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Purpose@#The aim of this study was to identify core keywords and topic groups in the “adolescent pregnancy” field of research for a better understanding of research trends in the past 10 years. @*Methods@#Topics related to adolescent pregnancy were extracted from 3,819 articles that were published in journals between January 2013 and July 2023. Abstracts were retrieved from five databases (MEDLINE, CINAHL, Embase, RISS, and KISS). Keywords were extracted from the abstracts and cleaned using semantic morphemes. Text network analysis and topic modeling were performed using NetMiner 4.3.3. @*Results@#The most important keywords were “health,” “woman,” “risk,” “group,” “girl,” “school,” “service,” “family,” “program,” and “contraception.” Five topic groups were identified through topic modeling. Through the topic modeling analysis, five themes were derived: “health service,” “community program for school girls,” “risks for adult women,” “relationship risks,” and “sexual contraceptive knowledge.” @*Conclusion@#This study utilized text network analysis and topic modeling to analyze keywords from abstracts of research conducted over the past decade on adolescent pregnancy. Given that adolescent pregnancy leads to physical, mental, social, and economic issues, it is imperative to provide integrated intervention programs, including prenatal/postnatal care, psychological services, proper contraception methods, and sex education, through school and community partnerships, as well as related research studies. Nurses can play a vital role by actively engaging in prevention efforts and directly supporting and educating socially disadvantaged adolescent mothers, which could significantly contribute to improving their quality of life.
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Purpose@#This study aimed to develop a case-based nursing education program using generative artificial intelligence and to assess its usability and applicability in nursing curriculums. @*Methods@#The program was developed by following the five steps of the ADDIE model: analysis, design, development, implementation, and evaluation. A panel of five nursing professors served as experts to implement and evaluate the program. @*Results@#Utilizing ChatGPT, six program modules were designed and developed based on experiential learning theory. The experts’ evaluations confirmed that the program was suitable for case-based learning, highly usable, and applicable to nursing education. @*Conclusion@#Generative artificial intelligence was identified as a valuable tool for enhancing the effectiveness of case-based learning. This study provides insights and future directions for integrating generative artificial intelligence into nursing education. Further research should be attempted to implement and evaluate this program with nursing students.
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The purpose of this study was to identify the influencing effects of job stress, professional autonomy, and reciprocity on the job embeddedness among comprehensive nursing care unit nurses. Methods: The participants in this study were 147 nurses who have worked for over 6 months in Comprehensive Nursing Care Unit. Data were collected from January 3 to January 31, 2022 from six general hospitals with more than 300 beds in three cities in G, G and P. Results: As the results of hierarchical regression analysis, job embeddedness was lower when nurses had clinical experiences for 1 to under 5 years (β=-.49, p<.001), 5 to under 10 years (β=-.27, p=.035), 10 to under 20 years (β=-.54, p<.001) compared to those who had clinical experiences for more than 20 years. Also, job embeddedness was higher when there was greater balance within team caregiving of reciprocality (β=.27, p<.001) and intrinsic reward (β=.22, p=.003), and lower role conflict (β =-.27, p<.001). Conclusion: The results of the study showed that job embededness would increase if the role conflict of comprehensive nursing care unit nurses reduces, if there was a culture that the members can make cooperative relationship with other health care professionals and, if there was an appropriate intrinsic reward depending on their work experience.
