PURPOSE: The purpose of this study was to develop a revised version of the clinical critical thinking skills test (CCTS) and to subsequently validate its performance. METHODS: This study is a secondary analysis of the CCTS. Data were obtained from a convenience sample of 284 college students in June 2011. Thirty items were analyzed using item response theory and test reliability was assessed. Test-retest reliability was measured using the results of 20 nursing college and graduate school students in July 2013. The content validity of the revised items was analyzed by calculating the degree of agreement between instrument developer intention in item development and the judgments of six experts. To analyze response process validity, qualitative data related to the response processes of nine nursing college students obtained through cognitive interviews were analyzed. RESULTS: Out of initial 30 items, 11 items were excluded after the analysis of difficulty and discrimination parameter. When the 19 items of the revised version of the CCTS were analyzed, levels of item difficulty were found to be relatively low and levels of discrimination were found to be appropriate or high. The degree of agreement between item developer intention and expert judgments equaled or exceeded 50%. CONCLUSION: From above results, evidence of the response process validity was demonstrated, indicating that subjects respondeds as intended by the test developer. The revised 19-item CCTS was found to have sufficient reliability and validity and will therefore represents a more convenient measurement of critical thinking ability.
Discrimination (Psychology) ; Humans ; Intention ; Judgment ; Nursing* ; Reproducibility of Results ; Students, Nursing ; Thinking*

PURPOSE: This study aimed to investigate the relationships between the level of knowledge, attitude and compliance of preventive behaviors of the Middle East respiratory syndrome (MERS) among nursing students. METHODS: The study sample consisted of 219 nursing students. Through the use of a structured questionnaire, data collection was conducted from June 1st to June 30th 2015. The descriptive statistics, independent t-tests and Pearson's correlation coefficient were employed to analyze the data. RESULTS: The score of the MERS-related knowledge was 9.15 out of 13. The participants had a positive attitude toward the MERS. The level of MERS-related knowledge was high in the case of temporary school closure or break in clinical practice because of the clinical training in hospitals that MERS occurred (t=2.42, p=.016). The compliance level of the preventive behavior for MERS was high in female students (t=−2.11, p=.036), in the case of temporary school closure or break in clinical practice due to the clinical training in hospitals that MERS occurred (t=3.29, p=.001), and in students that had MERS-related education for prevention (t=2.80, p=.006). The MERS-related knowledge was positively correlated with the level of compliance for preventive behavior (r=.18, p=.009). CONCLUSION: To prevent MERS infection in nursing students, the level of knowledge on MERS should be enhanced so that they can practice preventive behaviors against it. Additionally, the MERS infection control education should include etiology and treatment products based on the MERS response guideline issued by the Centers for Korea Disease Control and Prevention.
Compliance ; Coronavirus Infections ; Data Collection ; Education ; Female ; Humans ; Infection Control ; Korea ; Middle East ; Nursing ; Students, Nursing

Background: Low-density lipoprotein (LDL) cholesterol is a strong predictor of cardiovascular disease, resulting in the promotion of low-fat diets that emphasize the need to lower LDL cholesterol levels. We investigated the relationship between dietary carbohydrate intake and cardiovascular risk factors according to LDL cholesterol levels in Korean adults who typically consumed high-carbohydrate, low-fat diets. Methods: A total of 25,925 Korean adults were selected from the 2007-2015 Korea National Health and Nutrition Examination Surveys. Dietary carbohydrate intake was grouped into quintiles and cardiovascular risk factors included obesity, metabolic syndrome, type 2 diabetes, and dyslipidemia. Multiple logistic regression models were used to examine association between carbohydrate intake and cardiovascular risk factors by sex and LDL cholesterol levels. Results: Subjects with LDL cholesterol ≥130 mg/dL had significantly less energy and fat intake than those with LDL cholesterol <130 mg/dL both in men and women. In men, a higher carbohydrate intake was related to increased prevalence of atherogenic dyslipidemia and low high-density lipoprotein (HDL) cholesterol regardless of LDL cholesterol levels. Meanwhile, dietary carbohydrate intake was positively associated with low HDL cholesterol but inversely associated with hypercholesterolemia only in women with LDL cholesterol <130 mg/dL. Conclusions High carbohydrate intake in Korean adults is associated with low HDL cholesterol or atherogenic dyslipidemia regardless of LDL cholesterol levels. Carbohydrate intake should be carefully recommended according to the lipid profiles of individuals for the prevention and management of cardiovascular disease.

