Objective: The aim of this study was to develop a Korean version of the Thinking About Life Experiences (TALE-K) scale and to analyze the characteristics of autobiographical memory function (AMF) in community-dwelling older adults. Methods: To develop TALE-K, a translation and back-translation procedure followed by an understanding test was performed. Then, a survey was conducted to examine the associations of AMF with psychosocial variables using TALE-K, Index of Well-Being (IWB), Meaning in Life Scale for older adults, Revised UCLA Loneliness Scale, Medical Outcomes Study Social Support Survey, and Brief Resilience Scale. Results: Data from 75 community-dwelling older adults were used for the final analysis. The average scores of all three sub-scales of TALE-K were below 3 points (less frequent than occasionally). The correlation results showed that TALE-K total score was significantly associated with IWB and the Meaning in life scale for older adults. The multiple linear regression results present-ed that higher AMF was significantly associated with higher IWB, along with having siblings, higher meaning in life and resilience,and lower loneliness. Conclusion Including a validation study of TALE-K, studies for understanding the characteristics of AMF in older adults using TALE-K are needed.

BACKGROUND AND OBJECTIVES: The plasma lipid levels play crucial roles in the development of atherosclerotic diseases. We estimated the genetic variance of the lipid levels according to the contributions of the single nucleotide polymorphisms (SNPs) and haplotypes in 5 candidate genes. SUBJECTS AND METHODS: We selected SNPs in the ATP binding cassette A1 (ABCA1) gene, the apolipoprotien A5 (APOA5), apolipoprotien E (APOE) gene, the cholesterol ester transfer protein (CETP) gene and the hepatic triglyceride lipase (LIPC) gene in 383 individuals from 100 Korean families. The genotype was determined by Orchid's SNP-IT(TM) technology. The association analysis of the quantitative traits was performed using the quantitative transmission disequilibrium test. RESULTS: A component analysis of the phenotypic variance explained 24.7% of the genetic variance on the total cholesterol, 26.4% of the genetic variance of the high density lipoprotein (HDL)-cholesterol, 11% of the genetic variance of the triglycerides, 35.6% of the genetic variance of the low density lipoprotein (LDL)-cholesterol and 18.9% of the genetic variance of the LDL-C/HDL-C, respectively. The association of the SNPs in the candidate genes explained a major fraction of the genetic phenotypic variance in the LDL-C/HDL-C ratio, but not in the other lipid profiles. The association with SNPs explained 38.5% of the variance for the total cholesterol, 32.2% of the variance for HDL-cholesterol and 29.5% of the variance for LDL-cholesterol relative to the polygenic background. An analysis of the contribution of each gene to the genetic variance showed that ABCA1, APOE, CETP and LIPC influenced the variations in total cholesterol, LDL-cholesterol and LDL-C/HDL-C. The variation in HDL-cholesterol was influenced by ABCA1, APOA5 and APOE. CONCLUSION: We identified that the genetic variance for the total cholesterol, HDL-cholesterol and LDL-cholesterol, and the LDL-C/HDL-C ratio was significantly influenced by the genetic polymorphisms in 5 candidate genes in the Korean population. Further studies are necessary to identify other genes that can explain a major fraction of the genetic variance for the lipid levels.
Adenosine Triphosphate ; Apolipoproteins E ; Cholesterol ; Genotype ; Haplotypes ; Humans ; Lipase ; Lipoproteins ; Plasma ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Triglycerides

Interprofessional education (IPE) fosters knowledge, skills, and attitudes related to interprofessional collaboration (IPC) for safe, quality patient care. In recent years, the importance of IPC has extended beyond the medical field to local community settings. However, IPE has only recently been introduced and has yet to become widespread. This study reviews the origin and development of IPE in Korean medical education by comparing it with established models in other countries that provide useful insights into future directions for IPE in Korea. Dedicated institutions led the IPE effort in other countries; however, IPE initiatives in Korea were mainly driven by individual professors’ and medical schools’ interest and commitment, without structural support systems. An important finding of this study is that the lack of awareness and organizational support within the medical education community resulted in the absence of a mandatory curriculum for IPE, as it was omitted from the accreditation standards. For more organized adoption and implementation of IPE in Korea, this study suggests the need to widely communicate the importance of IPE to the medical community and the public. It is also imperative to establish leadership capable of guiding IPE, share materials through trusted institutions with IPE experience, and include IPE in the accreditation standards. These steps are essential for actively implementing IPE and meeting societal healthcare needs in Korea.