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Objectives@#This study aimed to analyze research trends in autism spectrum disorder (ASD) and savant syndrome and their cognitive characteristics through a systematic literature review. The objectives of this study were to establish an overview of research trends in ASD and savant syndrome, analyze the overall characteristics of individuals with ASD and savant syndrome, and examine their cognitive characteristics. @*Methods@#For the systematic literature review, three criteria were used to select review articles: 1) literature from peer-reviewed journals, published in the past 15 years, from 2008 to 2022; 2) subjects with ASD and savant syndrome; 3) study objectives focused on the basic phenomenon and cognitive characteristics of ASD and savant syndrome. Finally, based on the selection criteria, a total of 40 articles were included. @*Results@#Five themes and nine subthemes were derived from the analysis of 40 studies. The five main themes were as follows: 1) What is savant syndrome? 2) Demographic characteristics of savant syndrome; 3) Spectra of savant syndrome; 4) Savant syndrome and ASD;and 5) Cognitive characteristics of ASD with savant syndrome. The subthemes of the cognitive characteristics were weak central coherence, detail-focused cognitive processing, enhanced perceptual functioning, and hyper-systemizing. @*Conclusion@#Several studies have been conducted to understand ASD and savant syndrome; however, no single theory can specify the cognitive characteristics of people with ASD and savant syndrome. Therefore, further systematic and multi-layered research on ASD and savant syndrome are required for more comprehensive results.
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Background@#Although inequality in traumatic brain injury (TBI) by individual socioeconomic status (SES) exists, interventions to modify individual SES are difficult. However, as interventions for area-based SES can affect the individual SES, monitoring or public health intervention can be planned. We analyzed the effect of area-based SES on hospitalization for TBI and revealed yearly inequality trends to provide a basis for health intervention. @*Methods@#We included patients who were hospitalized due to intracranial injuries (ICIs) between 2008 and 2015 as a measure of severe TBI with data provided by the Korea National Hospital Discharge Survey. Area-based SES was synthesized using the 2010 census data. We assessed inequalities in ICI-related hospitalization rates using the relative index of inequality and the slope index of inequality for the periods 2008–2009, 2010–2011, 2012–2013, and 2014–2015. We analyzed the trends of these indices for the observation period by age and sex. @*Results@#The overall relative indices of inequality for each 2-year period were 1.82 (95% confidence interval, 1.5–2.3), 1.97 (1.6–2.5), 2.01 (1.6–2.5), and 2.01 (1.6–2.5), respectively. The overall slope indices of inequality in each period were 38.74 (23.5–54.0), 36.75 (21.7–51.8), 35.65 (20.7–50.6), and 43.11 (27.6–58.6), respectively. The relative indices of inequality showed a linear trend for men (P = 0.006), which was most evident in the ≥ 65-year age group. @*Conclusion@#Inequality in hospitalization for ICIs by area-based SES tended to increase during the observation period. Practical preventive interventions and input in healthcare resources for populations with low area-based SES are likely needed.
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Background@#Injury is a social problem that causes health and property losses, and it is important to identify the size and trend of injury for efficient prevention and management.Therefore, this study analyzed the trends in injury mortality and hospitalization rates from 2005 to 2019 in Korea. @*Methods@#Using mortality data by Statistics Korea and Korea National Hospital Discharge In-depth injury survey by the Korea Disease Control and Prevention Agency (KDCA), age standardized rates were calculated for death and hospitalization to analyze trends and annual changes with the joinpoint regression model. In addition, annual changes in the hospitalization rate of the transport accident and fall injuries by age group were analyzed, which are the major causes of injuries. @*Results@#From 2005 to 2019, the injury mortality rate has been on the decline, but the injury hospitalization rate has been on the rise. The annual rate of change varied depending on the injury mechanism, but the mortality rate tended to decrease or remain similar level, while the rate of hospitalization has steadily increased. In addition, by age group, injury mortality and hospitalization rates were high in the elderly. In particular, the hospitalization rate of the elderly was higher when comparing the hospitalization rate of the children in transport accidents and falls. Pedestrian transport accidents tended to decrease under the age of 15, but remained similar for those aged 65 and older, and bicycle accidents tended to increase in both groups. In addition, hospitalization rates were higher in the fall, with both groups showing a statistically significant increase in hospitalization rates caused by falls. @*Conclusion@#This study analyzed the trend of injury mortality and hospitalization and found that transport accidents and falls may vary depending on the means or age of the accident.Since injury is a big social problem that is a burden of disease, safety education and legal sanctions for injury prevention should be further improved in the future, especially by prioritizing vulnerable groups by age and detailed mechanisms of injury.
