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*

Background: Previous studies that have focused on the challenges faced by female surgeons, such as the gender pay gap, gender biases, lower likelihood of promotion, and gender differences in the perception of discrimination against women, are reviewed. A more comprehensive understanding of explicit and implicit gender discrimination and experiences and perceptions of discrimination is needed. This study aims to determine the current prevalence and degree of gender discrimination in the Korean Surgical Society and to compare the experiences and perceptions of gender discrimination between male and female surgeons. Methods: We analyzed 400 responses from a survey sent to all members of the Korean Surgical Society. This electronic survey included 16 items on experiences of gender discrimination and 17 items on perceptions of gender discrimination. We conducted χ2 tests and binary logistic regression on the data regarding these experiences and perceptions of gender discrimination. Results: Adjusted analyses found that female surgeons were more likely to experience gender discrimination than their male counterparts across all categories of discrimination. Further, adjusted analyses showed that female surgeons were more likely to confirm the presence of gender discrimination than male surgeons. Conclusion Female surgeons were more likely to experience implicit and explicit gender biases and discrimination throughout all stages of their career progression. We also discovered significant gender differences in the perception of gender discrimination, as well as the experience of it. Changing the male-dominated culture and raising awareness of gender biases and discrimination among male surgeons are crucial steps toward addressing gender discrimination in surgery.

Objective: Extant studies indicate that just one characteristic of sexual assault cannot properly represent the whole experience of sexual assault and, especially, the severity of sexual assault. This study aimed to understand the totality of sexual assault experiences and elucidate subtypes of sexual assault victims based on the detailed characteristics of their sexual assault experiences and those relationships with mental health. Methods: A total of 255 adult sexual violence victims who used intervention services and a comparison group were included. Information on their sexual assault experiences was gleaned from case records data. Results: The following four distinctive profile groups were identified: “Sexual Touching” (19.6%), “Rape/Social Relation” (30.4%), “Intimate Partner Violence (IPV)” (18.8%), and “Rape/Stranger” (31.3%). The subgroups differed in terms of secondary victimization and adverse childhood experiences. The Rape/Social Relation and IPV subgroups most frequently experienced secondary victimization and childhood adversity. The four profile subgroups demonstrated different relationships with mental health outcomes, with a complicated pattern. The Rap/Social Relation and IPV subgroups scored higher on mental health problem screening measures compared to other groups. However, a considerable proportion of victims in the Sexual Touching subgroup also reported suicidal behaviors and self-injury. Conclusion Based on the results, theoretical and clinical implications were discussed.

Objective: Extant studies indicate that just one characteristic of sexual assault cannot properly represent the whole experience of sexual assault and, especially, the severity of sexual assault. This study aimed to understand the totality of sexual assault experiences and elucidate subtypes of sexual assault victims based on the detailed characteristics of their sexual assault experiences and those relationships with mental health. Methods: A total of 255 adult sexual violence victims who used intervention services and a comparison group were included. Information on their sexual assault experiences was gleaned from case records data. Results: The following four distinctive profile groups were identified: “Sexual Touching” (19.6%), “Rape/Social Relation” (30.4%), “Intimate Partner Violence (IPV)” (18.8%), and “Rape/Stranger” (31.3%). The subgroups differed in terms of secondary victimization and adverse childhood experiences. The Rape/Social Relation and IPV subgroups most frequently experienced secondary victimization and childhood adversity. The four profile subgroups demonstrated different relationships with mental health outcomes, with a complicated pattern. The Rap/Social Relation and IPV subgroups scored higher on mental health problem screening measures compared to other groups. However, a considerable proportion of victims in the Sexual Touching subgroup also reported suicidal behaviors and self-injury. Conclusion Based on the results, theoretical and clinical implications were discussed.

PURPOSE: We aimed to determine the demographic and epidemiologic variables that are associated with no treatment in lung cancer patients. MATERIALS AND METHODS: Patient data were collected from the Korean National Health Insurance Database. The lung cancer group included patients with an initial diagnosis of lung cancer between January 2009 and December 2014. Treated cases were defined as those that underwent surgery, radiation, or chemotherapy until death, after the diagnosis of lung cancer. Risk of no treatment was calculated by multiple logistic regression analysis. RESULTS: Among the 2,148 new cases of lung cancer from 2009 to 2104, 612 (28.4%) were not treated. Risk of no treatment was higher in the following patients: patients in their 60s (odds ratio [OR], 1.18; 95% confidence interval [CI], 0.75 to 1.84), 70s (OR, 3.64; 95% CI, 2.41 to 5.50), and >80 years old (OR, 16.55; 95% CI, 10.53 to 25.03) than those in their 50s; patients with previous myocardial infarction (OR, 2.07; 95% CI, 1.01 to 4.25) or chronic kidney disease (OR, 2.88; 95% CI, 1.57 to 5.30); and patients diagnosed at a non-referral hospital (OR, 1.40; 95% CI, 1.01 to 1.92) or primary care provider (OR, 1.81; 95% CI, 1.43 to 2.29) compared with referral hospital. Low-income patients receiving Medicaid were 1.75 times (95% CI, 1.14 to 2.68) more likely to forgo treatment than high-income patients (upper 20%). Risk was not associated with sex or the year in which the lung cancer was diagnosed. CONCLUSION: Age predominantly determines whether patients with lung cancer undergo anti-cancer treatment.
Diagnosis ; Drug Therapy ; Humans ; Logistic Models ; Lung Neoplasms ; Lung ; Medicaid ; Myocardial Infarction ; National Health Programs ; Primary Health Care ; Referral and Consultation ; Renal Insufficiency, Chronic

In this study, almost complete genomic sequences of PPV1 and PPV4 circulating in commercial pig farms in South Korea were obtained and analyzed. Important mutations that may be precursors to host changes, such as premature stop codons of PPV1 and frameshift mutations of PPV4, were observed in these sequences. A 27a-like strain of PPV1, known to show a lack of cross-neutralization against existing commercial vaccine strains, was identified by phylogenetic analysis. Given the active genetic evolution, the additional precursors to host changes and emerging new genotypes of PPVs need to be monitored through continuous sampling and genetic analysis.

