using clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient-care. Data were analyzed using χ 2 -test, Fisher’s exact test, t-test, Wilcoxon signed-rank test, and Mann– Whitney U test. @*Results@#The levels of clinical reasoning competence, clinical competence, and performance confidence of the experimental group were significantly higher than that of the control group, and the level of anxiety was significantly low after simulation learning. @*Conclusion@#The nursing simulation learning module for COVID-19 patient-care is more effective than the traditional method in terms of improving students’ clinical reasoning competence, clinical competence, and performance confidence, and reducing their anxiety. The module is expected to be useful for educational and clinical environments as an effective teaching and learning strategy to empower nursing competency and contribute to nursing education and clinical changes.

Baseline Clinical and Biomarker Characteristics of Biobank Innovations for Chronic Cerebrovascular Disease With Alzheimer’s Disease Study: BICWALZS

Objective@#We aimed to present the study design and baseline cross-sectional participant characteristics of biobank innovations for chronic cerebrovascular disease with Alzheimer’s disease study (BICWALZS) participants. @*Methods@#A total of 1,013 participants were enrolled in BICWALZS from October 2016 to December 2020. All participants underwent clinical assessments, basic blood tests, and standardized neuropsychological tests (n=1,013). We performed brain magnetic resonance imaging (MRI, n=817), brain amyloid positron emission tomography (PET, n=713), single nucleotide polymorphism microarray chip (K-Chip, n=949), locomotor activity assessment (actigraphy, n=200), and patient-derived dermal fibroblast sampling (n=175) on a subset of participants. @*Results@#The mean age was 72.8 years, and 658 (65.0%) were females. Based on clinical assessments, total of 168, 534, 211, 80, and 20 had subjective cognitive decline, mild cognitive impairment (MCI), Alzheimer’s dementia, vascular dementia, and other types of dementia or not otherwise specified, respectively. Based on neuroimaging biomarkers and cognition, 199, 159, 78, and 204 were cognitively normal (CN), Alzheimer’s disease (AD)-related cognitive impairment, vascular cognitive impairment, and not otherwise specified due to mixed pathology (NOS). Each group exhibited many differences in various clinical, neuropsychological, and neuroimaging results at baseline. Baseline characteristics of BICWALZS participants in the MCI, AD, and vascular dementia groups were generally acceptable and consistent with 26 worldwide dementia cohorts and another independent AD cohort in Korea. @*Conclusion@#The BICWALZS is a prospective and longitudinal study assessing various clinical and biomarker characteristics in older adults with cognitive complaints. Details of the recruitment process, methodology, and baseline assessment results are described in this paper.

Two Cases of Patients with a Rash along the Intertriginous Area without Certain Drug History / 대한피부과학회지

We report a skin rash with a sharply demarcated erythema on the flexural area. The differential diagnoses included Baboon syndrome and symmetrical drug-related intertriginous and flexural exanthema. The diagnosis can be made based on the presence of previous cutaneous sensitization and causative agents. Our cases were consistent with a diagnosis of Baboon syndrome with no drug history.

Effects of a Web-Based Korean Triage and Acuity Scale Learning Program on Triage Self-Efficacy and Triage Performance Ability for Nurses in Emergency Department

PURPOSE: The Korean Triage and Acuity Scale (KTAS) is a tool used to classify the severity and urgency of emergency department (ED) patients, focusing on their symptoms. In consideration of the importance of the KTAS, a web-based learning program has emerged as a new mode of education; it enables ED triage nurses to access it anytime and anywhere, and according to their own learning abilities. This study aimed to develop a web-based KTAS learning program and evaluate its effects on self-efficacy and triage performance ability in ED nurses. METHODS: A quasi-experimental design with a non-equivalent control group pretest-posttest was used. The conceptual framework was Bandura's self-efficacy theory. There were 30 participants in the experimental group and 29 in the control group. The experimental group attended an orientation and 4 sessions of a web-based KTAS learning program. The learning program lasted 280 minutes over five weeks, consisting of 40 minutes of orientation and four 60-minute sessions. RESULTS: The scores of self-efficacy, triage performance ability in KTAS level, and chief complaints significantly increased in the experimental group compared to the control group. In addition, the numbers of under-triage in KTAS significantly decreased in the experimental group in comparison to the control group. CONCLUSION: The results suggest that the learning program was effective in improving ED nurses' level of self-efficacy and triage performance ability (KTAS level and KTAS chief complaint). Accordingly, the web-based KTAS learning program can be applied as an education intervention to improve ED nurses' triage skill.