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Complex chromosome rearrangements (CCRs) are structural chromosomal rearrangements involving at least three chromosomes and more than two breakpoints. CCR carriers are generally phenotypically normal but related to higher risk of recurrent miscarriage and having abnormal offspring with congenital anomalies. However, most of CCR carriers are not aware of their condition until genetic analysis of either abortus or affected baby or parental karyotyping is performed. Herein, we present the case that CCR carrier patients can be identified by preimplantation genetic testing of preimplantation embryos. An infertile male patient with severe oligoasthenoteratozoospermia was diagnosed balanced reciprocal translocation, 46,XY,t(3;11) (p26;p14) at first. After attempting the first preimplantation genetic testing for structural rearrangement (PGT-SR) cycle, we found the recurrent segmental gain or loss on 21q21.3-q22.3 of five out of nine embryos. As a result of karyotype re-analysis, the patient’s karyotype showed a balanced CCR involving chromosomes 3, 11, and 21 with three breakpoints 3p26, 11p14, and 21q21. The patient underwent two PGT-SR cycles, and a pregnancy was established after the transfer of an euploid embryo in the second cycle. Amniocentesis confirmed that the baby carried normal karyotype without mosaicism. At 37 weeks gestation, a healthy girl weighting 3,050 g was born.
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Purpose@#Preimplantation genetic testing for monogenic disorders (PGT-M) has been successfully used to prevent couples with monogenic disorders from passing them on to their child. Charcot–Marie–Tooth Disease (CMT) is a genetic disorder characterized by progressive extremity muscle degeneration and loss of sensory function. For the first time in Korea, we report our experience of applying single nucleotide polymorphism genotyping and karyomapping for PGT-M of CMT disease. @*Materials and Methods@#Prior to clinical PGT-M, preclinical tests were performed using genotypes of affected families to identify informative single-nucleotide polymorphisms associated with mutant alleles. We performed five cycles of in vitro fertilization PGT-M in four couples with CMT1A, CMT2A, and CMT2S in CHA Fertility Center, Seoul Station. @*Results@#From July 2020 through August 2021, five cycles of PGT-M with karyomapping in four cases with CMT1 and CMT2 were analyzed retrospectively. A total of 17 blastocysts were biopsied and 15 embryos were successfully diagnosed (88.2%).Ten out of 15 embryos were diagnosed as unaffected (66.7%). Five cycles of PGT-M resulted in four transfer cycles, in which four embryos were transferred. Three clinical pregnancies were achieved (75%) and the prenatal diagnosis by amniocentesis for all three women confirmed PGT-M of karyomapping. One woman delivered a healthy baby uneventfully and two pregnancies are currently ongoing. @*Conclusion@#This is the first report in Korea on the application of karyomapping in PGT-M for CMT patients. This study shows that karyomapping is an efficient, reliable and accurate diagnostic method for PGT-M in various types of CMT diseases.
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Purpose@#The purpose of this study is to determine the influence of the learning environment on nursing students' clinical practice education and the violence experienced during clinical practice on vocational identity. @*Methods@#The design of the study was a descriptive survey, and data were collected from November 15 to November 27, 2019. The data of the study were obtained from 515 nursing students attending three universities using self-administered questionnaires. Data were analyzed using the SPSS 25.0 program. @*Results@#For the experience of violence, verbal violence (98.3%) was the type most commonly experienced, and patients (97.7%) were the most frequent perpetrators. The clinical learning environment was perceived differently according to gender, personality, interpersonal relationship, satisfaction with nursing, clinical practice satisfaction, violence prevention education, the need for violence prevention education, sexual violence experiences, and violent perpetrators. The most influential factor on vocational identity was satisfaction with the nursing major (β=0.24, p<.001), followed by extroverted personality (β=0.18, p<.001), clinical learning environment (β=0.15, p=.001), satisfaction with clinical practice (β =0.15, p=.002), and the experience of violence by patients (β=-0.10, p=.016), which together explained 24.1% of the variance in the model. @*Conclusion@#It is necessary to make efforts to ensure that students do not experience violence during clinical practice, to maintain a close cooperative relationship between university and clinical institutions to improve the learning environment for clinical practice, and to make the clinical field an educational learning environment.
