Purpose: This study investigated the effects of a nursing leadership program on self-leadership, interpersonal relationships, clinical performance, problem-solving abilities, and nursing professionalism among nursing students in South Korea. Methods: A quasi-experimental study was conducted. The Practice-Driven Nursing Leadership Program for Students (PDNLP-S) was developed based on the ADDIE model (analysis, design, development, implementation, and evaluation). This quasi-experimental study design included 60 nursing students. The experimental group (n=30) participated in the PDNLP-S for 120-minute sessions over 5 weeks, while the control group (n=30) received usual lectures. The PDNLP-S included lectures, discussions, and individual and group activities to cultivate core nursing leadership competencies such as individual growth, collaboration, nursing excellence, creative problem-solving, and influence. Data were analyzed using descriptive statistics, the Mann-Whitney U-test, and the independent t-test with IBM SPSS Windows ver. 26.0. Results: The experimental group demonstrated significant improvements in self-leadership (t=3.28, p=.001), interpersonal relationships (t=3.07, p=.002), clinical performance (U=268.50, p=.004), and problem-solving abilities (t=2.20, p=.017) compared to the control group. No significant difference was observed in nursing professionalism (t=0.50, p=.311). Conclusion This study demonstrates that the PDNLP-S improved nursing students’ self-leadership, interpersonal relationships, clinical performance, and problem-solving abilities. The PDNLP-S can play a significant role in cultivating future nurse leaders by enhancing these nursing leadership competencies among nursing students.

Purpose: This study aimed to understand the experiences of dialysis and their meaning among patients with chronic kidney disease through a meta-synthesis of the existing literature. Since 2010, the prevalence of end-stage renal disease has doubled in South Korea, which has the sixth-highest incidence worldwide. Although most kidney disease patients undergo dialysis to attenuate disease-related symptoms and prolong their lives, the implications of dialysis on their lives, together with the role played by patients’ significant others, remain underexplored. Similarly, existing research has not considered both patients with hemodialysis and peritoneal dialysis. Methods: In this meta-synthesis, seven electronic databases (PubMed, CINAHL, EMBASE, PsycINFO, DBpia, KISS, and RISS) were searched for the terms “dialysis” and “qualitative.” Thirty qualitative studies were selected for examination. Results: The overriding theme observed in the studies was “I do not have much time left.”–navigating the dual realities of one’s limited existence, while other key themes were: (1) the inevitable experience of the troubles of dialysis, (2) life is extended, but deteriorating in every aspect, (3) accepting dialysis with a positive outlook for life, and (4) essential support experienced in an exhausting life. Conclusion These findings are important for the design and delivery of practical and tailored nursing interventions to help patients overcome the various challenges related to dialysis treatment, and improve their quality of life.

This study aimed to evaluate the effect of the TouchCare system, a digital health management system utilizing the internet of things (IoT), based on the usage levels of older adults. Methods: This is a secondary analysis of data from a quasi-experimental study examining the effects of an IoT-based digital healthcare system. Participants were equipped with the TouchCare application, a touch-tag, and context-aware artificial intelligence. Data on cognitive function, frailty, depressive symptoms, nutritional status, and fall efficacy were collected at baseline and after six months of using the system. The participants were divided into a high-engagement group (n = 22) and a low-engagement group (n = 24) based on how many days they used the application during the study. We used descriptive statistics, the paired t-test, the independent-samples t-test, and two-way mixed analysis of variance. Results: In total, 46 participants completed the evaluations (mean age, 76.6 years). Two-way mixed analysis of variance revealed no significant group-by-time interaction for cognitive function (p = .184), frailty (p = .338), depressive symptoms (p = .543), and nutritional status (p = .589). There was no significant difference in fall efficacy between the two groups (p = .091). The high-engagement group exhibited significant improvements in visuospatial and executive functions on the Montreal Cognitive Assessment (p = .029). Conclusion: The IoT-based mobile health management application demonstrated benefits in improving cognitive health among older adults. The findings suggest that active engagement with healthcare technology can positively affect health in this population, emphasizing the need for continuous support from nurses as health providers.

