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

PURPOSE: This study was done to explore the relationship between expectations of the clinical ladder system (CLS), career commitment and turnover intention in nurses employed in small-medium sized hospitals. METHODS: Participants were 154 nurses from 3 small-medium sized hospitals in Gyeonggi Province and Gwangju City. From February, 8 to April, 14, 2017, self-report questionnaires were collected and analyzed using frequency, t-test, ANOVA, Scheffé test, and Person correlation coefficients. RESULTS: Of the participant nurses, 61% perceived the CLS as needed. The mean score for expectation of CLS, career commitment, and turnover intention on 5-point scale were 3.38, 3.17, 3.21, respectively. There were no significant differences in expectation of CLS according to general characteristics, but career commitment and turnover intention did show significant differences depending on age, position, type of work shift. Expectation of CLS correlated positively with career commitment (r=.23, p=.005), and career commitment correlated negatively with turnover intention (r=−.49, p < .001). CONCLUSION: The results of this study show that there is a need to adopt the clinical ladder system to improve career commitment.
Career Mobility ; Gwangju ; Gyeonggi-do ; Humans ; Intention

Purpose: Alzheimer disease (AD) is one of the most complex diseases and is characterized by AD-related neuropathological features, including accumulation of amyloid-β plaques and tau neurofibrillary tangles. Dysregulation of alternative splicing (AS) contributes to these features, and there is heterogeneity in features across brain regions between AD patients, leading to different severity and progression rates; however, brain region-specific AS mechanisms still remain unclear. Therefore, we aimed to systemically investigate AS in multiple brain regions of AD patients and how they affect clinical features. Methods: We analyzed RNA sequencing (RNA-Seq) data obtained from brain regions (frontal and temporal) of AD patients. Reads were mapped to the hg19 reference genome using the STAR aligner, and exon skipping (ES) rates were estimated as percent spliced in (PSI) by rMATs. We focused on AD-risk genes discovered by genome-wide association studies, and accordingly evaluated associations between PSI of skipped exons in AD-risk genes and Braak stage and plaque density mean (PM) for each brain region. We also integrated whole-genome sequencing data of the ascertained samples with RNA-Seq data to identify genetic regulators of feature-associated ES. Results: We identified 26 and 41 ES associated with Braak stage in frontal and temporal regions, respectively, and 10 and 50 ES associated with PM. Among those, 10 were frontal-specific (CLU and NTRK2), 65 temporal-specific (HIF1A and TRPC4AP), and 26 shared ES (APP) that accompanied functional Gene Ontology terms, including axonogenesis in shared-ES genes. We further identified genetic regulators that account for 44 ES (44% of the total). Finally, we present as a case study the systematic regulation of an ES in APP, which is important in AD pathogenesis. Conclusions This study provides new insights into brain region-dependent AS regulation of the architecture of AD-risk genes that contributes to AD pathologies, ultimately allowing identification of a treatment target and region-specific biomarkers for AD.

OBJECTIVE : To evaluate the vitamin D nutritional status and its influencing factors in Korean mothers and their newborn infants. METHODS : Maternal (n=181) and cord blood (n=180) serum concentrations of vitamin D (25OHD3), calcium, inorganic phosphorus, alkaline phosphatase, intact parathyroid hormone were measured at the time of delivery. We defined vitamin D deficient, insufficient, and sufficient as 25OHD3 <11, 11~30, and >30 ng/mL, respectively. Using questionnaires, average duration of sun-light exposure (minutes/day) and dietary intake of vitamin D (microngram/day) were obtained. RESULTS : 1) The mean 25OHD3 level in mothers was 23.4+/-9.9 (range 4~71.6) ng/mL, and in newborns, 16.9+/-7.5 (range 0.9~53.6) ng/mL. 2) 8.3% of mothers and 22.2 % of newborns were vitamin D deficient, and 70% of both mothers and newborns were insufficient. 3) Maternal 25OHD3 showed a strong positive correlation with cord blood 25OHD3 (r=0.727, p<0.001). 4) The most significant risk factor for low 25OHD3 levels was the season of birth (June through November) in both mothers and newborns. 5) In multiple logistic regression analysis, the season of birth and the mode of delivery remained significant for maternal vitamin D status, whereas maternal 25OHD3 and the mode of delivery remained significant for neonatal vitamin D status. CONCLUSION : In conclusion, vitamin D deficiency or insufficiency was relatively common in Korean mothers and their newborn infants, and the most significant risk factor for low vitamin D status was the season of birth.
Alkaline Phosphatase ; Calcium ; Fetal Blood ; Humans ; Infant, Newborn* ; Logistic Models ; Mothers* ; Nutritional Status* ; Parathyroid Hormone ; Parturition ; Phosphorus ; Surveys and Questionnaires ; Risk Factors ; Seasons ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