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Background@#Most unintentional injuries that occur at home are preventable. However, it may be difficult to sufficiently reduce the number of falls occurring at home by only identifying risk factors focused on specific age groups. Therefore, this study aimed to identify the risk factors (especially age and places where injuries occurred at home) for intracranial injury (ICI) caused by unintentional falls at home. @*Methods@#Using the Emergency Department (ED)-Based Injury In-depth Surveillance, we analyzed the data of patients who visited the ED due to unintentional falls at home. Risk factors were identified using multivariable logistic regression according to age groups and interactions between place of injury occurrence and age groups, and sex and age groups were assessed. @*Results@#In total, 232,124 patients were included in the analysis; older adults had a higher adjusted odds ratio (aOR) 14.05 (95% confidence interval [CI], 12.74–15.49) of ICI than infants. The corridor was associated with ICI in the male pediatric group (aOR, 2.71; 95% CI, 1.08–6.84) and the balcony with the female pediatric group (aOR, 2.04; 95% CI, 1.03–4.04). In the adult group, aOR of kitchen was 1.38 (95% CI, 1.02–1.88) in females and 0.56 (95% CI, 0.48–0.66) in males. @*Conclusion@#In this study, we identified the risk factors of ICI caused by falls at home using ED-based injury surveillance data. The risk of ICI was different among places of occurrence in the home depending on the age groups and sex.
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OBJECTIVES@#We aimed to explore trends in the prevalence and management of obesity, hypertension, diabetes, and hypercholesterolemia in Korean adults from 1998 to 2018 using data from the Korea National Health and Nutrition Examination Survey (KNHANES). @*METHODS@#The study participants included 79,753 individuals aged ≥ 30 years who had participated in the health examination and health interview of the first (1998) to the seventh (2016-2018) KNHANES. The prevalence and management as well as annual percent change (APC) in chronic diseases were analyzed using SAS and the Joinpoint software program. @*RESULTS@#The prevalence of obesity in men significantly increased from 26.8% in 1998 to 44.7% in 2018 (APC= 1.9, p< 0.001), whereas that in women decreased slightly from 30.5% in 1998 to 28.3% in 2018 (APC= -0.5, p< 0.001). The prevalence of hypertension in men was 33.2% in 2018, with no significant change, whereas that in women slightly decreased to 23.1% in 2018 (APC= -0.9, p< 0.001). The prevalence of diabetes in men increased slightly from 10.5% in 2005 to 12.9% in 2018 (APC= 1.6, p< 0.001), whereas that in women remained at approximately 8%, with no significant change. The prevalence of hypercholesterolemia in both men and women increased 3-fold in 2018 (20.9% in men [APC = 8.2, p < 0.001] and 21.4% in women [APC= 7.1, p< 0.001]) compared to that in 2005. The awareness rate, treatment rate, and control rate of hypertension and hypercholesterolemia increased 2-3 fold. Regarding diabetes, the treatment rate increased, but the control rate did not change. @*CONCLUSIONS@#Over the past 20 years, the prevalence of obesity (in men), diabetes, and hypercholesterolemia has increased and management indicators, such as the awareness rate, treatment rate, and control rate of chronic diseases, have improved continuously.
