Purpose: To evaluate the clinical outcomes of myopic choroidal neovascularization (CNV) and atrophic and tractional changes according to the ATN (A: atrophy, T: traction, N: neovascularization) classification system. Methods: This was a retrospective review of the medical records of myopic CNV patients treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections and followed up for at least 3 years. Atrophic and tractional components were graded according to the ATN system at baseline and the last visit. Results: The study included 21 eyes in 21 patients. The mean age was 52.29 ± 14.6 years, the mean follow-up duration was 57.65 ± 18.8 months, and the mean number of injections was 2.9 ± 1.9. Recurrence occurred in seven eyes (33.3%). Five patients (23.8%) developed myopic CNV in the contralateral eye. The mean initial and final logarithm of the minimum angle of resolution (logMAR) visual acuities were 0.44 ± 0.30 and 0.33 ± 0.39, respectively. Visual acuity was maintained or improved compared to baseline in 15 eyes (71.4%). Baseline visual acuity was significantly associated with the final visual acuity (p = 0.026). Based on the ATN classification system, the atrophic component progressed in four eyes (19.0%), while the tractional component improved in one eye (4.8%) and progressed in five eyes (23.8%). Conclusions Intravitreal anti-VEGF injection therapy effectively preserved long-term vision in myopic CNV patients. Evaluation of the atrophic and tractional components should not be neglected during the follow-up.

Purpose: This study aims to identify the knowledge, risk perception, fear, self-efficacy, and preventive behaviors among nursing students, and factors influencing preventive behaviors on COVID-19. Methods: Data was collected from March, 2022 to May, 2022. The participants included 218 nursing students in their 3rd and 4th grade of three universities in two cities. Results: The knowledge of COVID-19 was 13.54 out of 15 points, risk perception was 4.83 out of 8 points, fear was 13.26 out of 35 points, self-efficacy was 19.96 out of 25 points, and preventive behaviors were 7.56 out of 9 points. The explanatory power of self efficacy (β = .21, p = .002), which affects preventive behaviors was 67.0%. Conclusion Based on the results of this study, it is necessary to develop a systematic nursing intervention that improves self-efficacy to improve preventive behaviors against COVID-19 among students. This study’s result can be used in the future to develop appropriate health policies and program to prevent emerging infectious diseases.

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: Span of Control defines the scope of the managers' responsibilities to manage nursing staff. This study was done to measure span of control of front-line nurse managers (FLNMs) in Korea hospitals resulting in improvement in their work efficiency. METHODS: A sample of 203 FLNMs from five tertiary hospitals was recruited and completed the questionnaires. Data were analyzed using χ²-test, Fisher's exact test, independent t-test, ANOVA, Scheffé, and Pearson correlation coefficient. RESULTS: FLNMs had ‘narrow’ (n=8, 4.3%), ‘appropriate’ (n=161, 87.0%), and ‘wide’ (n=16, 8.6%) span of control. Span of control had significant correlations with the number of nurses (r=.63, p<.001), the number of non-nurses (r=.53, p<.001), units (r=.52, p<.001), staff (r=.83, p<.001), and programs (r=.67, p<.001). CONCLUSION: The research findings indicate that attention should be given to unit complexity, program diversity, total staff, and skills. Moreover, administrators of hospital and nursing departments need to provide systematic support in accordance with FLNMs’ wide span of control.
Administrative Personnel ; Humans ; Korea ; Nurse Administrators* ; Nursing ; Nursing Staff ; Personnel Management ; Tertiary Care Centers