The skin is the first line of defense of our body, and it is composed of the epidermis and dermis with diverse immune cells. Various in vitro models have been investigated to recapitulate the immunological functions of the skin and to model inflammatory skin diseases. The simplest model is a two-dimensional (2D) co-culture system, which helps understand the direct and indirect cellto-cell interactions between immune and structural cells; however, it has limitations when observing three-dimensional (3D) interactions or reproducing skin barriers. Conversely, 3D skin constructs can mimic the human skin characteristics in terms of epidermal and dermal structures, barrier functions, cell migration, and cell-to-cell interaction in the 3D space. Recently, as the importance of neuro-immune-cutaneous interactions in the inflammatory response is emerging, 3D skin constructs containing both immune cells and neurons are being developed. A microfluidic culture device called “skin-on-a-chip,” which simulates the structures and functions of the human skin with perfusion, was also developed to mimic immune cell migration through the vascular system. This review summarizes the in vitro skin models with immune components, focusing on two highly prevalent chronic inflammatory skin diseases: atopic dermatitis and psoriasis. The development of these models will be valuable in studying the pathophysiology of skin diseases and evaluating the efficacy and toxicity of new drugs.

The skin is the first line of defense of our body, and it is composed of the epidermis and dermis with diverse immune cells. Various in vitro models have been investigated to recapitulate the immunological functions of the skin and to model inflammatory skin diseases. The simplest model is a two-dimensional (2D) co-culture system, which helps understand the direct and indirect cellto-cell interactions between immune and structural cells; however, it has limitations when observing three-dimensional (3D) interactions or reproducing skin barriers. Conversely, 3D skin constructs can mimic the human skin characteristics in terms of epidermal and dermal structures, barrier functions, cell migration, and cell-to-cell interaction in the 3D space. Recently, as the importance of neuro-immune-cutaneous interactions in the inflammatory response is emerging, 3D skin constructs containing both immune cells and neurons are being developed. A microfluidic culture device called “skin-on-a-chip,” which simulates the structures and functions of the human skin with perfusion, was also developed to mimic immune cell migration through the vascular system. This review summarizes the in vitro skin models with immune components, focusing on two highly prevalent chronic inflammatory skin diseases: atopic dermatitis and psoriasis. The development of these models will be valuable in studying the pathophysiology of skin diseases and evaluating the efficacy and toxicity of new drugs.

Background: Low-density lipoprotein (LDL) cholesterol is a strong predictor of cardiovascular disease, resulting in the promotion of low-fat diets that emphasize the need to lower LDL cholesterol levels. We investigated the relationship between dietary carbohydrate intake and cardiovascular risk factors according to LDL cholesterol levels in Korean adults who typically consumed high-carbohydrate, low-fat diets. Methods: A total of 25,925 Korean adults were selected from the 2007-2015 Korea National Health and Nutrition Examination Surveys. Dietary carbohydrate intake was grouped into quintiles and cardiovascular risk factors included obesity, metabolic syndrome, type 2 diabetes, and dyslipidemia. Multiple logistic regression models were used to examine association between carbohydrate intake and cardiovascular risk factors by sex and LDL cholesterol levels. Results: Subjects with LDL cholesterol ≥130 mg/dL had significantly less energy and fat intake than those with LDL cholesterol <130 mg/dL both in men and women. In men, a higher carbohydrate intake was related to increased prevalence of atherogenic dyslipidemia and low high-density lipoprotein (HDL) cholesterol regardless of LDL cholesterol levels. Meanwhile, dietary carbohydrate intake was positively associated with low HDL cholesterol but inversely associated with hypercholesterolemia only in women with LDL cholesterol <130 mg/dL. Conclusions High carbohydrate intake in Korean adults is associated with low HDL cholesterol or atherogenic dyslipidemia regardless of LDL cholesterol levels. Carbohydrate intake should be carefully recommended according to the lipid profiles of individuals for the prevention and management of cardiovascular disease.

