PURPOSE: This study was a cross-sectional study done to determine the relevance and impact factors of nursing practice environment and self-esteem on critical thinking disposition in clinical nurses. METHODS: A survey was conducted from March to May 2015 with self-report questionnaire. Participants were 281 registered nurses working in one tertiary hospital. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple regression with SPSS/WIN 21.0. RESULTS: Factors affecting the nurses' critical thinking disposition included age (F=7.23, p<.001), educational background (F=7.82, p<.001), position (F=14.95, p<.001), clinical career (F=7.66, p<.001). Further, critical thinking disposition had a positive correlation with nursing practice environment (r=.60, p<.001) and self-esteem (r=.41, p<.001). Self-esteem and nursing practice environment accounted for 43% of the variance in critical thinking disposition. CONCLUSION: The study findings show that critical thinking disposition is influenced by nursing foundations for quality of care and the collegial nurse-physician relations of nursing practice environment. Therefore, it's necessary to provide continuing education for clinical nurses to reconstruct the organizational culture of nurses and physician partnerships. In addition, increasing self-esteem through various motivational programs should increase critical thinking disposition.
Cross-Sectional Studies ; Education, Continuing ; Foundations ; Humans ; Nurses ; Nursing* ; Organizational Culture ; Physician-Nurse Relations ; Tertiary Care Centers ; Thinking*

Cell culture is a widely used in vitro tool that enhances our understanding of cell biology, disease mechanisms, drug responses, and the development of tissue engineering. However, there are a number of important drawbacks to conventional two-dimensional (2D) cultures, such as the loss of polarity, altered cell shape, and disruption of cell-extracellular matrix connections. Alternatively, organoids are tissue-engineered, cell-based in vitro models derivedfrom stem cells that can self-organize and differentiate into three-dimensional (3D) structures,recapitulating the morphology and functions of their in vivo counterparts. Bisphenol A (BPA), a ubiquitous industrial chemical, has recently gained recognition as an environmental hazard.Previous research has demonstrated that BPA negatively affects the integrity of the intestinalbarrier by triggering programmed cell death and suppressing cell growth in human colonic epithelial cell lines. However, a 2D-based cellular study cannot represent its exposure to multicellular organs. This work investigates the impact of BPA on the structure and function of theintestinal barrier. We examine the effect of BPA on the proliferation and tight junction geneexpression with two models: the HT-29 colon cancer cell line and an intestine organoid model and morphological changes of intestinal organoid (I/O). The proliferation was increased in a dose-dependent manner with I/O, but at the same concentration, BPA does not increasethe significant number of HT-29 cell respectively. Proliferation-related gene and tight junctiongene expression pattern was similar between HT-29 and I/O other than Claudin-4. Therefore, this study offers a more precise depiction of the functional and morphological alterations caused by BPA in comparison to traditional 2D cell cultures.

Cell culture is a widely used in vitro tool that enhances our understanding of cell biology, disease mechanisms, drug responses, and the development of tissue engineering. However, there are a number of important drawbacks to conventional two-dimensional (2D) cultures, such as the loss of polarity, altered cell shape, and disruption of cell-extracellular matrix connections. Alternatively, organoids are tissue-engineered, cell-based in vitro models derivedfrom stem cells that can self-organize and differentiate into three-dimensional (3D) structures,recapitulating the morphology and functions of their in vivo counterparts. Bisphenol A (BPA), a ubiquitous industrial chemical, has recently gained recognition as an environmental hazard.Previous research has demonstrated that BPA negatively affects the integrity of the intestinalbarrier by triggering programmed cell death and suppressing cell growth in human colonic epithelial cell lines. However, a 2D-based cellular study cannot represent its exposure to multicellular organs. This work investigates the impact of BPA on the structure and function of theintestinal barrier. We examine the effect of BPA on the proliferation and tight junction geneexpression with two models: the HT-29 colon cancer cell line and an intestine organoid model and morphological changes of intestinal organoid (I/O). The proliferation was increased in a dose-dependent manner with I/O, but at the same concentration, BPA does not increasethe significant number of HT-29 cell respectively. Proliferation-related gene and tight junctiongene expression pattern was similar between HT-29 and I/O other than Claudin-4. Therefore, this study offers a more precise depiction of the functional and morphological alterations caused by BPA in comparison to traditional 2D cell cultures.

