Transferrin saturation (TSAT) has been used as an indicator of iron deficiency. However, there is no consensus regarding its optimal range for patient with chronic kidney disease (CKD). We aimed to analyze the effect of TSAT on the prognosis of patients with non-dialysis CKD (NDCKD). Methods: From 2011 to 2016, 2157 NDCKD patients with baseline TSAT measurements were followed for 10 years. Patients were divided into three groups based on baseline TSAT values: <25%, ≥25% and <45%, and ≥45%. All-cause mortality and 4-point major adverse cardiovascular events (MACE) were analyzed using multivariable Cox regression analysis. Other iron biomarkers and mortality were also analyzed. Results: During a mean follow-up of 7.1 ± 2.9 years, 182 of a total of 2,157 patients (8.4%) died. Compared with the TSAT ≥25% and <45% group, the TSAT <25% group showed significantly increased all-cause mortality (hazard ratio [HR], 1.44; 95% confidence interval (CI), 1.02–2.03; p = 0.04). The occurrence of 4-point MACE was significantly increased in univariable analysis in the TSAT <25% group (HR, 1.48; 95% CI, 1.02–2.15; p = 0.04), but it was not significant in the multivariable analysis (HR, 1.38; 95% CI, 0.89–2.15; p = 0.15). Tertile comparisons of the iron-to-log-ferritin ratio showed increased mortality in the first tertile group. Conclusion: TSAT <25% is an independent risk factor for all-cause mortality in patients with NDCKD and care should be taken to prevent TSAT values of <25%. Other indicators, such as serum iron and iron-to-log-ferritin ratio, may also be used to assess iron deficiency.

Transferrin saturation (TSAT) has been used as an indicator of iron deficiency. However, there is no consensus regarding its optimal range for patient with chronic kidney disease (CKD). We aimed to analyze the effect of TSAT on the prognosis of patients with non-dialysis CKD (NDCKD). Methods: From 2011 to 2016, 2157 NDCKD patients with baseline TSAT measurements were followed for 10 years. Patients were divided into three groups based on baseline TSAT values: <25%, ≥25% and <45%, and ≥45%. All-cause mortality and 4-point major adverse cardiovascular events (MACE) were analyzed using multivariable Cox regression analysis. Other iron biomarkers and mortality were also analyzed. Results: During a mean follow-up of 7.1 ± 2.9 years, 182 of a total of 2,157 patients (8.4%) died. Compared with the TSAT ≥25% and <45% group, the TSAT <25% group showed significantly increased all-cause mortality (hazard ratio [HR], 1.44; 95% confidence interval (CI), 1.02–2.03; p = 0.04). The occurrence of 4-point MACE was significantly increased in univariable analysis in the TSAT <25% group (HR, 1.48; 95% CI, 1.02–2.15; p = 0.04), but it was not significant in the multivariable analysis (HR, 1.38; 95% CI, 0.89–2.15; p = 0.15). Tertile comparisons of the iron-to-log-ferritin ratio showed increased mortality in the first tertile group. Conclusion: TSAT <25% is an independent risk factor for all-cause mortality in patients with NDCKD and care should be taken to prevent TSAT values of <25%. Other indicators, such as serum iron and iron-to-log-ferritin ratio, may also be used to assess iron deficiency.

Transferrin saturation (TSAT) has been used as an indicator of iron deficiency. However, there is no consensus regarding its optimal range for patient with chronic kidney disease (CKD). We aimed to analyze the effect of TSAT on the prognosis of patients with non-dialysis CKD (NDCKD). Methods: From 2011 to 2016, 2157 NDCKD patients with baseline TSAT measurements were followed for 10 years. Patients were divided into three groups based on baseline TSAT values: <25%, ≥25% and <45%, and ≥45%. All-cause mortality and 4-point major adverse cardiovascular events (MACE) were analyzed using multivariable Cox regression analysis. Other iron biomarkers and mortality were also analyzed. Results: During a mean follow-up of 7.1 ± 2.9 years, 182 of a total of 2,157 patients (8.4%) died. Compared with the TSAT ≥25% and <45% group, the TSAT <25% group showed significantly increased all-cause mortality (hazard ratio [HR], 1.44; 95% confidence interval (CI), 1.02–2.03; p = 0.04). The occurrence of 4-point MACE was significantly increased in univariable analysis in the TSAT <25% group (HR, 1.48; 95% CI, 1.02–2.15; p = 0.04), but it was not significant in the multivariable analysis (HR, 1.38; 95% CI, 0.89–2.15; p = 0.15). Tertile comparisons of the iron-to-log-ferritin ratio showed increased mortality in the first tertile group. Conclusion: TSAT <25% is an independent risk factor for all-cause mortality in patients with NDCKD and care should be taken to prevent TSAT values of <25%. Other indicators, such as serum iron and iron-to-log-ferritin ratio, may also be used to assess iron deficiency.

