Adequacy of the examination-based licensing system and a training-based licensing system for midwifery license according to changes in childbirth medical infrastructure in Korea: a surveybased descriptive study

PURPOSE: The number of Korean midwifery licensing examination applicants has steadily decreased due to the low birth rate and lack of training institutions for midwives. This study aimed to evaluate the adequacy of the examination-based licensing system and the possibility of a training-based licensing system. METHODS: A survey questionnaire was developed and dispatched to 230 professionals from December 28, 2022 to January 13, 2023, through an online form using Google Surveys. Descriptive statistics were used to analyze the results. RESULTS: Responses from 217 persons (94.3%) were analyzed after excluding incomplete responses. Out of the 217 participants, 198 (91.2%) agreed with maintaining the current examination-based licensing system; 94 (43.3%) agreed with implementing a training-based licensing system to cover the examination costs due to the decreasing number of applicants; 132 (60.8%) agreed with establishing a midwifery education evaluation center for a training-based licensing system; 163 (75.1%) said that the quality of midwifery might be lowered if midwives were produced only by a training-based licensing system, and 197 (90.8%) said that the training of midwives as birth support personnel should be promoted in Korea. CONCLUSION: Favorable results were reported for the examination-based licensing system; however, if a training-based licensing system is implemented, it will be necessary to establish a midwifery education evaluation center to manage the quality of midwives. As the annual number of candidates for the Korean midwifery licensing examination has been approximately 10 in recent years, it is necessary to consider more actively granting midwifery licenses through a training-based licensing system.

Experiences of Forest Healing Instructors Who Met Cancer Patients in Forest Healing Programs: FGI Research.

BACKGROUND: Demand for urban forest programs for the healing of cancer survivors is increasing. To develop a forest healing program for the integrated care of cancer patients, it is necessary to analyze the experiences of forest healing instructors who have conducted programs for cancer patients. METHODS: This qualitative study applied focus group interviews (FGIs; four interviews with sixteen participants) to describe and understand the experiences of forest healing instructors who run forest healing programs for cancer patients. RESULTS: Four themes were identified: "prepared encounters and unexpected encounters," "yearning for healing," "people who need special care," and "things to prepare for cancer patient programs." CONCLUSION: Forest healing instructors had difficulty facilitating programs for cancer patients owing to prejudice and a lack of knowledge about the characteristics of cancer patients. Moreover, differentiated programs and places that align with the specific needs of cancer patients are needed. It is necessary to develop an integrated care forest healing program for cancer patients and educate forest healing instructors about the needs of cancer patients.

A present from the forest: Focus group interviews on cancer survivors' forest experiences.

Objective: To explore cancer survivors' forest experiences and to understand the relevance of these experiences from their perspectives in the context of the growing interest in nature's impact on health and quality of life. Methods: From July 29 to August 12, 2021, four focus group interviews were conducted with cancer survivors who visited forests in South Korea. The data were analyzed using qualitative content and thematic analysis. Results: The participants were 21 female cancer survivors with a mean age of 58.4 (age range 44-69) years. The focus group interviews revealed three themes and 10 sub-themes regarding subjective perceptions and experiences related to forests. The overarching themes were as follows: (1) awakened bodily senses and fascination with the forest; (2) remedial effect; and (3) a source of inspiration. These three themes capture the impact of forest experiences on participants' lives and the value they derived from these experiences. The participants considered these experiences a gift from forests. In particular, they experienced aesthetic enrichment and restorative effects such as boosted energy levels, reduced fatigue, and a buffer against mood swings. Finally, forests were a source of inspiration that led the participants toward personal growth. Conclusions: By gaining a better understanding of survivors' forest experiences, we identified that forest-based interventions for supportive cancer care can align with patients' values and preferences and serve as a secure space where they can feel cared for. This study can contribute to the development of forest-based interventions for cancer survivorship care.

Effects of a Neonatal Supportive Positioning Training Video Program for Preterm Infants on the Knowledge and Performance of Nurses in Neonatal Intensive Care Units.

PURPOSE: The purpose of this study is to develop and apply a neonatal supportive positioning (NSP) training video program for premature infants, using a position support mat for nurses in neonatal intensive care units (NICUs), and to verify its effect on nurses' performance. METHODS: Thirty-five NICU nurses were included in the study. For the pre-test, preliminary check-ups were conducted, questionnaires about NSP knowledge on preterm infants were distributed, and NSP performance using neonatal dolls were video recorded for each participant. PowerPoint presentations and videos were used to educate participants on NSP. Furthermore, a 20-minute one-on-one training session was conducted using an NPS kit. Two weeks after the training, we repeated the process of distributing questionnaires about NSP knowledge and recording nurses' performance videos using neonatal dolls. Questionnaires and videos collected before and after the training were compared. RESULTS: After NSP training, the mean knowledge score of the participants improved significantly from 23.71 ± 3.62 to 29.51 ± 2.29 (Z = -5.09, p < .001). The performance score for postural supportive positioning was 38.03 ± 7.46 before training and 80.06 ± 9.85 after receiving training, indicating a high-performance score after NSP training (Z = -5.16, p < .001). CONCLUSION: Our NSP training video program increased nurses' NSP knowledge and performance. Continuous training NICU nurses on NSP, using a standardized training video program, can help improve the care of premature infants.

