During tumor progression, a subset of cells acquires metastatic properties, presumably through a series of genetic alterations. CD44 variant glycoproteins containing sequences encoded by exon v6 are related to tumor progression of human colorectal cancer. But their expression in normal colonic epithelium is controversial and studies of CD44 on each step of colorectal carcinogenesis are scanty. We studied CD44v6 expression in the normal colonic mucosa, adenoma, carcinoma in situ, and invasive colorectal carcinomas of different Astler-Coller stages. Endoscopically or surgically resected 36 normal colonic mucosa, 19 adenomas, 8 cases of carcinoma in situ, and 25 cases of carcinoma were selected. After immunohistochemical stain with CD44v6 antibody, positivity was graded as 0 to 4 based on the estimated percentage of positively stained tumor cells. The intensity of positive staining cells was also graded as 0 to 3. In all but one cases (97.2%), normal colorectal mucosa was negative for CD44v6. Positive rates in adenoma, carcinoma in situ, Astler-Coller stage A/B and C/D carcinoma were 73.6%, 88.9% and 87.5%, respectively. There was no statistically significant difference in the positivity between these groups. The staining intensity was significantly higher in the cases of stage C/D carcinoma group than those of adenomas (p<0.05). The percentage of positivity for CD44v6 was higher in stage C/D carcinoma group than adenoma, carcinoma in situ, and stage A/B carcinoma group (p<0.05). Expression of CD44v6 in the normal colonic mucosa was extremely rare and the positivity was increased according to the progression of colorectal tumors. Furthermore, it is more important to interpret the CD44v6 positivity according to the estimated percentage of positively stained tumor cells.
Adenoma ; Carcinogenesis ; Carcinoma in Situ ; Colon ; Colorectal Neoplasms* ; Epithelium ; Exons ; Glycoproteins ; Humans ; Mucous Membrane ; Neoplasm Metastasis

PURPOSE: In this study the costs and benefits of a home health care program were examined to evaluate the economic feasibility of the program. METHODS: The study participants included 349 patients in the community who had been registered at a home health care center for 5 years. The costs and benefits of the program were analyzed using performance data and health data. The benefits were classified as the effects of pressure ulcer care, skin wound care and catheters management. The program effect was evaluated on the change of progress using transition probability. Benefits were divided into direct benefit such as the savings in medical costs and transportation costs, and indirect benefits which included saving in productivity loss and lost future income. RESULTS: Participants had an average of 1.82 health problems. The input cost was KRW 36.8~153.3 million, the benefit was KRW 95.4~279.7 million. Direct benefits accounted for 53.4%~81.2%, and was higher than indirect benefits. The net benefit was greater than 0 from 2006 to 2009, and then dropped below 0 in 2010. CONCLUSION: The average net benefit during 5 years was over 0 and the benefit cost ratoi was over 1.00, indicating that the home health care program si economical.
Catheters ; Cost-Benefit Analysis ; Delivery of Health Care* ; Efficiency ; Home Care Services ; Humans ; Income ; Pressure Ulcer ; Skin Care ; Transportation ; Vulnerable Populations* ; Wounds and Injuries

PURPOSE: This study was done to evaluate the operating status of community-based home health center for revitalization of the centers. METHOD: In this study performance data including organization plan and service utilization plan were evaluated according process theory. Target of evaluation was the community-based home health care center. RESULTS: The vulnerable part of the organization was the information system and financial resources. The home health center introduced PDA (Personal Digital Assistants) in 2005, however home health care nurses did not make full use of it. This service received full support from Seoul city and local government and there were no other sources of income. The vulnerable part of service utilization was service expansion and standardization due to vulnerability of organizational aspects. CONCLUSIONS: The home health care center provides high quality services to underprivileged people. In the future, these services should be provided with equity for continuous health care for this population.
Delivery of Health Care ; Information Systems ; Local Government

Purpose: This study investigated the effects of newly graduated nurses’ perceived readiness for nursing practice, resilience, and preceptors’ teaching behaviors on turnover intention. Methods: A survey was conducted among 168 newly graduated nurses between August 7 and 31, 2023. The data were analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression analysis. Results: The factors that significantly affected turnover intention included preceptors' teaching behavior (β=-.29, p=.001) and resilience (β= -.21, p=.026). This model explained 32.0% of the variance. Conclusion Newly graduated nurses’ resilience and their initial training environment are key factors influencing turnover intention. Therefore, nursing managers should develop strategies to enhance the resilience of newly graduated nurses and improve training systems. Additionally, efforts should be made to promote positive teaching behaviors among the educators responsible for training newly graduated nurses.

Purpose: This study investigated the effects of newly graduated nurses’ perceived readiness for nursing practice, resilience, and preceptors’ teaching behaviors on turnover intention. Methods: A survey was conducted among 168 newly graduated nurses between August 7 and 31, 2023. The data were analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression analysis. Results: The factors that significantly affected turnover intention included preceptors' teaching behavior (β=-.29, p=.001) and resilience (β= -.21, p=.026). This model explained 32.0% of the variance. Conclusion Newly graduated nurses’ resilience and their initial training environment are key factors influencing turnover intention. Therefore, nursing managers should develop strategies to enhance the resilience of newly graduated nurses and improve training systems. Additionally, efforts should be made to promote positive teaching behaviors among the educators responsible for training newly graduated nurses.

