Purpose: The purpose of this study was to identify the possible correlations of ‘satisfaction with clinical practice (SA)’ with ‘clinical learning environment (EN)’ and ‘clinical practice stress (ST).’ We searched for the mediating effect of ‘clinical practice stress’ on ‘satisfaction with clinical practice’ when the clinical learning environment influences ‘satisfaction with clinical practice.’ Methods: This research investigated 208 medical and nursing students attending the school of medicine and nursing in Korea. The total number of nursing students was 135 (64.9%); 73 medical students participated (35.1%). We used the Korean-Undergraduate Clinical Education Environment in 24 questions for EN, ST scale in 24 questions, and SA scale in 10 questions. We performed measurement structural equation model analysis to identify a path of the model. Results: Medical students had significantly higher levels of ST. EN had a significant negative correlation with ST and a significant positive correlation with SA. The ST had a significant negative correlation with SA. The results of the goodness of fit index have fulfilled the criteria of goodness of fit. There was a significant mediating effect of ST on SA when EN influences SA. Conclusion The clinical learning environment affected satisfaction with the clinical practice directly or indirectly mediated by clinical practice stress. Therefore, educational institutes should try to increase satisfaction with clinical practice by continuously monitoring and improving the clinical learning environment in addition to taking measures for decreasing the clinical practice stress.

PURPOSE: We conducted objective structured clinical examinations (OSCEs) in medical students both before entering clinical clerkship and after finishing clinical clerkship for the purpose of evaluating the usefulness of OSCEs before clinical clerkship. METHODS: The subjects of the study comprised 77 3rd-year medical students who participated in a 2-week course of physical diagnosis before clinical clerkship, and 98 4th-year medical students who had completed their clinical clerkship. The OSCE consisted of 17 cases and 17 stations for the 3rd-year medical students, and 20 cases and 28 stations for the 4th-year students. We assigned 4 minutes and 30 seconds to each station. OSCE stations were duplicated at two sites and were performed twice. After the OSCE, we used structured questionnaires to survey the subjects for their opinions of the current process and the need for an OSCE. RESULTS: At the psychiatric station, which applied an identical scenario and checklists to both the 3rd- and 4th-year medical students, the mean score of the 3rd-year medical students was significantly lower than that of the 4th-year students. The correlation coefficient between OSCE score and cumulative performance grade of 3rd-year medical students (r=0.29) also was lower than that of 4th-year medical students (r=0.53). Over 80% of the 3rd-year medical students and over 90% of the 4th-year responded that an OSCE is necessary. However, around 70% of students preferred an OSCE for each clinical class during clinical clerkship, and only 33~38% of students preferred an OSCE as a final examination. Almost all students wanted to receive feedback after an OSCE. CONCLUSIONS: Performing an OSCE on 3rd-year medical students before they enter clinical clerkship provides better preparation for the clinical clerkship than an evaluation alone. We suggest that an OSCE should be used as a formative assessment in addition to a summative evaluation such as a final examination.
Checklist ; Clinical Clerkship* ; Diagnosis ; Humans ; Students, Medical* ; Surveys and Questionnaires

We have previously shown that 2,4,3',5'-tetramethoxystilbene (TMS), a trans-stilbene analogue, induces apoptosis in human cancer cells. However, the detailed mechanisms of mitochondria-dependent apoptosis induced by TMS are not fully understood. In the present study, the possible roles of annexin A5 in TMS-mediated apoptosis were investigated in MCF7 human breast cancer cells. Quantitative real-time PCR analysis and Western blot analysis showed that the expression of annexin A5 was strongly increased in TMS-treated cells. TMS caused a strong translocation of annexin A5 from cytosol into mitochondria. Confocal laser scanning microscopic analysis clearly showed that TMS induced translocation of annexin A5 into mitochondria. TMS increased the expression and oligomerization of voltage-dependent anion channel (VDAC) 1, which may promote mitochondria-dependent apoptosis through disruption of mitochondrial membrane potential. When cells were treated with TMS, the levels of Bax, and Bak as well as annexin A5 were strongly enhanced. Moreover, we found that the cytosolic release of apoptogenic factors such as cytochrome c, or apoptosis-inducing factor (AIF) in mitochondria was markedly increased. Annexin A5 depletion by siRNA led to decreased proapoptotic factors such as Bax , Bak, and annexin A5. Taken together, our results indicate that annexin A5 may play an important role in TMS-mediated mitochondrial apoptosis through the regulation of proapoptotic proteins and VDAC1 expression.
Annexin A5* ; Apoptosis Inducing Factor ; Apoptosis* ; Blotting, Western ; Breast Neoplasms* ; Cytochromes c ; Cytosol ; Humans ; Membrane Potential, Mitochondrial ; Mitochondria ; Real-Time Polymerase Chain Reaction ; RNA, Small Interfering

OBJECTIVES: This study was performed to understand farmers' health status by general characteristic, and to find out the related factors. METHODS: All the 984 subjects were interviewed by means of a structured questionnaire and SF-12. Among them, only 812 were eligible for analysis. Statistical methods used included frequency, t-test, ANOVA, binary logistic regression with SPSS 19.0. RESULTS: In binary logistic regression, marital status, smoking, regular exercise and monthly day off were associated with physical component score. Marital status, smoking and score of pesticide protective device wearing were associated with mental component score. CONCLUSIONS: This study suggests that effort to develop health promotion programs for workers of agricultural industry considering these results can improve their perceived health status.
Health Promotion ; Logistic Models ; Marital Status ; Protective Devices ; Smoke ; Smoking

PURPOSE: To analyze and compare the clinical factors and neurodevelopmental outcomes compare early- and late-onset periventricular leukomalacia (PVL) in very low birth weight infants (VLBWI). METHODS: We performed a retrospective study involving 199 newborn infants weighing < 1,500 g admitted to the neonatal intensive care unit between March 2009 and December 2015. VLBWI with PVL were categorized into early- and late-onset PVL groups based on the time of diagnosis based on 28 days of age. We analyzed the clinical factors and neurodevelopmental outcomes between the groups. RESULTS: The incidence rate of PVL was 10.1% (16/158). The Apgar score at 1 minute and the mean duration of tocolytic therapy were associated with the development of PVL. The incidence rate of premature rupture of membranes (PROM) was significantly higher in the early-onset PVL group (P=0.041). No significant differences were observed in neurodevelopmental outcomes between the early- and late-onset PVL groups. CONCLUSION: Results suggest that a higher incidence of PROM was associated with clinical characteristics in the early-onset PVL group. No significant intergroup differences were observed in neurodevelopmental outcomes; however, the Bayley Scales of Infant Development-III scores were lower in the early-onset PVL group.
Apgar Score ; Diagnosis ; Female ; Fetal Membranes, Premature Rupture ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Leukomalacia, Periventricular ; Membranes ; Pregnancy ; Retrospective Studies ; Rupture ; Tocolysis ; Weights and Measures

Protective ventilation is a prevailing ventilatory strategy these days and is comprised of small tidal volume, limited inspiratory pressure, and application of positive end-expiratory pressure (PEEP). However, several retrospective studies recently suggested that tidal volume, inspiratory pressure, and PEEP are not related to patient outcomes, or only related when they influence the driving pressure. Therefore, this review introduces the concept of driving pressure and looks into the possibility of driving pressure-guided ventilation as a new ventilatory strategy, especially in thoracic surgery where postoperative pulmonary complications are common, and thus, lung protection is of utmost importance.