Enteral nutrition (EN) formulas are foods that are used to improve the nutritional status of patients and these foods' safety and quality must be ensured. Therefore, EN formulas in other countries are managed differently from that of general foods. We investigated the direction of development of the relevant laws regulations and guidelines pertaining to EN formulas and we compared these laws regulations and guidelines from different countries, including Korea. The United States and Europe manage EN formulas as foods, but they are managed differently compared to general foods because of separate laws or programs pertaining to EN foods. In addition, the use of the formulas does not necessarily require a prescription, but when used by prescription, then medical insurance covers them. In Japan, there are two types of EN formulas, food and drug, and there are differences for their management and insurance coverage. In the case of Korea, EN formulas are classified as food and drug, and different management and insurance are applied in each case, which inhibits their systematic management and industrial development. Integration of a management system and establishment of a legal foundation is necessary for the systematic management and development of EN formula in Korea.
Enteral Nutrition ; Europe ; Humans ; Industrial Development ; Insurance ; Insurance Coverage ; Japan ; Jurisprudence ; Korea ; Nutritional Status ; Prescriptions ; Social Control, Formal ; United States

PURPOSE: This study was done to examine the frequency of irritable bowel syndrome (IBS), entrance examination stress, mental health, and quality of life among adolescent women. Methods: A survey conducted to collect data from 925 adolescent women in Gyeonggi Province. The measurements included the Rome III criteria (to diagnose IBS), the entrance examination stress scale (to evaluate stress), symptom check list90R (SCL-90R to evaluate mental health), and World Health Organization Quality of Life Abbreviated Version (WHOQOL-BREF to evaluate quality of life). Frequency, chi square-tests, t-test, and analysis of variance (ANOVA) with the SPSS 16.0 program were used to analyze the data. RESULTS: The frequency of IBS in the women was 22.8%. One hundred thirty eight women (65.4%) had the mixed constipation and diarrhea subtype of IBS. Compared to the women without IBS, those with IBS reported significantly higher scores on entrance examination stress scale, SCL-90R, all subscales of SCL-90R, and lower scores on WOLQOL-BREF. CONCLUSION: Nursing interventions targeting adolescent women with IBS should be developed in order to alleviate the associated stress and mental health and to promote quality of life.
Adolescent ; Constipation ; Diarrhea ; Female ; Humans ; Irritable Bowel Syndrome ; Mental Health ; Quality of Life ; Rome ; World Health Organization

Purpose: The purpose of this study was to examine the effects of auricular acupressure on the knee pain, joint angle and sleep among elderly workers with knee osteoarthritis. Methods: This study conducted with a randomized, single-blind, and quasi-experimental design. Participants were 41 elderly workers with knee osteoarthritis and they were allocated to the experimental group (n=21) and sham control group (n=20). The intervention lasted six weeks. In order to examine intervention effects of auricular acupressure, Visual Analogue Scale (VAS), and extension, flexion, Pittsburg Sleep Quality Index (PSQI), Fitbit tracker were measured in order to examine the effects of auricular acupressure. Results: Auricular acupressure was effective for knee pain relief after 6 weeks (F=2.83, p=.024). There was no difference in joint angle. Sleep quality was significantly affected by sleep duration (t=3.02, p=.004), habitual sleep efficiency (t=2.36, p=.029), and daytime dysfunction (t=2.16, p=.038), and the sleep stage was effective on slight sleep (t=2.19, p=.034). Conclusion The findings of this study suggest that auricular acupressure can be a complementary nursing intervention for the elderly workers with knee osteoarthritis to decrease knee pain and to improve sleeping disorder, and has advantages such as reduction of medical expenses, convenience, and high safety.

BACKGROUND: Osteoclasts are the only cell type capable of breaking down bone matrix, and its excessive activation is responsible for the development of bone-destructive diseases. Euphorbia lathyris L. (ELL) is an herbal plant that belongs to the Euphorbiaceae family. This study investigated the effects of the methanol extract of the aerial part of ELL on receptor activator of nuclear factor-kappa B ligand (RANKL)-induced osteoclast formation and signaling pathways. METHODS: Osteoclasts were formed by co-culturing mouse bone marrow with osteoblasts or by culturing mouse bone marrow-derived macrophages (BMMs) with macrophage colony-stimulating factor (M-CSF) and RANKL. Bone resorption assays were performed using dentine slices. The expression level of mRNA was analyzed by real-time polymerase chain reaction (PCR) or reverse transcription (RT)-PCR. Western blotting assays were performed to detect the expression or activation level of proteins. RESULTS: ELL inhibited RANKL-induced osteoclast formation without cytotoxicity. Furthermore, the RANKL-stimulated bone resorption was diminished by ELL. Mechanistically, ELL blocked the RANKL-triggered p38 mitogen-activated protein kinase (MAPK) phosphorylation, which resulted in the suppression of the expression of c-Fos and nuclear factor of activated T cells (NFATc1). In osteoblasts, ELL had little effect on the mRNA expression of RANKL and osteoprotegerin (OPG). CONCLUSIONS: The present data suggest that ELL has an inhibitory effect on osteoclast differentiation and function via downregulation of the p38/c-Fos/NFATc1 signaling pathways. Thus, ELL could be useful for the treatment of bone diseases associated with excessive bone resorption.
Animals ; Blotting, Western ; Bone Diseases ; Bone Marrow ; Bone Matrix ; Bone Resorption ; Dentin ; Down-Regulation ; Euphorbia* ; Euphorbiaceae ; Humans ; Macrophage Colony-Stimulating Factor ; Macrophages ; Methanol ; Mice ; Osteoblasts ; Osteoclasts* ; Osteoprotegerin ; p38 Mitogen-Activated Protein Kinases ; Phosphorylation ; Plants ; Protein Kinases ; RANK Ligand ; Real-Time Polymerase Chain Reaction ; Reverse Transcription ; RNA, Messenger ; T-Lymphocytes