PURPOSE: The purpose of this study was to evaluate the methodological quality of nursing studies using structural equation modeling in Korea. METHODS: Databases of KISS, DBPIA, and National Assembly Library up to March 2014 were searched using the MeSH terms 'nursing', 'structure', 'model'. A total of 152 studies were screened. After removal of duplicates and non-relevant titles, 61 papers were read in full. RESULTS: Of the sixty-one articles retrieved, 14 studies were published between 1992 and 2000, 27, between 2001 and 2010, and 20, between 2011 and March 2014. The methodological quality of the review examined varied considerably. CONCLUSION: The findings of this study suggest that more rigorous research is necessary to address theoretical identification, two indicator rule, distribution of sample, treatment of missing values, mediator effect, discriminant validity, convergent validity, post hoc model modification, equivalent models issues, and alternative models issues should be undergone. Further research with robust consistent methodological study designs from model identification to model respecification is needed to improve the validity of the research.
Databases, Factual ; Humans ; Models, Theoretical ; Nursing Research/*methods ; Publishing ; Republic of Korea

BACKGROUND: Repeated 24 hour recall has been considered as a preferred method for obtaining accurate dietary information while time and cost for coding and data processing have been a major barrier for their use in large studies. This burden can be resolved by automating the interview and data processing. However, there has been no report about a computerized interview system for dietary survey in a free-living population in Korea. METHODS: This study attempts to test the feasibility of a newly-developed web-based dietary assessment program, Diet Evaluation System (DES) for subjects in a mixed region of urban and rural areas via wireless internet. We conducted total of 134 interviews, twice for each of 67 subjects of various age. As another aspect of feasibility, the group discussion among interviewers was done. RESULTS: Success rate of total attempted interviews was about 70%. Major reasons for problem with DES were instability of wireless internet and consequent inefficient booting of laptops in some areas. It took 14 minute 56 seconds on average to complete an interview and data processing conducted automatically. Subjects' age and internet environment influenced the DES interview time. The group discussion revealed that one-stop system with DES is fast and convenient assuming good wireless internet environment. CONCLUSIONS: Web-based dietary assessment was feasible in this community nutrition survey. To confirm the feasibility in large scale, studies with more comprehensive area and subjects are needed with various wireless condition.
Automatic Data Processing ; Clinical Coding ; Diet ; Diet Surveys ; Feasibility Studies ; Internet ; Korea* ; Methods ; Nutrition Surveys*

The quantitative expansion of nursing schools has necessitated the qualitative improvement of nursing education, which requires the development of nursing education for clinical practice. To identify strategies for strengthening the educational capacity of clinical fields and nursing schools, this study first examined the current status of nursing education for clinical practice, and then proposed several prospective directions for education. Nursing clinical practice-related studies from several Korean and international electronic databases were reviewed. Insufficient training hospitals and lack of qualified clinical training instructors were the main problems found within nursing educational resources for clinical practice, while the simple practice contents based on observation and inadequate evaluations were the main problems found in nursing educational management for clinical practice. This study suggests better standards and educational accountability for training hospitals and programs to nurture human resources for clinical practice, as well as a variety of training methods to integrate practical training courses and the expansion of formation evaluation. Based on these results, it is necessary to establish governance for nursing education for clinical practice and clarify the role and standards of each practitioner, strengthen the educational role of the hospital, and improve the system. In addition, introducing various types of education methods and strengthening evaluation standards are needed in order to enhance nursing education for clinical practice.
Education ; Education, Nursing ; Humans ; Nursing ; Preceptorship ; Prospective Studies ; Schools, Nursing ; Social Responsibility