PURPOSE: This study was done to establish a clinical ladder system for nurses in a small and medium-sized hospital in Korea. METHODS: The study was carried from July, 2016 to May, 2018. Data collection was done in a general hospital with 250 beds located in Gyeonggi Province. The clinical ladder system was developed and operated according to the value system of small and medium-sized hospital. Focus group interviews and a satisfaction survey were conducted for evaluation. Collected quantitative data were analyzed using the SPSS/WIN 22.0 program and qualitative data underwent content analysis. RESULTS: The clinical ladder system is a 5-step ladder that includes 3 domains, 5 nursing competencies and 25 nursing behavioral indicators related to core values of the hospital. The operating system were promotion review system, education system and support/reward system. After conducting a pilot clinical ladder system, satisfaction of nurses was 2.86, out of a possible 4. Nurses who participated in the clinical ladder system experienced improvement in motivation, job performance, self-esteem, professionalism, recognition and were able to develop a goal in their minds. CONCLUSION: The results indicate that the clinical ladder system can be used as a strategy for professional development for nurses in small and medium-sized hospitals.
Career Mobility ; Data Collection ; Education ; Focus Groups ; Gyeonggi-do ; Hospitals, General ; Korea ; Motivation ; Nursing ; Professionalism ; Work Performance

The aim of this study was to determine the relationship of alpha-smooth muscle actin (ASMA) and the proliferation marker Ki-67 of glomerulonephritis (GN). Immunohistochemical stainings with the usual streptavidin-biotin peroxidase method were performed on 86 renal biopsies using monoclonal 1A4 and Ki-67. The results of the quantitative evaluation of ASMA and Ki-67 were analyzed for the correlation between positive value of ASMA and Ki-67 in different GN. ASMA expressions of glomeruli were highest in acute post-infectious GN [APGN; 16.9 Fraction Volume (FV)%], followed by unclassified proliferative GN (UnGN; 12.5 FV%), membranoproliferative GN (MPGN; 8.5 FV%), lupus nephritis (LupusN; 6.3 FV%), IgA nephritis (IgAN; 5.6 FV%), and normal control (0.1 FV%). The Ki-67 staining was considerably elevated in lupusN (4.3 Ki-67 positives/glomerulus), APGN (2.7), MPGN (2.5), UnGN (1.66), IgAN (0.5), compared with that in normal control group (0.1 Ki-67 positives/glomerulus). Ki-67 value in each category of glomerular diseases was significantly different from that in the control biopsies (p<0.004). The relationship between morphometric results of ASMA and Ki-67 was statistically significant regardless of the diagnosis. (rs=0.425, p=0.000, ASMA= 0.1113+0.1665 Ki-67). In conclusion, the immunohistochemical assessment of ASMA and Ki-67 expression in GN might be a reliable indicator for the progression of GN. This study indicates that active cellular proliferation is associated with increased actin deposition in glomeruli.
Actins/*analysis ; Biopsy ; Cell Division ; Glomerulonephritis/*metabolism/pathology ; Human ; Immunohistochemistry ; Ki-67 Antigen/*analysis ; Kidney/pathology

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

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