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OBJECTIVES@#We aimed to examine the current status and trends of food and nutrient intake in the Korean population over the past 20 years using the data from the Korea National Health and Nutrition Examination Survey (KNHANES). @*METHODS@#We conducted a survey of 116,284 subjects over the age of one year in Korea, who participated in the KNHANES between 1998 and 2018. We collected data on the subjects’ intake for the day before using the 24-hour recall method. The annual percent change (APC) in the food groups and nutrient intake were calculated using SAS and Joinpoint software. @*RESULTS@#The intake of grains (APC=-0.4, p<0.05) and vegetables (APC=-0.8, p<0.05) was observed to decrease. In contrast, the intake of beverages, meat, dairy, and eggs increased. In particular, beverage intake increased by more than four times (APC=9.2, p<0.05). There was no significant change in energy intake. However, the proportion of energy intake from carbohydrates decreased by approximately 5%p (APC=-0.3, p<0.05), whereas that from fat increased by approximately 5%p (APC= 1.1, p<0.05). Additionally, there were decreases in the proportion of energy intake from breakfast and homemade meals and increases in the energy intake from snacks, dining out, and convenience food. The intake of vitamin C (APC=-3.2, p<0.05) and sodium (APC=-2.3, p<0.05) significantly decreased. @*CONCLUSIONS@#Over the past 20 years, there has been decreases in the intake of grains, vegetables, carbohydrates, sodium, and vitamin C and increases in the intake of beverages, dairy, meat, eggs, and fat. Since nutritional status is an important factor in the prevention and management of chronic diseases, it should be continuously monitored.
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OBJECTIVES@#This study aimed to examine the trends in health behaviors in Korean population using data from the Korea National Health and Nutrition Examination Survey (KNHANES). @*METHODS@#The subjects were 96,408 adults aged 19 years or older who participated in the first (1998) through seventh (2016-2018) KNHANES health interview. The prevalence of health behaviors (cigarette smoking, alcohol drinking, and physical activity) and annual percent change (APC) were estimated using SAS and the Joinpoint program. @*RESULTS@#The prevalence of current cigarette smoking in men decreased by 2.8%p (APC= -2.8, p< 0.001) annually over the 20-year period, and the prevalence of exposure to secondhand smoke at home substantially decreased compared to 2005 (APC= -8.8, p< 0.001). Compared to 2005, the prevalence of current alcohol drinking in women, but not men, increased (APC= 2.0, p< 0.001), and the prevalence of binge drinking decreased in men (APC= -0.7, p< 0.001) and increased in women (APC= 2.4, p< 0.001). The prevalence of aerobic physical activity decreased from 2014 in both gendersd (p< 0.001). The prevalence of healthy behaviors practice (non-smoking, alcohol abstinence, and aerobic physical activity) was down-trending (APC= -5.3, p< 0.001), especially among women (APC= -6.4, p< 0.001). @*CONCLUSIONS@#Over the past 20 years, smoking behaviors improved. However, drinking behavior was unchanged and physical activity indicators markedly decreased. More active programs are necessary for improving health behaviors, which are major risk factors linked to chronic diseases.
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The Korea National Health and Nutrition Examination Survey (KNHANES) was initiated in 1998 to provide evidence for the development and evaluation of health policies and programs. The Korea Disease Control and Prevention Agency is responsible for the KNHANES and has conducted it as a series of surveys. Over the past 20 years, efforts to produce accurate, timely, and nationwide health statistics have been refined by establishing a continuous annual survey system with full-time field staff, incrementally expanding survey components, collaborating with relevant academic societies for quality control, and revising the survey methods. Additionally, the utility of the collected data was increased by linking the KNHANES data with related data from other government agencies or institutions and making the overall data publicly available on the official website of KNHANES (https://knhanes.kdca.go.kr). Additional long-term plans are being developed, including plans to continue producing nationwide health indicators and invigorating the utilization of the KNHANES data.