BACKGROUND AND PURPOSE: This study was performed to newly develop the Way-Finding Ability Scale (WFAS) for middle-aged and older adults and validate its clinical utility. METHODS: The participants for verifying construct validity included 324 adults aged from 45 to 79 years, and 22 normal old adults without way-finding deficit (WFD), 41 amnestic mild cognitive impairment (aMCI), and 35 patients with Parkinson's disease (PD-MCI) for verifying discriminant validity. All participants were administered the newly constructed 28-item WFAS. RESULTS: Exploratory factor analysis of the WFAS revealed a four-factor solution (sense of direction and inattention, spatial learning and memory, strategic ability, and cardinal direction). This four-factor structure was confirmed by confirmatory factor analysis. The discriminant validity was examined by administering the WFAS to normal older adults and two patient groups (aMCI & PD-MCI). The results showed that the total scores of two patient groups were lower than that of normal older adults. The patients with WFD had significantly lower total scores than those without WFD. Interestingly, the total scores of patients without WFD were significantly lower than those of normal older adults suggesting that the cognitive functions associated with way-finding ability (WFA) were partially impaired in aMCI and PD-MCI patients without apparent WFD. The patients with WFD had consistently lower scores in every four-factor than those without WFD. CONCLUSIONS: These results indicated that the WFAS assesses the WFD reliably as well as estimates the degree of decline in WFA.
Adult* ; Cognition ; Humans ; Memory ; Mild Cognitive Impairment ; Parkinson Disease ; Spatial Learning

PURPOSE: The aim of this study was to evaluate the dietary behaviors of preschoolers in Daejeon using the Nutrition Quotient for Preschoolers (NQ-P). METHODS: The study subjects were recruited from child-care centers and kindergartens located in Daedeok-gu, Daejeon between August and September 2018. A total of 411 preschoolers aged 3 ~ 6 years were included in the data analyses. A questionnaire of NQ-P, which consisted of 14 checklist items on dietary behaviors, was completed by the parents or guardians of the study subjects. The NQ-P scores and its three factors, including “balance”, “moderation”, and “environment” factors, were calculated according to sex, age, and weight status. Differences in the NQ-P scores and their factors according to sex, age, and weight status were tested using a student's t-test. RESULTS: The mean NQ-P score of the total subjects was 58.5 ± 9.2, which was within the medium-low grade. The NQ-P score was 58.5 ± 9.4 in boys and 58.6 ± 9.0 in girls (p = 0.955). The NQ-P score was similar regardless of the age groups (57.8 ± 9.4 in 3 ~ 4 years vs. 59.2 ± 9.0 in 5 ~ 6 years, p = 0.124), whereas subjects aged 5 ~ 6 years showed a significantly higher scores of environment factors than those aged 3 ~ 4 years (67.9 ± 16.8 vs. 61.7 ± 17.3). The mean score of the moderation factor was lower in the overweight/obese children compared to the non-overweight/obese children (46.6 ± 13.3 vs. 51.0 ± 16.2, p = 0.012). Compared to children aged 3 ~ 4 years, children aged 5 ~ 6 years had higher intakes of vegetable dishes and processed meat. The overweight/obese group showed a higher consumption of processed beverages than the non-overweight/obese group. CONCLUSION: The current study indicates that the dietary behaviors of preschoolers residing in Daejeon need to be improved. These findings suggest that nutrition education or health interventions targeting young children is necessary for improving their nutritional health status.
Beverages ; Checklist ; Child ; Child, Preschool ; Education ; Feeding Behavior ; Female ; Food Habits ; Humans ; Meat ; Parents ; Statistics as Topic ; Vegetables

Androgenetic alopecia (AGA) is the most common type of hair loss and affects both men and women. Male pattern hair loss shows characteristic frontal recession and vertex baldness, whereas female pattern hair loss produces diffuse alopecia over the mid-frontal scalp. AGA is mediated by increased androgen susceptibility in affected scalp hairs. 5α-Reductase converts testosterone into dihydrotestosterone, a potent androgen, in the scalp. Both androgen receptors and 5α-reductase have higher expression levels in the balding scalp than in non-affected regions. Increased androgen susceptibility induces hair follicle miniaturization, which leads to the progressive loss of thicker terminal hairs in the balding scalp. Currently, topical minoxidil and oral 5α-reductase inhibitors, such as finasteride and dutasteride, are approved options for the pharmacological treatment of AGA. Topical minoxidil remains the mainstay of therapy for mild to moderate AGA in both men and women. The daily intake of 1-mg finasteride or 0.5-mg dutasteride shows better efficacy than topical minoxidil in regard to hair regrowth in male AGA. Anti-androgens can be used in female AGA wit clinical and biochemical evidence of hyperandrogenism. Patients may be overwhelmed and confused by the variety of treatment options for AGA management, including over-the-count drugs with low evidence quality. Therefore, physicians must be aware of the current guidelines for the management of AGA based on evidence-based approaches to select better options for patients.