Effects of Facilitative Nurse-Patient Interaction using an Informational Leaflet on Emergency Care / 기본간호학회지

PURPOSE: The purpose of this study was to develop an informational leaflet on emergency care and to explore effects of facilitative nurse-patient interaction behavior using an informational leaflet on patient satisfaction with nurse-patient interaction behavior, patient anxiety, and patient satisfaction with use of emergency care. METHODS: This study was a quasi-experimental study that applied a nonequivalent control-group posttest-only design. The participants were 81 patients who visited the emergency department of a hospital in Korea; the experimental group (n=40) received facilitative nurse-patient interaction behavior using an informational leaflet, and the control group (n=41) received care under routine protocols without an information leaflet. The effects of the two groups were analyzed using an independent t-test with SPSS computer program. RESULTS: Patient satisfaction with nurse-patient interaction behavior and use of emergency care in the experimental group were significantly higher than in the control group. Patient anxiety related to using emergency care in the experimental group was significantly lower than the control group. CONCLUSION: Therefore, facilitative nurse-patient interaction behavior using an informational leaflet to the patient may be useful interventions that are easily implemented by nurses in emergency settings.

Effects of a Web-Based Korean Triage and Acuity Scale Learning Program on Triage Self-Efficacy and Triage Performance Ability for Nurses in Emergency Department

PURPOSE@#The Korean Triage and Acuity Scale (KTAS) is a tool used to classify the severity and urgency of emergency department (ED) patients, focusing on their symptoms. In consideration of the importance of the KTAS, a web-based learning program has emerged as a new mode of education; it enables ED triage nurses to access it anytime and anywhere, and according to their own learning abilities. This study aimed to develop a web-based KTAS learning program and evaluate its effects on self-efficacy and triage performance ability in ED nurses.@*METHODS@#A quasi-experimental design with a non-equivalent control group pretest-posttest was used. The conceptual framework was Bandura's self-efficacy theory. There were 30 participants in the experimental group and 29 in the control group. The experimental group attended an orientation and 4 sessions of a web-based KTAS learning program. The learning program lasted 280 minutes over five weeks, consisting of 40 minutes of orientation and four 60-minute sessions.@*RESULTS@#The scores of self-efficacy, triage performance ability in KTAS level, and chief complaints significantly increased in the experimental group compared to the control group. In addition, the numbers of under-triage in KTAS significantly decreased in the experimental group in comparison to the control group.@*CONCLUSION@#The results suggest that the learning program was effective in improving ED nurses' level of self-efficacy and triage performance ability (KTAS level and KTAS chief complaint). Accordingly, the web-based KTAS learning program can be applied as an education intervention to improve ED nurses' triage skill.

Recurrent Ischemic Strokes with Progression of Middle Cerebral Artery Stenosis during HIV Treatment

Human immunodeficiency virus (HIV) infection can result in ischemic stroke via several mechanisms, including opportunistic infection, vasculopathy, cardioembolism, and coagulopathy. HIV-vasculopathy is related to endothelial dysfunction, stenosis and aneurysm formation, infectious vasculitis, dissection and accelerated atherosclerosis during highly active antiretroviral therapy (HAART). We represent a case of HIV infection manifested as an acute ischemic stroke attack. After 4 months during HAART, our patient experienced a recurrent ischemic stroke with progression of middle cerebral artery stenosis.