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OBJECTIVES@#We aimed to explore trends in the prevalence and management of obesity, hypertension, diabetes, and hypercholesterolemia in Korean adults from 1998 to 2018 using data from the Korea National Health and Nutrition Examination Survey (KNHANES). @*METHODS@#The study participants included 79,753 individuals aged ≥ 30 years who had participated in the health examination and health interview of the first (1998) to the seventh (2016-2018) KNHANES. The prevalence and management as well as annual percent change (APC) in chronic diseases were analyzed using SAS and the Joinpoint software program. @*RESULTS@#The prevalence of obesity in men significantly increased from 26.8% in 1998 to 44.7% in 2018 (APC= 1.9, p< 0.001), whereas that in women decreased slightly from 30.5% in 1998 to 28.3% in 2018 (APC= -0.5, p< 0.001). The prevalence of hypertension in men was 33.2% in 2018, with no significant change, whereas that in women slightly decreased to 23.1% in 2018 (APC= -0.9, p< 0.001). The prevalence of diabetes in men increased slightly from 10.5% in 2005 to 12.9% in 2018 (APC= 1.6, p< 0.001), whereas that in women remained at approximately 8%, with no significant change. The prevalence of hypercholesterolemia in both men and women increased 3-fold in 2018 (20.9% in men [APC = 8.2, p < 0.001] and 21.4% in women [APC= 7.1, p< 0.001]) compared to that in 2005. The awareness rate, treatment rate, and control rate of hypertension and hypercholesterolemia increased 2-3 fold. Regarding diabetes, the treatment rate increased, but the control rate did not change. @*CONCLUSIONS@#Over the past 20 years, the prevalence of obesity (in men), diabetes, and hypercholesterolemia has increased and management indicators, such as the awareness rate, treatment rate, and control rate of chronic diseases, have improved continuously.
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OBJECTIVES@#We aimed to examine the current status and trends of food and nutrient intake in the Korean population over the past 20 years using the data from the Korea National Health and Nutrition Examination Survey (KNHANES). @*METHODS@#We conducted a survey of 116,284 subjects over the age of one year in Korea, who participated in the KNHANES between 1998 and 2018. We collected data on the subjects’ intake for the day before using the 24-hour recall method. The annual percent change (APC) in the food groups and nutrient intake were calculated using SAS and Joinpoint software. @*RESULTS@#The intake of grains (APC=-0.4, p<0.05) and vegetables (APC=-0.8, p<0.05) was observed to decrease. In contrast, the intake of beverages, meat, dairy, and eggs increased. In particular, beverage intake increased by more than four times (APC=9.2, p<0.05). There was no significant change in energy intake. However, the proportion of energy intake from carbohydrates decreased by approximately 5%p (APC=-0.3, p<0.05), whereas that from fat increased by approximately 5%p (APC= 1.1, p<0.05). Additionally, there were decreases in the proportion of energy intake from breakfast and homemade meals and increases in the energy intake from snacks, dining out, and convenience food. The intake of vitamin C (APC=-3.2, p<0.05) and sodium (APC=-2.3, p<0.05) significantly decreased. @*CONCLUSIONS@#Over the past 20 years, there has been decreases in the intake of grains, vegetables, carbohydrates, sodium, and vitamin C and increases in the intake of beverages, dairy, meat, eggs, and fat. Since nutritional status is an important factor in the prevention and management of chronic diseases, it should be continuously monitored.
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OBJECTIVES@#This study aimed to examine the trends in health behaviors in Korean population using data from the Korea National Health and Nutrition Examination Survey (KNHANES). @*METHODS@#The subjects were 96,408 adults aged 19 years or older who participated in the first (1998) through seventh (2016-2018) KNHANES health interview. The prevalence of health behaviors (cigarette smoking, alcohol drinking, and physical activity) and annual percent change (APC) were estimated using SAS and the Joinpoint program. @*RESULTS@#The prevalence of current cigarette smoking in men decreased by 2.8%p (APC= -2.8, p< 0.001) annually over the 20-year period, and the prevalence of exposure to secondhand smoke at home substantially decreased compared to 2005 (APC= -8.8, p< 0.001). Compared to 2005, the prevalence of current alcohol drinking in women, but not men, increased (APC= 2.0, p< 0.001), and the prevalence of binge drinking decreased in men (APC= -0.7, p< 0.001) and increased in women (APC= 2.4, p< 0.001). The prevalence of aerobic physical activity decreased from 2014 in both gendersd (p< 0.001). The prevalence of healthy behaviors practice (non-smoking, alcohol abstinence, and aerobic physical activity) was down-trending (APC= -5.3, p< 0.001), especially among women (APC= -6.4, p< 0.001). @*CONCLUSIONS@#Over the past 20 years, smoking behaviors improved. However, drinking behavior was unchanged and physical activity indicators markedly decreased. More active programs are necessary for improving health behaviors, which are major risk factors linked to chronic diseases.