This study examined the perception and readiness of nursing educators regarding interprofessional education (IPE), and discussed the validity and application of IPE in nursing. From December 2016 to January 2017, 239 nursing professors and nurses completed a structured questionnaire consisting of general characteristics, the Interdisciplinary Education Perception Scale, the Readiness for Interprofessional Learning Survey (RIPLS), and an IPE action plan. The collected data were analyzed by descriptive statistics and t-test using the IBM SPSS ver. 23.0 program (IBM Corp., Armonk, NY, USA). The analysis revealed that 91.6% of the participants had not experienced IPE, and only 11.7% knew about IPE. However, approximately 80.0% answered that IPE is necessary. The results of this study showed that the score of the perceived need for cooperation was higher in nurses than it was in professors, while the score on competency and autonomy was higher in professors than it was in nurses. With reference to the scores on the RIPLS, those of professors were high on the sub-scales of teamwork and collaboration, professional identity, and roles and responsibility. The results revealed that participants considered the upper-grade undergraduate years as the ideal time for imparting IPE, and it was deemed suitable to include communication, simulation, and clinical practice in IPE. Doctors, pharmacists, and physiotherapists were thought to require cooperation for IPE the most. Despite the presence of several barriers to IPE, the participants thought that IPE can achieve learning outcomes such as interprofessional communication and cooperation, conflict resolution, and teamwork. It is necessary to cooperate with professionals in the complex clinical environment as professional areas are specialized and subdivided. Therefore, it is necessary to examine the application of IPE in undergraduate education and in on-the-job training.
Cooperative Behavior ; Education ; Education, Nursing ; Humans ; Inservice Training ; Learning ; Negotiating ; Nursing ; Pharmacists ; Physical Therapists

It is natural for all human beings to die; hence, death is an inevitable event. However, advances in medical technology are changing the meaning of natural death. These advanced treatments provide the capability to intervene at the time of death and to reshape the circumstances around natural death, by sustaining human life. However, it is extremely difficult to judge when treatment is futile for the patient's best interests. It is therefore recommended to make time to discuss the concept of medical futility during the course of caring for a critically ill patient. Despite the expectations and efforts of the patient, the patient's family, and medical staff, the patient will eventually, have a ‘hopeless’ medical condition. Most discussions about decision-making in end-of-life treatment have neen ethical debates focused on the patient's self-determination and best interest in the context of concepts such as euthanasia or death with dignity. However, such discussions are insufficient for resolving the wide variety of circumstances that occur in clinical settings. Instead, the various ethical dilemmas inherent to end-of-life care should be approached by educating medical teams, patients, and their families about how to recognize medical futility. Furthermore, it is important to optimize the balance between the rights of patients and the responsibility of physicians.
Critical Illness ; Euthanasia ; Humans ; Medical Futility ; Medical Staff ; Personal Autonomy ; Right to Die ; Withholding Treatment

Purpose: To report the efficacy of frontalis suspension using a silicone rod or preserved fascia lata for patients with blepharospasm who exhibit persistent symptoms and visual dysfunction unresponsive to botulinum injections. Methods: The clinical records of five patients (10 eyes) with essential blepharospasm who underwent frontalis suspension were reviewed. Patients who continued to report eyelid-opening difficulties despite prior administration of botulinum toxin were included. Results: The mean patient age was 60.2 years; and 40% of the patients were women. The frontalis was suspended using silicone rods (n = 3) or preserved fascia lata (n = 2). Blepharospasm frequency and severity were measured using the Jankovic Rating Scale (JRS). Compared with preoperative scores, the summed JRS scores decreased 1 week, 1 month, and 3 months after surgery. Postoperatively, two patients (40%) did not require further botulinum toxin injections. In three patients, the intervals between injections were increased after surgery. No patient experienced any significant complication. Conclusions Frontalis suspension is safe and effective for patients with blepharospasm and apraxia of eyelid opening, who have not responded to botulinum toxin injections.