Purpose: This study investigated the effects of newly graduated nurses’ perceived readiness for nursing practice, resilience, and preceptors’ teaching behaviors on turnover intention. Methods: A survey was conducted among 168 newly graduated nurses between August 7 and 31, 2023. The data were analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression analysis. Results: The factors that significantly affected turnover intention included preceptors' teaching behavior (β=-.29, p=.001) and resilience (β= -.21, p=.026). This model explained 32.0% of the variance. Conclusion Newly graduated nurses’ resilience and their initial training environment are key factors influencing turnover intention. Therefore, nursing managers should develop strategies to enhance the resilience of newly graduated nurses and improve training systems. Additionally, efforts should be made to promote positive teaching behaviors among the educators responsible for training newly graduated nurses.

Purpose: This study investigated the effects of newly graduated nurses’ perceived readiness for nursing practice, resilience, and preceptors’ teaching behaviors on turnover intention. Methods: A survey was conducted among 168 newly graduated nurses between August 7 and 31, 2023. The data were analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression analysis. Results: The factors that significantly affected turnover intention included preceptors' teaching behavior (β=-.29, p=.001) and resilience (β= -.21, p=.026). This model explained 32.0% of the variance. Conclusion Newly graduated nurses’ resilience and their initial training environment are key factors influencing turnover intention. Therefore, nursing managers should develop strategies to enhance the resilience of newly graduated nurses and improve training systems. Additionally, efforts should be made to promote positive teaching behaviors among the educators responsible for training newly graduated nurses.

PURPOSE: The purpose of this study was to examine the social determinants of health (SDH) associated with health-related quality of life (HQOL) among the community-dwelling elderly, based on the conceptual framework of the Commission on Social Determinants of Health (CSDH). METHODS: A survey was conducted with 199 elders aged 65 years or older sampled through convenient sampling. Data were collected through face to face interviews by trained interviewers using a structured questionnaire, which included scales of the residential area, social support, sense of community, social network, health behaviors, and HQOL. Data were analyzed by ANOVA and stepwise multivariate regression. RESULTS: Major SDH affecting HQOL included the participants' residential area, sense of community, and health behavior. The HQOL of the elderly residing in the B area with a low rate of basic livelihood security recipients was higher than that of those residing in other areas. CONCLUSION: CSDH framework was useful to determine the factors associated with HQOL among the community-dwelling elderly. In addition to their health behavior, their sense of community was found to be a SDH of HQOL, indicating the need of health promotion programs tailored to the characteristics of residential areas and strategies to enhance involvement in community activities.
Aged* ; Health Behavior ; Health Promotion ; Humans ; Quality of Life* ; Social Determinants of Health* ; Weights and Measures ; Surveys and Questionnaires

PURPOSE: This study was done to evaluate validity and reliability of the Korean version of the expanded nursing stress scale (ENSS). METHODS: Forward-backward translation of ENSS from English to Korean was conducted. The translated instrument was pilot-tested and administrated to 285 nurses who worked in five general hospitals in Korea. Internal consistency reliability was assessed using Cronbach's alpha and composite reliability. Validity was evaluated through construct validity with confirmatory factor analysis, convergent and discriminant validity. RESULTS: The Korean version of ENSS showed a reliable internal consistency with Cronbach's alpha .95 and composite reliability .99. Model fit indexes for 46 items were validated by confirmatory factor analysis(goodness of fit index .82, Tucker-Lewis index .92, root mean square error of approximation .04), indicating suitable construct validity. Factor loading of the 48 items (.47~.88) and average variance extracted out of nine factors (.52~.71.) indicated satisfactory convergent validity. Some values of square of the correlation coefficient between factors (.12~.89) were higher than average variance extracted values of each factor (.52~.71) so that it partly satisfied discriminant validity. CONCLUSION: Findings show that the Korean version ENSS has good reliability and suitable validity; therefore, can be used to assess and identify Korean nurses' job stress.
Factor Analysis, Statistical ; Hospitals, General ; Korea ; Nursing* ; Reproducibility of Results* ; Stress, Psychological ; Translations

PURPOSE: This study was conducted to examine activities of daily living (ADL) of older adults admitted to Korean long-term care hospitals (LTCHs), and to explore the patient and organizational factors that have an impact on the ADL of this population. METHODS: A secondary analysis of the Korean minimum data set (K-MDS) of patients (N=14,369) and of the profiles of LTCHs (N=358) from the Health Insurance Review and Assessment Service was done between January and July 2008. The outcome variable was ADL score 6 months after baseline assessment. Multi-level linear regression was employed to explore the patient and organizational factors that affected ADL scores. RESULTS: Of the patients, 45.4% had a baseline ADL score of between 31 and 40, with a score of 40 indicating that the patient was entirely dependent for all items. None of the organizational characteristics were significantly associated with effects on the ADLs of older adults who had been in a LTHC for at least 6 months. However, patient characteristics, such as age, baseline ADL, frequency of physical therapy, urinary incontinence, fecal incontinence, pressure ulcers, and having a tube or catheter, were significantly associated with ADL 6 months after baseline. CONCLUSION: In order to maintain and improve the ADL of older adults in LTCHs, we should develop strategies to prevent urinary and fecal incontinence, pressure ulcers, unnecessary tubes or catheters, providing adequate physical therapy. Additional studies should include more detailed information regarding nursing staff, including RN hours for direct care, education level and turnover.
*Activities of Daily Living ; Age Factors ; Aged ; Aged, 80 and over ; Catheterization ; Fecal Incontinence ; Female ; Hospitals/*statistics & numerical data ; Humans ; Long-Term Care ; Male ; Pressure Ulcer ; Republic of Korea ; Urinary Incontinence