Cell culture is a widely used in vitro tool that enhances our understanding of cell biology, disease mechanisms, drug responses, and the development of tissue engineering. However, there are a number of important drawbacks to conventional two-dimensional (2D) cultures, such as the loss of polarity, altered cell shape, and disruption of cell-extracellular matrix connections. Alternatively, organoids are tissue-engineered, cell-based in vitro models derivedfrom stem cells that can self-organize and differentiate into three-dimensional (3D) structures,recapitulating the morphology and functions of their in vivo counterparts. Bisphenol A (BPA), a ubiquitous industrial chemical, has recently gained recognition as an environmental hazard.Previous research has demonstrated that BPA negatively affects the integrity of the intestinalbarrier by triggering programmed cell death and suppressing cell growth in human colonic epithelial cell lines. However, a 2D-based cellular study cannot represent its exposure to multicellular organs. This work investigates the impact of BPA on the structure and function of theintestinal barrier. We examine the effect of BPA on the proliferation and tight junction geneexpression with two models: the HT-29 colon cancer cell line and an intestine organoid model and morphological changes of intestinal organoid (I/O). The proliferation was increased in a dose-dependent manner with I/O, but at the same concentration, BPA does not increasethe significant number of HT-29 cell respectively. Proliferation-related gene and tight junctiongene expression pattern was similar between HT-29 and I/O other than Claudin-4. Therefore, this study offers a more precise depiction of the functional and morphological alterations caused by BPA in comparison to traditional 2D cell cultures.

It remains unclear as to whether insulin resistance alone or in the presence of wellknown risk factors, such as diabetes or obesity, is associated with gallstones in men. The aim of this study was to determine whether insulin resistance is associated independently with gallstone disease in non-diabetic men, regardless of obesity. Study subjects were 19,503 Korean men, aged 30-69 yr, with fasting blood glucose level <126 mg/dL and without a documented history of diabetes. Gallbladder status was assessed via abdominal ultrasonography after overnight fast. Body mass index and waist circumference were measured. Insulin resistance was estimated by the Homeostasis Model Assessment of insulin resistance (HOMA-IR). The prevalence of obesity, abdominal obesity, and metabolic syndrome in the subjects with gallstones were higher than in those without. The prevalence of elevated HOMA (>75 percentile) in subjects with gallstones was significantly higher than in those without, and this association remained even after the obesity stratification was applied. In multiple logistic regression analyses, only age and HOMA proved to be independent predictors of gallstones. Insulin resistance was positively associated with gallstones in non-diabetic Korean men, and this occurred regardless of obesity. Gallstones appear to be a marker for insulin resistance, even in non-diabetic, nonobese men.
Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Gallstones/*etiology ; Humans ; *Insulin Resistance ; Logistic Models ; Male ; Middle Aged ; Obesity/complications ; Risk Factors

Aged ; Consensus ; Frail Elderly ; Geriatric Assessment ; Humans ; Risk Factors

Frailty is defined as a reduced physiologic reserve vulnerable to external stressors. For older individuals, frailty plays a decisive role in increasing adverse health outcomes in most clinical situations. Many tools or criteria have been introduced to define frailty in recent years, and the definition of frailty has gradually converged into several consensuses. Frail older adults often have multi-domain risk factors in terms of physical, psychological, and social health. Comprehensive geriatric assessment (CGA) is the process of identifying and quantifying frailty by examining various risky domains and body functions, which is the basis for geriatric medicine and research. CGA provides physicians with information on the reversible area of frailty and the leading cause of deterioration in frail older adults. Therefore frailty assessment based on understanding CGA and its relationship with frailty, can help establish treatment strategies and intervention in frail older adults. This review article summarizes the recent consensus and evidence of frailty and CGA.