Clinical, Histopathological, and Immunohistochemical Differences between Men and Women with Psoriasis According to Disease Severity: Possible Role of Estrogen / 대한피부과학회지

BACKGROUND: Psoriasis is a chronic inflammatory skin disorder histopathologically characterized by epidermal hyperplasia, vascular proliferation, and inflammatory infiltrates. It runs a less severe course in women than in men. The role of estrogen in the pathogenesis of psoriasis remains unclear. OBJECTIVE: We investigated the clinicohistopathological differences between men and women with psoriasis and examined whether serum estrogen levels and immunohistochemical findings correlate with gender and disease severity. METHODS: We retrospectively reviewed the medical records of 500 patients with psoriasis. Among these patients, 60 who consented to participate in the study were classified into four groups as follows: 10 men showing psoriasis on < 10% of their body surface area (BSA) with psoriasis area severity index (PASI) < 10; 20 men showing psoriasis on ≥10% of their BSA with PASI≥10; 10 women showing psoriasis on < 10% of their BSA with PASI < 10; and 20 women showing psoriasis on ≥10% of their BSA with PASI ≥10. Serum estrogen levels were measured using radioimmunoassay. Immunohistochemical staining of skin biopsy tissues was performed using ERα, ERβ, and CCL5. RESULTS: Men diagnosed with psoriasis showed higher BSA and PASI scores than women. Women aged ≥60 years showed higher BSA and PASI scores than women aged < 60 years. There were no histological differences between the four groups. Serum estrogen levels were higher in the patients presenting with mild psoriasis, as well as in women. ERα, ERβ, and CCL5 showed a stronger staining tendency in patients with more severe psoriasis. CONCLUSION: Gender influences the severity of psoriasis, and estrogen plays an important role. This finding is explained by the fact that estrogen decreases inflammation in psoriasis possibly via its action on estrogen receptors in epidermal keratinocytes.

Erratum: Neutrophilic Dermatosis Confined to the Lymphedematous Area

We found that the year of Accepted for publication of the letter was published incorrectly.

Nurses' Perception of Patient Safety Culture and Safety Control in Patient Safety Management Activities / 간호행정학회지

PURPOSE: There have been global initiatives and efforts over the last decade to manage patient safety. Thus aims of this study were to examine university hospital nurses' perceptions of patient safety culture and levels of safety control, and to identify factors that affect patient safety management activities. METHODS: Participants were 222 nurses who had worked as nurses for more than one year and who conducted patient safety management activities at a university hospital. Data were collected using structured questionnaires and were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression analysis with SPSS/WIN 20.0 computer program. RESULTS: General factors which positively impacted nurses' patient safety management were total length of work in nursing, total length of work in present hospital, and experience of a patient safety accident along with safety factors of perception of communication about accident related events and frequency of reporting accident events. These variables explained 45% of the variance in patient safety management activities. CONCLUSION: The findings from this study suggest solutions to promote patient safety management activities in hospitals and provide basic background for nursing education intervention strategies to promote safety control and patient safety management activities intended for nurses.

Histopathological Differential Diagnosis of Psoriasis and Seborrheic Dermatitis of the Scalp

BACKGROUND: The differential diagnosis of psoriasis and seborrheic dermatitis can be difficult when both conditions are localized to the scalp without the involvement of other skin sites. OBJECTIVE: We aimed to evaluate the histopathological differences between psoriasis and seborrheic dermatitis on the scalp and identify favorable criteria for their differential diagnosis. METHODS: We evaluated 15 cases of psoriasis and 20 cases of seborrheic dermatitis of the scalp that had been clinicopathologically diagnosed. Skin biopsy sections stained with H&E were examined. Additional immunohistochemistry was performed, including Ki-67, keratin 10, caspase-5, and GLUT-1. RESULTS: On histopathological examination, mounds of parakeratosis with neutrophils, spongiform micropustules of Kogoj, and clubbed and evenly elongated rete ridges were significantly more frequently observed in psoriasis. Follicular plugging, shoulder parakeratosis and prominent lymphocytic exocytosis were significantly more common in seborrheic dermatitis. Moreover, significantly higher mitotic figures were observed in psoriatic lesions than in seborrheic dermatitis. Immunohistochemistry did not show any difference between psoriasis and seborrheic dermatitis. CONCLUSION: Histopathological features favoring psoriasis include mounds of parakeratosis with neutrophils, spongiform micropustules of Kogoj, clubbed and evenly elongated rete ridges, and increased mitotic figures (≥6/high-powered field). Features indicating seborrheic dermatitis are follicular plugging, shoulder parakeratosis and prominent lymphocytic exocytosis. Immunohistochemistry was not helpful in differentiating psoriasis from seborrheic dermatitis.