It is uncommon for a palatal fistula to be detected in individuals who have not undergone surgery, and only sporadic cases have been reported. It is even more difficult to find cases of acquired palatal fistula in patients with submucous or incomplete cleft palate. Herein, we present 2 rare cases of this phenomenon. Case 1 was a patient with submucous cleft palate who acquired a palatal fistula after suffering from oral candidiasis at the age of 5 months. Case 2 was a patient with incomplete cleft palate who spontaneously, without trauma or infection, presented with a palatal fistula at the age of 9 months.
Candidiasis, Oral ; Cleft Palate* ; Fistula* ; Humans ; Oral Fistula

Background/Aims: The treatment of epidermal growth factor receptor (EGFR)-mutated lung cancer cases has shown remarkable development in the past two decades. However, there have been limited studies comparing the prognostic effects of EGFR-tyrosine kinase inhibitor (TKI) and other treatment modalities. Therefore, we compared the survival outcomes of patients treated with EGFR-TKIs versus those treated with other treatment modalities. Methods: Patient data were collected from the Korean National Health Insurance Database, National Health Insurance Service- National Sample Cohort 2002 to 2015, which was released by the Korean National Health Insurance Service in 2015. The lung cancer group included patients (n = 2,003) initially diagnosed with lung cancer between January 2010 and December 2013. The main outcome was all-cause mortality. A Cox proportional hazard regression analysis was used to calculate the relative risk of mortality. Results: Among the newly diagnosed lung cancer cases, 1,004 (50.1%) were included in the analysis. A 15.1-month median survival benefit was observed in the EGFR-TKI group than that of the multimodality therapy group. The risk of mortality was as follows: EGFR-TKI treatment group (n = 142; hazard ratio [HR], 5.29; 95% confidence interval [CI], 3.57 to 7.86) and multimodality therapy group (n = 326; HR, 7.42; 95% CI, 5.19 to 10.63) compared to surgery only (n = 275). Conclusions Patients with advanced lung cancer harbouring EGFR mutations treated with EGFR-TKIs showed better median survival and lower risk of mortality than those in the multimodality therapy group. In the case of EGFR-mutated advanced lung cancer, there is room for downstaging in the TNM classification.

Background: The mechanisms leading to lung fibrosis are still under investigation. This study aimed to demonstrate whether antacids could prevent the development of interstitial lung disease (ILD). Methods: This population-based longitudinal cohort study was conducted between January 2006 and December 2010 in South Korea. Eligible subjects were ≥40 years of age, exposed to proton pump inhibitors (PPI)±histamine-2 receptor antagonists (H-2 blockers) or H-2 blockers only, and had no history of ILD between 2004 and 2005. Exposure to antacids was defined as the administration of either PPI or H-2 receptor antagonists for >14 days, whereas underexposure was defined as antacid treatment administered for less than 14 days. Newly developed ILDs, including idiopathic pulmonary fibrosis (IPF), were counted during the 5-year observation period. The association between antacid exposure and ILD development was evaluated using adjusted Cox regression models with variables, such as age, sex, smoking history, and comorbidities. Results: The incidence rates of ILD with/without antacid use were 43.2 and 33.8/100,000 person-years, respectively and those of IPF were 14.9 and 22.9/100,000 person-years, respectively. In multivariable analysis, exposure to antacid before the diagnosis of ILD was independently associated with a reduced development of ILD (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.45 to 0.71; p<0.001), while antacid exposure was not associated with development of IPF (HR, 0.88; 95% CI, 0.72 to 1.09; p=0.06). Conclusion Antacid exposure may be independently associated with a decreased risk of ILD development.

Background: Pregnant women are at a high-risk of influenza infection. We have previously reported a low influenza vaccination coverage rate (4.0%) in Korea during the 2006–2007 influenza season. We conducted follow-up studies in 2011–2012 and 2018–2019 to observe changes in influenza vaccination coverage. Methods: Women who delivered at Inha University Hospital (Incheon, Korea) in 2011–2012 and 2018–2019 were enrolled in the study. We surveyed the rate of influenza vaccination, perception scores, and related factors through telephonic interviews and compared the results from 2011–2012 and 2018–2019 with those from 2006–2007. Results: The number of survey respondents was 227 in 2006–2007, 152 in 2011–2012, and 171 in 2018–2019. The rate of vaccination coverage increased from 4.0% in 2006–2007 to 42.0% in 2011–2012 and 59.3% in 2018–2019. Perception scores also increased progressively from 3.8 in 2006–2007 to 4.2 in 2011–2012 and 5.1 in 2018–2019. Physician recommendations for influenza vaccination also increased from 4.8% in 2006–2007 to 36.8% in 2011–2012 and 49.7% in 2018–2019. The most common reason for not getting vaccinated was the lack of awareness of influenza vaccination during pregnancy (36.9%). The perception scores and physician recommendation rates were significantly lower for unvaccinated women (3.87 and 8.4%, respectively) than for vaccinated women (5.14 and 69.1%, respectively). Conclusion The influenza vaccination coverage rate in pregnant women has increased significantly since our study in 2006–2007. However, further improvement in the coverage rate is needed. There is a need for active and comprehensive publicity and education regarding this issue among physicians and pregnant women.