Sarcopenia, which is characterized by an age-related decline in muscle mass and function, poses significant challenges to geriatric care. Its definition has evolved from muscle-specific criteria to include muscle mass, muscle function, and physical performance, recognizing sarcopenia as a physical frailty. Sarcopenia is associated with adverse outcomes, including mortality, falls, fractures, cognitive decline, and admission to long-term care facilities. Neuromechanical factors, protein-energy balance, and muscle protein synthesis-breakdown mechanisms contribute to its pathophysiology. The identification of sarcopenia involves screening tests and a comprehensive assessment of muscle mass, strength, and physical function. Clinical approaches aligned with the principles of comprehensive geriatric assessment prioritize patient-centered care. This assessment aids in identifying issues related to activities of daily living, cognition, mood, nutrition, and social support, alongside other aspects. The general approach to factors underlying muscle loss and functional decline in patients with sarcopenia includes managing chronic diseases and evaluating administered medications, with interventions including exercise and nutrition, as well as evolving pharmacological options. Ongoing research targeting pathways, such as myostatin-activin and exercise mimetics, holds promise for pharmacological interventions. In summary, sarcopenia requires a multifaceted approach, acknowledging its complex etiology and tailoring interventions to individual patient needs.

BACKGROUND: The American Geriatric Society released the 2012 updated version of the Beers criteria with intentions to improve care of older adults by reducing their exposure to potentially inappropriate medications (PIMs). However, there have been no reports on the prevalence of PIMs prescriptions according to the 2012 version of Beers criteria in South Korea. METHODS: This is a retrospective study using medical records and code analysis of each PIM to survey the prevalence of PIMs prescriptions and common PIMs used for elderly patients. Locating the PIMs was carried out in all outpatients who visited Asan Medical Center from May 2012 to April 2013. Selection of PIMs was based on the 2012 updated version of the Beers criteria. RESULTS: A total of 652,192 outpatients older than 65 years visited our medical center during the study period and were analyzed. Among them, 33,810 (5.19%) received at least one PIM and 125,498 cases of PIM prescriptions were written. The percentage of the patients who received at least two kinds of PIMs concurrently was 33.14%. Common PIMs were tramadol (24.15%), clonazepam(11.51%), ibuprofen (10.02%), megesterol (9.80%), and amitriptyline (9.51%). CONCLUSION: Our study investigated the prevalence of PIMs prescription for Korean elderly outpatients in a single tertiary medical center. Compared to previous reports using the older version of the Beers criteria, our study showed a change in the priority of common PIMs.
Adult ; Aged ; Amitriptyline ; Beer ; Humans ; Ibuprofen ; Inappropriate Prescribing ; Intention ; Medical Records ; Outpatients ; Polypharmacy ; Prescriptions ; Prevalence ; Republic of Korea ; Retrospective Studies ; Tramadol

Background: The C-C motif chemokine ligand 11 (CCL11) has been receiving attention as a potential pro-aging factor. Accordingly, it may be involved in muscle metabolism and sarcopenia, a key component of aging phenotypes. To clarify this potential, we investigated the effects of CCL11 on in vitro muscle biology and its clinical relevance for sarcopenia parameters in older adults. Methods: Myogenesis was induced in mouse C2C12 myoblasts with 2% horse serum. Human blood samples were collected from 79 participants who underwent a functional assessment. Thereafter, CCL11 level was measured using a quantikine ELISA kit. Sarcopenia was defined using the Asian-specific guideline. Results: Recombinant CCL11 treatment significantly stimulated myogenesis in a dose-dependent manner, and consistently increased the expression of myogenic differentiation markers. Among the C-C chemokine receptors (CCRs), CCR5, not CCR2 and CCR3, was predominantly expressed in muscle cells. Further, the CCR5 inhibitor blocked recombinant CCL11-stimulated myogenesis. In a clinical study, serum CCL11 level was not significantly different according to the status of sarcopenia, low muscle mass, weak muscle strength, and poor physical performance, and was not associated with skeletal muscle index, grip strength, short physical performance battery score, gait speed, and time to complete 5 chair stands, after adjusting for sex, age, and body mass index. Conclusion Contrary to expectations, CCL11 exerted beneficial effects on muscle metabolism at least in vitro system. However, its impact on human muscle health was not evident, suggesting that circulating CCL11 may not be a useful biomarker for sarcopenia risk assessment in older adults.