Evaluation of Student Satisfaction with Ubiquitous-Based Tests in Women's Health Nursing Course.

Learning evaluation using ubiquitous-based tests may be essential during a public health crisis, such as the COVID-19 pandemic, during which theoretical classes and clinical practice are conducted online. However, students may not be as familiar with ubiquitous-based tests as they are with paper-based tests. This survey study aimed to evaluate students' satisfaction with ubiquitous-based tests and compare the evaluation results of a paper-based test with that of a ubiquitous-based test in nursing education. For the midterm exam of the Women's Health Nursing course, a paper-based test was conducted, while a ubiquitous-based test using a tablet computer was used for the final exam. The Ubiquitous-Based Test Usefulness and Satisfaction tool, which has a five-point Likert-type response scale, was employed to evaluate the post-test usefulness and satisfaction scores of the ubiquitous-based test. The mean score of the ubiquitous-based test usefulness was 4.01 ± 0.67. There was a significant difference in satisfaction levels between the ubiquitous-based and the paper-based test (t = -3.36, p = 0.001). Specifically, the evaluation scores were not affected by different evaluation methods. Study participants deemed the ubiquitous-based test highly useful and satisfactory, suggesting that such tests may be a future-oriented evaluation method, potentially replacing paper-based tests.

Dual Binding to Orthosteric and Allosteric Sites Enhances the Anticancer Activity of a TRAP1-Targeting Drug.

The molecular chaperone TRAP1 is the mitochondrial paralog of Hsp90 and is overexpressed in many cancer cells. The orthosteric ATP-binding site of TRAP1 has been considered the primary inhibitor binding location, but TRAP1 allosteric modulators have not yet been investigated. Here, we generated and characterized the Hsp90 inhibitor PU-H71, conjugated to the mitochondrial delivery vehicle triphenylphosphonium (TPP) with a C10 carbon spacer, named SMTIN-C10, to enable dual binding to orthosteric and allosteric sites. In addition to tight binding with the ATP-binding site through the PU-H71 moiety, SMTIN-C10 interacts with the E115 residue in the N-terminal domain through the TPP moiety and subsequently induces structural transition of TRAP1 to a tightly packed closed form. The data indicate the existence of a druggable allosteric site neighboring the orthosteric ATP pocket that can be exploited to develop potent TRAP1 modulators.

Micropatterning of polymer-embedded metal nanoparticles by an ion beam contact lithography.

A convenient and effective method to pattern polymer-embedded metal nanoparticles by ion irradiation has been developed. The thin Pluronic films containing silver nitrate as a precursor of silver nanoparticles were irradiated through a pattern mask with accelerated proton (H+) ions. It was found from the UV-Vis measurement that the formation of silver nanoparticles in the Pluronic matrix was dependant on the amount of silver nitrate. The 50 microm line (pitch 150 microm) patterns of the Pluronic containing silver nanoparticles were obtained with the thin film irradiated to 1 x 10(16) ions/cm2. The heat treatment effect on the morphology of the patterns was investigated by using a scanning electron microscope with an energy dispersive X-ray spectrometer. The results confirmed that the silver nanoparticles were successfully embedded in the Pluronic patterns and the patterns were changed into large silver particles by a heat treatment above 350 degrees C.

Micropatterning of poly(vinyl pyrrolidone)/silver nanoparticle thin films by ion irradiation.

This study describes a new patterning method of poly(vinyl pyrrolidone) (PVP) containing silver nanoparticles by using ion irradiation. The thin films prepared from PVP/silver nanoparticle solutions were irradiated through a mask with accelerated H+ ions. Well-defined 50 microm line (pitch 150 microm) patterns were generated from the film irradiated at 1 x 10(16) ions/cm2. The heat treatment effect on the morphology of the patterns was investigated by using a scanning electron microscope with an energy dispersive X-ray spectrometer. The results confirmed that the silver nanoparticles were successfully immobilized in the PVP patterns and the patterns were changed into silver particles by heat treatment above 300 degrees C.