Recurrence of Nevus of Ota after Successful Laser Treatment: Possible Role of Dermal Stem Cells

No abstract available.

Recurrence of Nevus of Ota after Successful Laser Treatment: Possible Role of Dermal Stem Cells

No abstract available.

Claudin-1, -2, -4, and -5: comparison of expression levels and distribution in equine tissues

Claudins, which are known as transmembrane proteins play an essential role in tight junctions (TJs) to form physical barriers and regulate paracellular transportation. To understand equine diseases, it is helpful to measure the tissue-specific expression of TJs in horses. Major equine diseases such as colic and West Nile cause damage to TJs. In this study, the expression level and distribution of claudin-1, -2, -4, and -5 in eight tissues were assessed by Western blotting and immunohistochemistry methods. Claudin-1 was primarily identified in the lung, duodenum, and uterus, claudin-2 was evenly observed in equine tissues, claudin-4 was abundantly detected in the liver, kidney and uterus, and claudin-5 was strongly expressed in the lung, duodenum, ovary, and uterus, as determined by Western blotting method. The localization of equine claudins was observed by immunohistochemistry methods. These findings provide knowledge regarding the expression patterns and localization of equine claudins, as well as valuable information to understand tight junction-related diseases according to tissue specificity and function of claudins in horses.

Effects of Early Exercise Education using Video on Exercise Knowledge and Compliance of Elderly Patients Who Undergo Total Knee Replacement Surgery / 한국간호교육학회지

PURPOSE: This study was conducted to identify the effects of early exercise education using videos on exercise knowledge and compliance of elderly patients who undergo total knee replacement surgery. METHODS: This is a quasi-experimental study with a nonequivalent control group non-synchronized design. The participants were 70 elderly patients who had total knee arthroplasty in the C university hospital located in G city, Korea. Thirty-five patients were assigned to an experimental group and the other patients were assigned to a control group. After the total knee arthroplasty, the early exercise education accompanied by watching video instruction was conducted on the experimental group at post-operation second and third day for 15 minutes. General exercise education was administered to the control group. The exercise knowledge and compliance of the elderly patients were measured through structured questionnaires. CONCLUSION: The results of this study indicate that early exercise education using videos has positive effects to improve the exercise knowledge and compliance of elderly patients after total knee arthroplasty. This early exercise education can be used going forward as nursing intervention for elderly patients who undergo total knee replacement surgery.

Stress, Stress Coping Methods, and College Adjustment according to Behavioral Styles in Freshman Nursing Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to describe stress levels, stress coping methods, and college adjustment according to behavior styles in freshman nursing students. METHODS: Data were collected through a structured questionnaire targeting general characteristics, behavior styles, stress levels, stress coping methods, and college adjustment, and were analyzed with descriptive statistics, ANOVA, t-tests, and Pearson correlation using the SPSS program. RESULTS: Stress was related to perceived physical health status, satisfaction with school life, and behavior style. Problem-focused coping was related to exercise, satisfaction with school life, and behavior style. College adjustment was related to place of residence, personality, perceived physical health status, motivation for entrance, and satisfaction with school life. College adjustment had significant positive correlations with stress and problem-focused coping. The relationship between college adjustment and hopeful-thought coping had a significantly negative correlation. CONCLUSION: These results suggest that identifying the effects of self-understanding programs on stress management and college adjustment is required.

Uterine expression of tight junctions in the Canine uterus / 동물의과학연구지

Tight junctions (TJs) form continuous intercellular contacts in intercellular junctions. TJs involve integral proteins such as occludin (OCLN) and claudins (CLDNs) as well as peripheral proteins such as zona occludens-1 (ZO-1) and junctional adhesion molecules (JAMs). TJs control paracellular transportation across cell-to-cell junctions. Although TJs have been studied for several decades, comparison of the transcriptional-translational levels of these molecules in canine organs has not yet been performed. In this study, we examined uterine expression of CLDNs, OCLN, junction adhesion molecule-A, and ZO-1 in canine. Expression levels of canine uterine TJ proteins, including CLDN1, 2, 4, 5, JAM-A, ZO-1, and OCLN, were measured using reverse transcription PCR, real-time PCR, and Western blotting, whereas TJs distribution was determined by immunohistochemistry. The mRNA and protein expression levels of OCLN, CLDN-1, 4, JAM-1, and ZO-1 were identified in the uterus. Immunohistochemistry demonstrated that TJs were localized to the endometrium and/or myometrium of the uterus. Our results show that canine TJ proteins, including CLDNs, OCLN, JAM-A, and ZO-1, were expressed in the canine uterus. Taken together, these proteins may perform unique physiological roles in the uterus. Therefore, these findings may serve as a basis for further studies on TJ proteins and their roles in the physiological or pathological condition of the canine uterus.