Transferrin saturation (TSAT) has been used as an indicator of iron deficiency. However, there is no consensus regarding its optimal range for patient with chronic kidney disease (CKD). We aimed to analyze the effect of TSAT on the prognosis of patients with non-dialysis CKD (NDCKD). Methods: From 2011 to 2016, 2157 NDCKD patients with baseline TSAT measurements were followed for 10 years. Patients were divided into three groups based on baseline TSAT values: <25%, ≥25% and <45%, and ≥45%. All-cause mortality and 4-point major adverse cardiovascular events (MACE) were analyzed using multivariable Cox regression analysis. Other iron biomarkers and mortality were also analyzed. Results: During a mean follow-up of 7.1 ± 2.9 years, 182 of a total of 2,157 patients (8.4%) died. Compared with the TSAT ≥25% and <45% group, the TSAT <25% group showed significantly increased all-cause mortality (hazard ratio [HR], 1.44; 95% confidence interval (CI), 1.02–2.03; p = 0.04). The occurrence of 4-point MACE was significantly increased in univariable analysis in the TSAT <25% group (HR, 1.48; 95% CI, 1.02–2.15; p = 0.04), but it was not significant in the multivariable analysis (HR, 1.38; 95% CI, 0.89–2.15; p = 0.15). Tertile comparisons of the iron-to-log-ferritin ratio showed increased mortality in the first tertile group. Conclusion: TSAT <25% is an independent risk factor for all-cause mortality in patients with NDCKD and care should be taken to prevent TSAT values of <25%. Other indicators, such as serum iron and iron-to-log-ferritin ratio, may also be used to assess iron deficiency.

This study investigated the cumulative effects of depressive symptoms on cognitive function over time in community-dwelling older adults. Methods: Data were investigated from 2,533 community-dwelling older adults who participated in the Korean Longitudinal Study of Aging (KLoSA) from the 5th (2014) to the 8th wave (2020). The association between cumulative depressive symptoms and cognitive function was identified through multiple regression analysis. Results: When the multiple regression analysis was conducted from each wave, the current depressive symptoms scores and cognitive function scores were negatively associated, regardless of the waves (B5th = - 0.26, B6th = - 0.26, B7th = - 0.26, and B8th = - 0.27; all p < .001). Further, when all the previous depressive symptoms scores were added as explanatory variables in the 8th wave, the current one (B8th = - 0.09, p < .001) and the previous ones (B5th = - 0.11, B6th = - 0.09, and B7th = - 0.13; all p < .001) were also negatively associated with the cognitive function score. The delta R2 , which indicates the difference between the model’s R2 with and without the depressive symptoms scores, was greater in the model with all the previous and current depressive symptoms scores (6.4%) than in the model with only the current depressive symptoms score (3.6%). Conclusion: Depressive symptoms in older adults have a long-term impact. This results in an accumulated adverse effect on the cognitive function. Therefore, to prevent cognitive decline in older adults, we suggest detecting their depressive symptoms early and providing continuous intervention to reduce exposure to long-term depressive symptoms.

The role that children play in the transmission of the omicron variant is unclear. Here we report an outbreak that started in young children attending various pediatric facilities, leading to extensive household transmission that affected 75 families with 88 confirmed case-patients in 3 weeks. Tailored social and public health measures directed towards children and pediatric facilities are warranted with the emergence of highly transmissible omicron variant to mitigate the impact of coronavirus diseases 2019 (COVID-19).