RESUMO
The Korea National Health and Nutrition Examination Survey (KNHANES) was initiated in 1998 to provide evidence for the development and evaluation of health policies and programs. The Korea Disease Control and Prevention Agency is responsible for the KNHANES and has conducted it as a series of surveys. Over the past 20 years, efforts to produce accurate, timely, and nationwide health statistics have been refined by establishing a continuous annual survey system with full-time field staff, incrementally expanding survey components, collaborating with relevant academic societies for quality control, and revising the survey methods. Additionally, the utility of the collected data was increased by linking the KNHANES data with related data from other government agencies or institutions and making the overall data publicly available on the official website of KNHANES (https://knhanes.kdca.go.kr). Additional long-term plans are being developed, including plans to continue producing nationwide health indicators and invigorating the utilization of the KNHANES data.
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Asthma exacerbations are a major cause of intractable morbidity, increases in health care costs, and a greater progressive loss of lung function. Asthma exacerbations are most commonly triggered by respiratory viral infections, particularly with human rhinovirus (hRV). Respiratory viral infections are believed to affect the expression of indoleamine 2,3-dioxygenase (IDO), a limiting enzyme in tryptophan catabolism, which is presumed to alter asthmatic airway inflammation. Here, we explored the detailed role of IDO in the progression of asthma exacerbations using a mouse model for asthma exacerbation caused by hRV infection. Our results reveal that IDO is required to prevent neutrophilic inflammation in the course of asthma exacerbation caused by an hRV infection, as corroborated by markedly enhanced Th17- and Th1-type neutrophilia in the airways of IDO-deficient mice. This neutrophilia was closely associated with disrupted expression of tight junctions and enhanced expression of inflammasomerelated molecules and mucin-inducing genes. In addition, IDO ablation enhanced allergenspecific Th17- and Th1-biased CD4 + T-cell responses following hRV infection. The role of IDO in attenuating Th17- and Th1-type neutrophilic airway inflammation became more apparent in chronic asthma exacerbations after repeated allergen exposures and hRV infections. Furthermore, IDO enzymatic induction in leukocytes derived from the hematopoietic stem cell (HSC) lineage appeared to play a dominant role in attenuating Th17- and Th1-type neutrophilic inflammation in the airway following hRV infection. Therefore, IDO activity in HSC-derived leukocytes is required to regulate Th17- and Th1-type neutrophilic inflammation in the airway during asthma exacerbations caused by hRV infections.
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Purpose@#The purpose of this study is to determine the influence of the learning environment on nursing students' clinical practice education and the violence experienced during clinical practice on vocational identity. @*Methods@#The design of the study was a descriptive survey, and data were collected from November 15 to November 27, 2019. The data of the study were obtained from 515 nursing students attending three universities using self-administered questionnaires. Data were analyzed using the SPSS 25.0 program. @*Results@#For the experience of violence, verbal violence (98.3%) was the type most commonly experienced, and patients (97.7%) were the most frequent perpetrators. The clinical learning environment was perceived differently according to gender, personality, interpersonal relationship, satisfaction with nursing, clinical practice satisfaction, violence prevention education, the need for violence prevention education, sexual violence experiences, and violent perpetrators. The most influential factor on vocational identity was satisfaction with the nursing major (β=0.24, p<.001), followed by extroverted personality (β=0.18, p<.001), clinical learning environment (β=0.15, p=.001), satisfaction with clinical practice (β =0.15, p=.002), and the experience of violence by patients (β=-0.10, p=.016), which together explained 24.1% of the variance in the model. @*Conclusion@#It is necessary to make efforts to ensure that students do not experience violence during clinical practice, to maintain a close cooperative relationship between university and clinical institutions to improve the learning environment for clinical practice, and to make the clinical field an educational learning environment.