PURPOSE: The purpose of this paper is to determine effects of auricular acupressure on knee pain, range of motion, and sleep in the elderly with knee osteoarthritis. METHODS: This is an experimental study designed with randomization and single-blind in a placebo-control approach. The subjects included the elderly with knee osteoarthritis who were using an elderly welfare facility. In each of the groups, 28 subjects were assigned. For the experimental group, auricular acupressure was applied to five pressure points related to the pain caused by osteoarthritis and sleep. In the case of the placebo-control group, auricular acupressure was applied to other five points than the former. The intervention lasted eight weeks. In order to examine intervention effects of auricular acupressure, joint pain, Pressure Pain Thresholds (PPTs), and extension and flexion range of motion (ROM) were measured weekly. As for the pre- and post-examinations, pain, sleep quality, and the time-by-sleep stage of the patients with knee osteoarthritis were measured. RESULTS: The VAS scores in the experimental group with auricular acupressure significantly decreased through time (p<.001) and WOMAC also significantly decreased (p<.01) compared with the placebo-control group. However, there were no significant differences in PPTs. The flexion (p<.01) and extension (p<.001) ROMs measured for eight weeks improved over time. Meanwhile, sleep quality improved significantly after the intervention termination (p<.01), but there was no significant difference found in the time-by-sleep stage. CONCLUSION: Auricular acupressure applied for eight weeks was found to be effective in reducing joint pain, improving knee ROM, and improving sleep quality in patients with degenerative knee arthritis.
Acupressure ; Aged ; Arthralgia ; Arthritis ; Humans ; Joints ; Knee ; Osteoarthritis ; Osteoarthritis, Knee ; Pain Threshold ; Random Allocation ; Range of Motion, Articular ; Sleep Stages

Background: To overcome the limitations of relying on data from a single institution, many researchers have studied data linkage methodologies. Data linkage includes errors owing to legal issues surrounding personal information and technical issues related to data processing. Linkage errors affect selection bias, and external and internal validity. Therefore, quality verification for each connection method with adherence to personal information protection is an important issue. This study evaluated the linkage quality of linked data and analyzed the potential bias resulting from linkage errors. Methods: This study analyzed claims data submitted to the Health Insurance Review and Assessment Service (HIRA DATA). The linkage errors of the two deterministic linkage methods were evaluated based on the use of the match key. The first deterministic linkage uses a unique identification number, and the second deterministic linkage uses the name, gender, and date of birth as a set of partial identifiers. The linkage error included in this deterministic linkage method was compared with the absolute standardized difference (ASD) of Cohen’s according to the baseline characteristics, and the linkage quality was evaluated through the following indicators: linked rate, false match rate, missed match rate, positive predictive value, sensitivity, specificity, and F1-score. Results: For the deterministic linkage method that used the name, gender, and date of birth as a set of partial identifiers, the true match rate was 83.5 and the missed match rate was 16.5.Although there was bias in some characteristics of the data, most of the ASD values were less than 0.1, with no case greater than 0.5. Therefore, it is difficult to determine whether linked data constructed with deterministic linkages have substantial differences. Conclusion This study confirms the possibility of building health and medical data at the national level as the first data linkage quality verification study using big data from the HIRA. Analyzing the quality of linkages is crucial for comprehending linkage errors and generating reliable analytical outcomes. Linkers should increase the reliability of linked data by providing linkage error-related information to researchers. The results of this study will serve as reference data to increase the reliability of multicenter data linkage studies.

