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: 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.

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: 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

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: 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

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.

Purpose: This study aimed to examine whether first-time mothers’ grit, spousal support, and age can make significant differences in latent means of child-rearing passion, postpartum depression, and happiness. Methods: Data were collected from April 2 to July 16, 2019. Two hundred sixteen first-time mothers of infants and toddlers aged 0–2 years participated in a self-reported questionnaire study in which scales of nurturing passion, postpartum depression, happiness, grit, and spousal support were included. The collected data were analyzed with IBM SPSS ver. 18.0 (IBM Co., Armonk, NY, USA) for descriptive statistics and Pearson correlation analyses. In addition, Mplus (ver. 7.0) was used for the Multiple Indicators Multiple Causes (MIMIC) model approach. Results: The MIMIC model yielded an appropriate fit to the data (χ2=103.74, degrees of freedom=53, comparative fit index=0.96, root mean square error of approximation=0.07, standardized root mean square residual=0.05). The paths from grit and spousal support all had significantly positive beta coefficients (p<0.05) to child-rearing passion (β=0.3 and β=0.26, respectively) and happiness (β=0.22 and β=0.39, respectively), while the corresponding paths to postpartum depression were all negatively significant (β= -0.24 for both). These results suggest that unlike chronological maturity (i.e., age), grittier individuals with stronger spousal support display greater passion for child-rearing, as well as greater happiness. In a similar vein, they suffered less from postpartum depression. Conclusion These results imply that grit can be employed to enhance first-time mothers’ child-rearing passion and happiness as it can also concurrently offset the effects of a negative labor and child-birth experience on first-time mothers’ mental health, e.g., in terms of reducing postpartum depression.

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.

Purpose: This study was designed to verify whether shear-wave elastography (SWE) can be used to differentiate ulnar neuropathy at the cubital tunnel from asymptomatic ulnar nerve or medial epicondylitis. An additional aim was to determine a cut-off value to identify patients with ulnar neuropathy. Methods: This study included 10 patients with ulnar neuropathy at the cubital tunnel as confirmed with electromyography (three women and seven men; mean age, 51.9 years), 10 patients with medial epicondylitis (nine women and one man; mean age, 56.1 years), and 37 patients with asymptomatic ulnar nerve and lateral epicondylitis (21 women and 16 men; mean age, 54.0 years). Each patient underwent SWE of the ulnar nerve at the cubital tunnel, distal upper arm, and proximal forearm. Results: Patients with ulnar neuropathy at the cubital tunnel exhibited significantly greater mean ulnar nerve stiffness at the cubital tunnel (66.8 kPa) than controls with medial epicondylitis (21.2 kPa, P=0.015) or lateral epicondylitis (33.9 kPa, P=0.040). No significant differences were observed between patients and controls with regard to ulnar nerve stiffness at the distal upper arm or the proximal forearm. A stiffness of 31.0 kPa provided 100% specificity, 80.0% sensitivity, 100% positive predictive value, and 83.3% negative predictive value for the differentiation between ulnar neuropathy and medial epicondylitis. Conclusion Cubital tunnel syndrome is associated with a stiffer ulnar nerve than lateral or medial epicondylitis. SWE seems to be a new, reliable, and simple quantitative diagnostic technique to aid in the precise diagnosis of ulnar neuropathy at the cubital tunnel.