The aim of this study was to analyze the natural history of atopic dermatitis (AD) and the risk factors associated with the remission of AD in Korean children. We enrolled 597 children with AD that occurred in the first year of life. A variety of factors influencing the prognosis were assessed by medical records and telephone interviews. Their outcome was classified into complete remission, intermittent, and persistent AD. AD had completely disappeared in 422 cases (70.6%), while 149 (25%) and 26 cases (4.4%) showed intermittent and persistent skin symptoms, respectively. The average healing time was 29.6 months in complete remission group and expected healing time of the AD was 60 months. None of risk factors were significant by multivariate analysis. But, in moderate-to-severe AD group, maternal diet restriction during lactation (P = 0.046) and no sensitization to cow's milk (P = 0.017) were significantly associated with remission of AD in the multivariate analysis. In conclusion, AD occurring in the first year of life disappears in a significant proportion of patients. In addition, in Korean children with moderate-to-severe AD, maternal diet restriction of allergenic food during lactation and sensitization to cow's milk seem to predict the prognosis of AD.
Adult ; Child, Preschool ; Dermatitis, Atopic/*diagnosis/etiology ; Female ; Food Hypersensitivity/complications ; Humans ; Infant ; Interviews as Topic ; Lactation ; Male ; Milk Hypersensitivity/complications ; Predictive Value of Tests ; Prognosis ; Remission Induction ; Republic of Korea ; Retrospective Studies ; Risk Factors

BACKGROUND AND OBJECTIVES: Embryonic stem (ES) cells have pluripotent ability to differentiate into multiple tissue lineages. SIRT1 is a class III histone deacetylase which modulates chromatin remodeling, gene silencing, cell survival, metabolism, and development. In this study, we examined the effects of SIRT1 inhibitors on the hematopoietic differentiation of mouse ES cells. METHODS AND RESULTS: Treatment with the SIRT1 inhibitors, nicotinamide and splitomicin, during the hematopoietic differentiation of ES cells enhanced the production of hematopoietic progenitors and slightly up-regulated erythroid and myeloid specific gene expression. Furthermore, treatment with splitomicin increased the percentage of erythroid and myeloid lineage cells. CONCLUSIONS: Application of the SIRT1 inhibitor splitomicin during ES cell differentiation to hematopoietic cells enhanced the yield of specific hematopoietic lineage cells from ES cells. This result suggests that SIRT1 is involved in the regulation of hematopoietic differentiation of specific lineages and that the modulation of the SIRT1 activity can be a strategy to enhance the efficiency of hematopoietic differentiation.
Animals ; Cell Differentiation ; Cell Survival ; Chromatin Assembly and Disassembly ; Gene Expression ; Gene Silencing ; Histone Deacetylases ; Metabolism ; Mice ; Mouse Embryonic Stem Cells ; Niacinamide

Background and Objectives: Embryonic stem (ES) cells have the capacity to self-renew and generate all types of cells.MUC1-C, a cytoplasmic subunit of MUC1, is overexpressed in various carcinomas and mediates signaling pathways to regulate intracellular metabolic processes and gene expression involved in the maintenance of cancer cells. However, the functional role of MUC1-C in ES cells is not well understood. In this study, we investigated the role of MUC1-C on growth, survival,: and differentiation of mouse ES (mES) cells. Methods: and Results: Undifferentiated mES cells expressed the MUC1-C protein and the expression level was decreased during differentiation. Inhibition of MUC1-C, by the specific inhibitor GO201, reduced proliferation of mES cells.However, there was no prominent effect on pluripotent markers such as Oct4 expression and STAT3 signaling, and MUC1-C inhibition did not induce differentiation. Inhibition of MUC1-C increased the G1 phase population, decreased the S phase population, and increased cell death. Furthermore, inhibition of MUC1-C induced disruption of the ROS balance in mES cells. Conclusions These results suggest that MUC1-C is involved in the growth and survival of mES cells.