Somatostatin down-regulates LFA-1 activation by modulating Rap1 expression in CD4+ and CD8+ T cells.

Leukocyte function-associated antigen-1 (LFA-1) is one of the integrins that are expressed on the leukocytes, and has been shown to play an important role in leukocyte trafficking. The adhesive activity of LFA-1 is governed partially by the Rap1. This study examined that the relationship between LFA-1 and Rap1 mRNA expressions by anti-CD3 and anti-CD3+SOM treatment in the CD4+ and CD8+ T cells. The LFA-1 mRNA expression levels following the anti-CD3 and anti-CD3+SOM treatment for 30 min was greater on the CD8+ T cells, and the LFA-1 expression of the CD8+ T cells with anti-CD+SOM treatment was affected more severely than that of the CD4+ T cells. The Rap1 mRNA expression patterns following anti-CD3 and anti-CD3+SOM stimulation in the CD4+ and CD8+ T cells were similar to the LFA-1 expression patterns, and the expression level following anti-CD3+SOM treatment was suppressed more significantly in the CD8+ T cells. These results suggest that the difference in the Rap1 expression level after stimulation might explain the differences in the LFA-1 expression level on the T cell subsets, and that the down-regulation of Rap1 expression following SOM treatment is closely related to the diminished LFA-1 expression.

Hepatic cirrhosis occurring in a young woodchuck (Marmota monax) due to vertical transmission of woodchuck hepatitis virus (WHV).

Histologic and clinicopathologic findings of a woodchuck (Marmota monax) vertically infected with woodchuck hepatitis virus (WHV) are presented. The liver exhibits marked cirrhotic changes, which is characteristic of the pre-transformation phase of WHV. At necropsy, the woodchuck exhibited ascites and the liver had a grossly nodular appearance. Microscopically, focal hepatocyte necrosis and inflammatory cells were observed in midzonal and periportal areas in the liver. In Macchiavellos stained sections, cytoplasmic inclusion bodies appeared reddish granular materials. We believe that this may represent a new suitable and cost-effective cirrhotic model for the disease processes associated with hepadnaviruses in a number of other species, most notably Hepatitis B virus infection in man.

Effects of benzo[alpha]pyrene, 2-bromopropane, phenol and 2,3,7,8-tetrachlorodibenzo-p-dioxin on IL-6 production in mice after single or repeated exposure.

Altered IL-6 production regulation is associated with the pathogenesis of chronic inflammatory diseases, lymphoid malignancies, chronic infectious processes and certain types of autoimmune conditions. Here, we examine the effects of pollutants on IL-6 levels in mice serum and in culture supernatants of spleen cells. Mice were treated with vehicles (PBS or olive oil), benzo[alpha]pyrene (B[alpha]P, 100 mg/kg body weight), 2-bromopropane (2-BP, 3.5 g/kg), phenol (21.2 mg/kg), or 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, 15 mg/kg). Serum IL-6 levels were significantly increased in the TCDD-treated group at 24 hours and 48 hours after a single exposure, whereas exposure to phenol, B[alpha]P or 2-BP did not cause a significant difference. IL-6 levels in culture supernatants of splenocytes were not affected at 24 hours and 48 hours after a single pollutant treatment. A repeated dose of TCDD (once/week for 4 weeks) resulted in a significant elevation of IL-6 levels in serum and its spontaneous production in culture supernatants of splenocytes. Repeatedly TCDD-treated mice contained more CD11b (Mac-1)-positive cells in the spleen and higher titers of tissue-specific autoantibodies than the vehicle-treated group. These results suggest that repeated exposure to TCDD might impair the regulation of immune response by deregulating the production of IL-6.

Fetal bladder outlet obstruction in a stillborn bovine fetus.

A stillborn bovine male fetus with abdominal distention, arthrogryposis and atresia ani was presented for diagnostic evaluation. At necropsy, this fetus had a large amount of ascites, urachal obstruction and marked bladder distention. The ventral surface of the bladder had ruptured and attached to the abdominal wall by fibrinous adhesions. There was bilateral hydronephrosis with moderate pelvic dilatation and cortical attenuation. The rectum was filled with meconium but the anus was imperforate. The right forelimb was contracted. The cause(s) of these abnormalities could not be determined; however, we believe that developmental abnormalities during embryogenesis may be the result of chromosomal abnormalities.

A novel aortic coarctation model for studying hypertension in the pig.