Clinicopathologic Features of Progressive Macular Hypomelanosis in Korea / 대한피부과학회지

BACKGROUND: Progressive macular hypomelanosis, a disease of uncertain etiology, was first described by Guillet et al. in 1988. It is characterized by asymptomatic hypopigmented macules and patches that appear on the trunk and upper extremities. It is a relatively recently described disorder and more case reports are needed. OBJECTIVE: The purpose of the study was to document the clinicopathologic and ultrastructural features of progressive macular hypomelanosis in Korean patients. METHODS: Patients who presented to our hospital and were diagnosed with progressive macular hypomelanosis from July 2009 to June 2014 were enrolled in this study. Skin scrapings were taken for fungal tests, and skin biopsy specimens from lesional and normal skin were obtained. Sections of the skin biopsies were stained with hematoxylin and eosin, Brown and Brenn Gram stain, and Fontana-Masson stain, and they were incubated with a panel of immunohistochemical reagents used to identify melanocytes, namely, gp-100, melan-A, and microphthalmia-associated transcription factor. The tissues from two patients were also examined using electron microscopy. RESULTS: Over the course of 5 years, 16 patients presented with ill-defined hypopigmented macules on their trunks and upper extremities. The mean age of the patients was 28.4+/-9.0 years and the male to female ratio was about 1 : 4. Histopathologically, lesional skin showed a reduced level of pigmentation, while the number of melanocytes was preserved. None of the patients showed bacterial colonization of the pilosebaceous units. Electron microscopy demonstrated smaller and less melanized melanosomes in the lesional keratinocytes. CONCLUSION: Progressive macular hypomelanosis is a hypopigmentary disorder that is characterized by a loss of melanosomes without damage to the melanocytes. Although there are several reports that describe a possible relationship between Propionibacterium acnes and progressive macular hypomelanosis, it remains unclear.

Triple Combination of Systemic Corticosteroids, Excimer Laser, and Topical Tacrolimus in the Treatment of Recently Developed Localized Vitiligo

No abstract available.

Prevalence of Vitiligo and Associated Comorbidities in Korea

PURPOSE: Vitiligo prevalence and its associated comorbidities rate have been reported variably among different populations. We aimed to determine the prevalence of vitiligo in Korea along with the baseline rate of comorbidities and compared the risks to the general population using hospital visit information of the total population in Korea. MATERIALS AND METHODS: We assessed demographic characteristics of vitiligo patients in Korean population from 2009 to 2011 in a nationwide data from Health Insurance Review Assessment Service. Patients who had at least one visit to Korea's primary, secondary, or tertiary referral hospitals with International Classification of Diseases, 10th Revision, Clinical Modification diagnosis code for vitiligo were identified. As a supplementary study, comorbidities associated with vitiligo were selected for further review to calculate relative risks compared to the general population. RESULTS: The annual prevalence of vitiligo determined by hospital-visiting rate in Korea was 0.12% to 0.13% over a three year period. In sync with other previous epidemiological studies, there was bimodal distribution among the age groups and no difference between genders. Also, vitiligo in Korean population was associated with various autoimmune/non-autoimmune diseases such as thyroiditis, atopic dermatitis, and psoriasis. CONCLUSION: This study was by far the most comprehensive review on prevalence of vitiligo using a data of total population in Korea. The prevalence is within a range of those reported in previous literatures, and increased risk of comorbidities such as thyroid diseases and psoriasis in vitiligo might aid clinicians in the initial work up of vitiligo patients and concurrent follow ups.