Objective: Since the characteristics of frequent emergency department (ED) users are heterogeneous, it is impossible to mitigate overcrowding of the ED without basic data of diagnoses and risk factors of frequent ED users. Instead of selecting for a limited disease group, our study included all ED patients, thereby providing invaluable information to help predict patient demand for medical resources. Methods: Frequent ED users are defined as patients who visit an ED between 7-17 times per calendar year, and highly frequent ED users are patients who visit an ED 18 times or more during the same period. Our study developed two logistic regression models comparing frequent users with less frequent users, and highly frequent users with frequent users. Results: Although 98.98% of all patients were determined as less frequent ED users, they encompassed only 92.27% of all ED visits. Frequent ED users were most strongly identified as wound dressing follow-up visits and liver diseases (standardized βvalue of 3.29 and 2.31, respectively). However, considering the different disease categories, no differences were obtained between highly frequent ED and frequent ED users. Conclusion The diagnoses and risk factors related to frequent ED visits in Korea identified in this study, will provide important reference for future research aimed at reducing ED overcrowding. By further analyzing the risk factors associated with frequent ED use, non-emergency administrative systems or medical facilities can be utilized to reduce the ED overload.

Objective: Since the characteristics of frequent emergency department (ED) users are heterogeneous, it is impossible to mitigate overcrowding of the ED without basic data of diagnoses and risk factors of frequent ED users. Instead of selecting for a limited disease group, our study included all ED patients, thereby providing invaluable information to help predict patient demand for medical resources. Methods: Frequent ED users are defined as patients who visit an ED between 7-17 times per calendar year, and highly frequent ED users are patients who visit an ED 18 times or more during the same period. Our study developed two logistic regression models comparing frequent users with less frequent users, and highly frequent users with frequent users. Results: Although 98.98% of all patients were determined as less frequent ED users, they encompassed only 92.27% of all ED visits. Frequent ED users were most strongly identified as wound dressing follow-up visits and liver diseases (standardized βvalue of 3.29 and 2.31, respectively). However, considering the different disease categories, no differences were obtained between highly frequent ED and frequent ED users. Conclusion The diagnoses and risk factors related to frequent ED visits in Korea identified in this study, will provide important reference for future research aimed at reducing ED overcrowding. By further analyzing the risk factors associated with frequent ED use, non-emergency administrative systems or medical facilities can be utilized to reduce the ED overload.

Purpose: : This study investigates the effects of a tabletop simulation game called Friday Night at the Emergency Room (FNER) on the premise that experience leads to systems thinking and innovative behavior in hospital staff. Methods: : This is a one-group pretest-posttest design study for 17 hospital staff. The tools were the systems thinking scale (STS; 20 questions), an innovative behavior questionnaire (IBQ; 9 questions), and a self-reflection essay. Paired t-test, Cohen’s d effect sizes, and content analysis were used for the analysis. Results: : After participating in the FNER game for hospital staff, systems thinking did not significantly improve, and the effect size of the program was low. But innovative behavior significantly improved, and the effect size of the program was high. Because of the contents of the self-reflection essay analysis, the importance of teamwork included the understanding of the hospital system. Conclusion : The educational effects of simulation-based FNER games are different depending on the organizational experience. Hospital educators should consider conducting complex problem-solving exercises, such as FNER, on new employees or early-experienced hospital staff to enhance and challenge the staff’s systems thinking and innovative behavior.

This study aimed to analyze the subjects, situations, and reflection levels related to role modeling experienced by medical students during their clinical clerkship and their own reflections. This study intends to suggest ways of improving how residents and clinical faculty should treat and teach medical students. Written interviews were conducted regarding senior medical students’ role modeling experiences during their clinical clerkships in 2018 and 2019. Content analysis was conducted for a total of 224 cases from 196 students. Content analysis revealed three types of role modeling content: subjects (faculty, residents, nurses, peer students), situations (clinical competence, personal qualities, teaching skills), and the level of reflection (critical reflection, reflection, thoughtful action, and habitual action) in each case. As role model subjects, faculty were found to be the paramount role model (n=142, 62.83%). Role modeling was the most frequently performed for clinical competence (n=103, 45.98%). Clinical competence was frequently shown in communication and empathic listening during rounds and outpatient relationships between the patient and doctor. Regarding the level of reflection for role modeling, the number of critical reflections was 86 (38.39%) and that of reflections was 80 (35.71%). In particular, negative role modeling showed a high level of critical reflection in relation to faculty (64.44%) and nurses (8.89%). In conclusion, role modeling of medical students participating in clinical clerkships occurs in situations that the role models are not aware of, with positive or negative effects on the formation of professional identity among medical students.