Background and Objectives: Embryonic stem (ES) cells have the capacity to self-renew and generate all types of cells.MUC1-C, a cytoplasmic subunit of MUC1, is overexpressed in various carcinomas and mediates signaling pathways to regulate intracellular metabolic processes and gene expression involved in the maintenance of cancer cells. However, the functional role of MUC1-C in ES cells is not well understood. In this study, we investigated the role of MUC1-C on growth, survival,: and differentiation of mouse ES (mES) cells. Methods: and Results: Undifferentiated mES cells expressed the MUC1-C protein and the expression level was decreased during differentiation. Inhibition of MUC1-C, by the specific inhibitor GO201, reduced proliferation of mES cells.However, there was no prominent effect on pluripotent markers such as Oct4 expression and STAT3 signaling, and MUC1-C inhibition did not induce differentiation. Inhibition of MUC1-C increased the G1 phase population, decreased the S phase population, and increased cell death. Furthermore, inhibition of MUC1-C induced disruption of the ROS balance in mES cells. Conclusions These results suggest that MUC1-C is involved in the growth and survival of mES cells.

We investigated the vitamin D status and the effect of vitamin D supplementation in Korean breast-fed infants. The healthy term newborns were divided into 3 groups; A, formula-fed; B, breast-fed only; S, breast-fed with vitamin D supplementation. We measured serum concentrations of vitamin D (25OHD3), calcium (Ca), phosphorus (P), alkaline phosphatase (AP), intact parathyroid hormone (iPTH) and bone mineral density (BMD) at 6 and 12 months of age. Using questionnaires, average duration of sun-light exposure and dietary intake of vitamin D, Ca and P were obtained. At 6 and 12 months of age, 25OHD3 was significantly higher in group S than in group B (P<0.001). iPTH was significantly lower in group S than in group B at 6 months (P=0.001), but did not differ at 12 months. Regardless of vitamin D supplementation, BMD was lower in group B and S than in group A (P<0.05). Total intake of vitamin D differed among 3 groups (P<0.001, A>S>B), but total intake of Ca and P were higher in group A than in group B and S (P<0.001). In conclusion, breast-fed infants show lower vitamin D status and bone mineralization than formula-fed infants. Vitamin D supplementation (200 IU/day) in breast-fed infants increases serum 25-OH vitamin D3, but not bone mineral density.
Alkaline Phosphatase/blood ; Bone Density ; *Breast Feeding ; Calcifediol/*blood ; Calcium/blood ; Cholecalciferol/blood ; *Dietary Supplements ; Female ; Humans ; Infant, Newborn ; Male ; Parathyroid Hormone/blood ; Phosphorus/blood ; Questionnaires ; Republic of Korea ; Vitamin D/*administration & dosage

PURPOSE: The prevalence of atopic dermatitis (AD) has been increased in Korea. We aim to investigate the risk factors for development of AD in infants, especially those factors related to the family history. METHODS: The data from 542 infants in our prospective birth cohort study were analyzed. The data from their parent were collected by questionnaires and skin prick tests. They were regularly followed up at 1 year of age when the presence of AD and allergen sensitization was determined. Various factors such as sex, cesarean section delivery, duration of breast feeding, presence of siblings, vaccination, antibiotic use and pet keeping were also assessed. RESULTS: AD developed in 109 infants (20.4%). In univariate analysis, the presence of either maternal or paternal allergic diseases increased the risk for development of AD in their infants. Multivariate logistic analysis, however, showed that only the presence of maternal allergic diseases correlated with the development of AD (P=0.018). While AD developed in 14.7% in infants of parents with no allergic history, the incidences of AD in infants with a single parent allergy history and in those with 2 parent allergy history were 27.0% and 41.7%, respectively. Their adjusted relative risks (95% confidence intervals) were 1.85 (1.24-2.89) and 2.93 (1.68-4.96), respectively. CONCLUSION: Parental allergic diseases, especially maternal allergic diseases, are possible risk factors for development of AD in Korean infants.
Breast Feeding ; Cesarean Section ; Cohort Studies ; Dermatitis, Atopic ; Female ; Humans ; Hypersensitivity ; Incidence ; Infant ; Korea ; Parents ; Parturition ; Pregnancy ; Prevalence ; Prospective Studies ; Surveys and Questionnaires ; Risk Factors ; Siblings ; Single Parent ; Skin ; Vaccination