We have developed a reproducible renovascular model of hypertension via a controllable, suprarenal aortic coarctation in the pig. This model has many potential applications, including investigation of the effects of acute hypertension in the conscious animal; identification of cardiac and vascular adaptations to chronic hypertension and their reversal; determining the effect of pharmacologic agents or other interventions on hypertension; and furthering our understanding of the implications of chronic hypertension on neurologic function. A totally implantable system was devised by attaching a reinforced silicone vascular occluder to a vascular access port. The occluder was placed around the suprarenal aorta proximal to the diaphragm. Ten pigs were made hypertensive by sequentially inflating the occluder. In six pigs, telemetric monitoring of blood pressure was used to determine when the pigs had reached target pressures (mean arterial blood pressure >150 mm Hg). Four pigs did not have telemetry units placed and blood pressure and heart rate were monitored for 4 weeks by periodically restraining the pigs in a sling. Two pigs reversed their occlusion due to presumed technical errors; the remaining pigs were studied for 4 (n = 5) or 8 (n = 3) weeks and then euthanized. Advantages of this model of aortic coarctation are that the occlusions are performed in awake animals and excessive occlusion of the aorta resulting in neurologic dysfunction or other distress to the animal can be easily corrected by simply withdrawing a small amount of the fluid used for inflation of the occluder. Additionally, removal of the constriction does not require a second surgical procedure.

Development and evaluation of a new apparatus for continuous perfusion of isolated perfused pig heart.

To develop a better model of isolated perfused heart, a new apparatus of coronary artery cannula- fixed-in-aortic tube was developed for continuous normothermic perfusion and compared to the Casalis apparatus with cold ischemia. Eight mongrel pigs with the body weight of 18 to 24 kg were divided half into two groups. All the continuous perfusion experimental hearts resumed a spontaneous heart beat and stabilized earlier than the control hearts without the need of defibrillator or pacemaker, indicating no reperfusion injury on the heart. All the experimental hearts did not show fibrillation nor stopped beating during the entire experiment, whereas the control hearts fibrillated. Two control hearts stopped beating, and only one of the two survived with the help of pacemaker.The coronary systolic, diastolic, and mean pressures were more stable with low variation in the experimental hearts than the cold ischemic control hearts. The experimental hearts consumed more oxygen than the control hearts, indicating more cardiac output. According to these results, the continuous normothermic perfusion method by the new cannula, even though with a short-period of hypothermic perfusion, provided better myocardial protection than the cold ischemia.

Frequencies of micronuclei in peripheral lymphocytes in Korean populations after chronic low-dose radiation exposure.

The purpose of this study was to estimate predictive markers of intrinsic radiosensitivity in individuals who were exposed to occupational or environmental radiation. Throughout this process, the actual biohazard risks and base-line chromosome damage were evaluated in human population. Further studies were carried out to provide evidence for the existence of individual variations in age-dependent responses through micronuclei (MN) assay. Spontaneous frequencies not only vary greatly between individuals, but also working or living areas. It was shown that the increased level of spontaneous cell with MN was observed with increasing age. The relationship between radiosensitivity and the increased spontaneous level of MN may be in an inverse proportion. Ionizing radiation may be targeted mutagenic effects at the usual exposures of background levels that populations were exposed. Age and gender are the most important demographic variables in determining the MN index with frequencies in females, which were greater than those in males. The main life-style factors influencing the MN index in subjects were correlated significantly and positively with smoke. The results showed that an indicator of the genetic damaged rate in MN index in human populations significantly correlated with age, sex and life-style factors. So far, it is evident that with regard to the application of MN assay all future studies have to take into account the influence of age, gender, and life-style. In Conclusion, using micronuclei assay technique a large population can be easily monitored. This study illustrated that the MN assay may provide a high potential to ensure appropriate quality control and standard documentation protocol that can be used to monitor a large population exposed to radiation epidemiologically.

Effects of benzo[a]pyrene, 2-bromopropane, phenol and 2,3,7,8-tetrachlorodibenzo-p-dioxin on proinflammatory cytokines gene expression by mice spleen cells.

The detrimental effects of environmental pollutants on the health of the individual are generally accepted, although the mechanisms of these effects remain to be incompletely understood. In the present study, we examined the effects of B[a]P, 2-BP, phenol and TCDD on proinflammatory cytokine gene expression in mice spleen cells which were stimulated with anti-CD3. 10(-9)M TCDD increased IFNgamma and TNFalpha gene expression, but suppressed IL-1 gene expression. 10(-6)M phenol inhibited IL-1, IL-6 and TNFalpha gene expression, and 10(-6)M of 2-BP downregulated TNFalpha gene expression. However, 10(-6)M of B[a]P did not influence on IL-1, IL-6, IFNgamma and TNFalpha gene expression. These findings suggest that TCDD may impair the immune functions of mice by enhancing proinflammatory cytokines production, whereas phenol and 2-BP may impair the functions by inhibiting the production of these cytokines.