There are few studies on the severity and prognosis of patients infected with the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) omicron variant. From January 11, 2022 to January 25, 2022, 181 patients were infected with the SARS-CoV-2 omicron variant in a single hospital in Korea. The initial clinical characteristics were investigated through the COVID-19 basic investigation form. Outcomes were reviewed using medical records. The median age of the patients was 57 years (range 1–90), and 95 patients (52.5%) were male. None were re-infected with SARS-CoV-2, and 127 (70.2%) were fully vaccinated (boosted or within 6 months after second vaccination). Forty-two patients (23.2%) were asymptomatic. Among symptomatic patients, the frequency of symptoms was as follows: cough (37.0%), sore throat (33.7%), and fever (30.4%). In terms of disease severity, 168 (92.8%) patients did not require supplemental oxygen, 6 (3.3%) required low-flow oxygen, 5 (2.8%) required high-flow oxygen, and 2 (1.1%) died. Four of the five individuals who required high-flow oxygen and the two who died were not vaccinated. Most of the patients who contracted the SARS-CoV-2 omicron variant exhibited mild clinical features; however, severe clinical features including mortality were encountered among individuals who were not vaccinated.

Purpose: The purpose of this qualitative study is to explore the changed parenting experiences of mothers of elementary school kids living in the aftermath of the COVID-19 outbreak in Korea. Methods: From July to August in 2020, 10 mothers parenting elementary school students under the COVID-19 were interviewed in depth. For data analysis, a phenomenological research methodology suggested by Colaizzi was used. Results: According to the analysis, the experiences of mothers consisted of four categories: the ‘pain from the uncontrollable COVID-19’, ‘the problem of family relations due to the COVID-19 pandemic situation’, ‘standing firm against the drastic changes’, and ‘accepting the world changed by the COVID-19’. Conclusion The findings in this study vividly represent the parenting experiences of mothers of elementary school students after the outbreak of COVID-19. As the pandemic persists, mothers parenting elementary school students feel complex emotions and experience exhaustion, but in the process, they found family members growing positively and trying to adjust to each other to overcome the crisis. To support positive adaptation to catastrophic situations, an institutional and political foundation is needed to develop a systematic crisis management program customized for mothers and families of elementary school students. The results of this study can be used as basic data when establishing national policies and support systems so that mothers parenting elementary school students can better adapt to and overcome crisis situations.

Energy requirement is defined as energy expenditure in an energy equilibrium state.The doubly labeled water (DLW) method is considered the gold standard for measuring total energy expenditure (TEE). In 2002, the Institute of Medicine (IOM) of the National Academies established dietary reference intakes (DRIs) for Americans and Canadians, and the equations for estimated energy requirement (EER) were developed by using pooled data from studies that had applied the DLW method. Since 2005, these equations have been used for establishing EER in the DRI for Koreans. These equations based on age group include the physical activity (PA) coefficient determined by the PA level (PAL; sedentary, low active, active and very active) as well as body weight and height. The PAL values of Koreans calculated using the DLW method and PA diaries were determined to fall in the low active category (1.40~1.59). Therefore, the PA coefficient corresponding to ‘low active’ was applied to the EER equations. In recent years, with increasing number of people regularly engaging in various physical activities in Korea, EER is now separately presented for people with ‘active’ and ‘very active’ PALs. In the future, like the United States and Japan, Korea needs to expand the DLW research for developing EER predictive equations for Koreans. In addition, standardized guidelines should be prepared to accurately evaluate the PAL using the physical activity diary and the new PA classification table for Koreans.

PURPOSE: The purpose of this study was to develop and establish the psychometric properties of a clinical nursing competency evaluation tool to be utilized by clinical preceptors. METHODS: The initial items were identified through in-depth literature review and field interviews based on a hybrid model. Content validation of the items was evaluated through three rounds of content validity testing. Participants were 34 clinical preceptors and 443 nursing students participating in clinical practice. Data were analyzed using exploratory and confirmatory factor analysis, convergence and discriminant validity, internal consistency and inter-rater reliability. RESULTS: The final scale consisted of 23 items and four factors, fundamental nursing skills performance, critical thinking skills based on the nursing process, basic nursing knowledge, and professional attitude; these factor explained 69.7% of the total variance. The analysis with multi-trait/multi-item matrix correlation coefficients yielded 100.0% and 95.7 % convergence and discriminant validity, respectively. Cronbach's alpha for the total items was .95. The four subscale model tested by confirmatory factor analysis was satisfactory. Inter-rater reliability ranged from .912 to .967. CONCLUSION: This scale was found to be a reliable and valid instrument that clinical preceptors can apply for evaluating the clinical nursing competency of nursing students in clinical settings.
Clinical Competence ; Humans ; Nursing Process ; Nursing* ; Psychometrics* ; Reproducibility of Results ; Students, Nursing ; Thinking