PURPOSE: The purpose of this research was to assess the methodological quality of non-randomized studies published in the Journal of Korean Fundamentals of Nursing. METHODS: A search of non-randomized studies assessing intervention effects was conducted among all articles published in the Journal of Korean Fundamentals of Nursing between 2011 and 2013. Articles were assessed for quality using the Methodological Index for Non Randomized Studies (MINORS). For each index item, the frequency and percentage of articles meeting the criteria were calculated, along with mean scores by research method, publication year, and research topic. RESULTS: A total of 22 studies were included. The mean score for studies without control groups was 11.75 (range 0-16), and for those with control groups, 19.27 (range 0-24). Results show that improvement is needed on several items: "endpoints appropriate to the aim of the study," "unbiased assessment of the study endpoint," "follow-up period appropriate to the aim of the study," "loss to follow up less than 5%," and "contemporary groups." CONCLUSION: Although the quality of articles published in the Journal of Korean Fundamentals of Nursing has consistently increased, more emphasis should be placed on using rigorous research methods.
Follow-Up Studies ; Clinical Trial ; Nursing* ; Publications

PURPOSE: The purpose of this study was to provide a basis for improvement and enhancement of nursing education by investigating learning outcomes that apply to fundamentals of nursing and teaching methods used in classes. METHODS: Data were collected from 111 professors of fundamentals of nursing who responded to the self-report questionnaire. Data were analyzed using chi-square test. RESULTS: For learning outcomes in fundamentals of nursing the most frequent number of outcomes was two (35.2%), or three (32.4%). For learning outcomes in fundamentals of nursing practicum, the most frequent number of outcomes was two (32.4%), or three (31.6%). In fundamental nursing classes, teaching methods used most frequently were lectures (98.2%) and videos (60.4%), and in practice classes, demonstration (98.2) and open laboratory (90.9%). Constructivist teaching methods that were utilized in fundamental nursing were team-based learning (19.8%) and case-based learning (19.8%), and for practice classes, objective structured clinical examination (29.7%). In the cross analysis, 28.8% of the nursing professor used the constructivist teaching methods in fundamental nursing and in practice classes. CONCLUSION: There is a need to continue to improve teaching methods for new nurse-educators and professors and to discuss learning outcomes of fundamental nursing.
Education ; Education, Nursing ; Learning* ; Lectures ; Nursing* ; Teaching*

Purpose: The purpose of this study is to understand the actual status of fundamentals of nursing practice (FNP) education at nursing colleges, and the difficulties of FNP operation in the early stages of the COVID-19. Methods: This study used a descriptive design. Data collection was conducted from December 9, 2020 to January 31, 2021 using the self-report questionnaire method for a total of 95 nursing colleges. The questionnaire consisted of characteristics related to FNP, changes in FNP education, difficulties in operating FNP, and countermeasures in the COVID-19 situation. Results: Changes in FNP due to COVID-19 were distribution of practice places, reduction of the number of students, short-term intensive classes, and reduction of face-to-face practice. Most colleges conducted FNP face-to-face, but some schools showed that FNP was conducted non-face-to-face. The difficulties of operating FNP that instructors experienced induced concerns about a decrease in student competency due to lack of face-to-face practice and an unofficial increase in the number of teaching hours and physical demands on instructors due to the expansion of the division. Conclusion In order to develop the capabilities of nursing students in other pandemic situations in the future, it is necessary to find systematic coping strategy to reduce the burden of FNP instructors, and to develop non-face-to-face online practice contents and consumables for online practice.

Single nucleotide polymorphisms (SNPs) are the most abundant forms of human genetic variations and resources for mapping complex genetic traits and disease association studies. We have constructed a linkage disequilibrium(LD) map of chromosome 22 in Korean samples and compared it with those of other populations, including Yorubans in Ibadan, Nigeria (YRI), Centred'Etude du Polymorphisme Humain (CEPH) reference families (CEU), Japanese in Tokyo (JPT) and Han Chinese in Beijing (CHB) in the HapMap database. We genotyped 4681 of 111,448 publicly available SNPs in 90 unrelated Koreans. Among genotyped SNPs, 4167 were polymorphic. Three hundred and five LD blocks were constructed to make up 18.6% (6.4 of 34.5 Mb) of chromosome 22 with 757 tagSNPs and 815 haplotypes(frequency > or = 5.0%). Of 3430 common SNPs genotyped in all five populations, 514 were monomorphic in Koreans. The CHB + JPT samples have more than a 72% overlap with the monomorphic SNPs in Koreans, while the CEU + YRI samples have less than a 38% overlap. The patterns of hot spots and LD blocks were dispersed throughout chromosome 22, with some common blocks among populations, highly concordant between the three Asian samples. Analysis of the distribution of chimpanzee-derived allele frequency (DAF), a measure of genetic differentiation, Fst levels, and allele frequency difference (AFD) among Koreans and the HapMap samples showed a strong correlation between the Asians, while the CEU and YRI samples showed a very weak correlation with Korean samples. Relative distance as a quantitative measurement based upon DAF, Fst, and AFD indicated that all three Asian samples are very proximate, while CEU and YRI are significantly remote from the Asian samples. Comparative genome-wide LD studies provide useful information on the association studies of complex diseases.
Asian Continental Ancestry Group ; Chromosomes, Human, Pair 22 ; Gene Frequency ; Genetic Variation ; Haplotypes ; HapMap Project ; Humans ; Nigeria ; Polymorphism, Single Nucleotide ; Tokyo