PURPOSE: We aimed to evaluate the respiratory illness-related hospital visits (out-patient clinics, emergency room, and re-admission) of preterm infants, and compare them according to corrected age and prematurity. METHODS: We reviewed the medical records of preterm infants born at < 37 weeks of gestation admitted to the neonatal intensive care unit (NICU) at Inha University Hospital between January 2012 and June 2015. Infant follow-up appointments in both neonatology and pulmonology out-patient clinics occurred for at least 2 years after NICU discharge. RESULTS: The proportion of infants who visited the hospital due to any respiratory illness was as high as 50% until 12 months of corrected age, and subsequently decreased over time. Hospital admission was significantly higher in early preterm infants ( < 34 weeks of gestation) compared to late preterm infants (≥34 and < 37 weeks of gestation). The proportion of infants who were re-admitted due to lower respiratory tract illness was significantly higher until 6 months of corrected age compared to the later, and did not differ between early and late preterm infants. CONCLUSION: The proportion of hospital visits of preterm infants due to respiratory disease was high until 12 months of corrected age. Most notably, the re-admission proportion from lower respiratory tract illness was high under 6 months in both early and late preterm infants. Preterm infants within this age that are visiting the hospital with respiratory symptoms should be carefully observed and followed up.
Appointments and Schedules ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Medical Records ; Neonatology ; Outpatients ; Patient Readmission ; Pregnancy ; Pulmonary Medicine ; Respiratory System ; Respiratory Tract Diseases

PURPOSE: To diagnose infantile colic from parent questionnaires, as well as investigating the risk factors and clinical course of infantile colic. METHODS: We retrospectively reviewed the medical records of 462 infants, with a corrected age of < 4 months at the time of visiting Inha University Hospital from January to December 2017. Parents responded to a 10-line questionnaire consisting of seven items relating to colic symptoms and three further items relating to underlying disease. The score was based on the number of days each symptom was evident during the preceding week. We defined infantile colic as the sum total being greater than seven points; if at least one of the three symptoms suggesting underlying disease was present, the infant was excluded from the diagnosis. RESULTS: One hundred and sixty-seven infants (36.1%) satisfied the criteria. The lower the gestational age, the more infantile colic they developed (P < 0.001). The prevalence of colic was higher in infants born with a birth weight < 2.5 kg (62.7% vs. 24.4%, P < 0.001) and in infants small for their gestational age, in the < 10th percentile (54.5% vs. 33.7%, P=0.003). The prevalence of colic was significantly different according to the type of feeding (P=0.001), being the lowest in breast-only feeding (29.8%), 32.8% in mixed feeding with breast milk and formula, and 49.7% in formula-only feeding. Colic symptoms improved by administering hydrolyzed formula (87.5%), low-lactose formula (47.1%), galactosidase (44.4%), and the probiotic Lactobacillus reuteri (34.5%). CONCLUSION: The prevalence of infantile colic was over 30%. Prematurity, lower birth weight, and small for gestational age were the risk factors of infantile colic. Clinical improvement was observed when active intervention was performed.
Birth Weight ; Colic ; Diagnosis ; Galactosidases ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Lactobacillus reuteri ; Medical Records ; Milk, Human ; Parents ; Prevalence ; Probiotics ; Retrospective Studies ; Risk Factors

Psoriasis is one of the most common inflammatory skin disorders, with a global prevalence of 2% – 3%. It is an autoimmune skin disorder characterized by excessive generation of plaques on the skin with typical long-lasting red, itchy, and scaly lesions. In this study, we aimed to elucidate the anti-psoriatic effect of the methanolic extract of Persicaria senticosa (PS), a bioactive edible plant extract used in traditional medicine, using a mouse model of imiquimod (IMQ)-induced psoriasis. The daily topical application of IMQ could induce human psoriasis-like lesion. The extract ameliorated IMQ-induced psoriasis. Furthermore, hematoxylin and eosin staining and the Psoriasis Area and Severity Index (PASI) scores indicated that topical application of PS led to an improvement in erythema, scaling, and thickness scores of the mouse dorsal skin and a considerable decrease in the epidermal thickness of the ear and dorsal skin in the IMQ-induced psoriatic mouse model. We also studied the effect of PS on the proliferation of keratinocytes using HaCaT cells. The extract inhibited cell proliferation and IL-6 and pSTAT3 expression induced by M5 cocktail (comprising interleukin [IL]-1α, IL-17A, IL-22, oncostatin M, and tumor necrosis factor-α) in HaCaT cells. Thus, PS might serve as a potential therapeutic agent for the treatment of psoriasis.