Purpose: This study aimed to perform a genome characterization of Streptococcus mitis KHUD 011, a strain isolated from the oral microbiome of a healthy Korean individual, and to compare its genomic features with other S. mitis strains. Materials and Methods: The strain was identified through 16S rRNA gene sequencing, and its genome was sequenced using the PacBio Sequel II platform. De novo assembly and annotation were performed, followed by comparative genomic analysis with three additional strains (S. mitis NCTC 12261, S022-V3-A4, and B6). Pan-genome and phylogenetic analyses were conducted to identify strain-specific genes and assess inter-strain genomic diversity. Results: The genome of S. mitis KHUD 011 consisted of 1,782 protein-coding genes, with a G+C content of 40.24%. Pan-genome analysis identified 1,263 core gene clusters (50.0%), 496 dispensable clusters (19.7%), and 763 strain-specific clusters (30.3%). KHUD 011 displayed 88 strain-specific genes, particularly associated with cell wall/membrane biogenesis, transcriptional regulation, and carbohydrate metabolism. Phylogenetic analysis placed KHUD 011 closely with NCTC 12261, forming a distinct cluster apart from other strains. Conclusion The genome characterization of S. mitis KHUD 011 underscores substantial inter-strain genomic diversity influenced by host interactions, ecological niches, and health status. The identified strain-specific genes, particularly those associated with cell wall/ membrane biogenesis, transcriptional regulation, and carbohydrate metabolism, suggest adaptations to the oral microbiome and its interaction with the host. These findings highlight the ecological versatility of S. mitis and the importance of exploring strains from diverse environments to better understand their role within the host and the broader microbiome.

Background: Fluorescein angiography (FA) is a diagnostic procedure that is crucial for conditions such as age-related macular degeneration and diabetic retinopathy, and due to its importance, the use of conventional and wide-angle FA (wide FA) is on the rise. This study aimed to analyze the annual trends of conventional and wide FA and the trends of healthcare institutions performing these examinations in Korea. Methods: This retrospective study examined data from the Health Insurance Review and Assessment Service’s Health and Medical Big Data Open Portal. We investigated the number of patients who underwent conventional and wide FA procedures performed in Korea from 2014 to 2023, categorized by age group and type of healthcare facility. Additionally, trends in healthcare expenditures were analyzed. Results: The number of patients undergoing conventional FA consistently declined, while those receiving wide FA increased steadily, keeping the overall patient count relatively stable.Healthcare costs related to conventional FA gradually decreased, whereas expenses for wide FA rose steadily, contributing to an increase in total medical expenses. Analysis of ten-year age intervals revealed that patients in their 60s were the most frequent recipients of wide FA in every year, except for 2014. The prevalence of wide FA at primary healthcare facilities has been steadily increasing. Conclusion The use of wide FA has been steadily increasing, gradually replacing conventional FA, particularly in primary healthcare settings. Overall, medical expenses continue to rise. The findings of this study provide valuable evidence for the efficient allocation of medical resources in the future.

Background: Tinnitus is a multifactorial condition with no universally accepted assessment guidelines. The Korean Tinnitus Study Group previously established consensus statements on the definition, classification, and diagnostic tests for tinnitus. As a continuation of this effort, this study aims to establish expert consensus on tinnitus assessment and treatment outcome evaluation, specifically tailored to the Korean clinical context. Methods: A modified Delphi method involving 26 otology experts from across Korea was used. A two-round Delphi survey was conducted to evaluate statements related to tinnitus assessment before and after treatment. Statements were rated on a scale of 1 to 9 for the level of agreement. Consensus was defined as ≥ 70% agreement (score of 7–9) and ≤ 15% disagreement (score of 1–3). Statistical measures such as content validity ratio and Kendall’s coefficient of concordance (W) were calculated to assess agreement levels. Results: Of the 46 assessment-related statements, 17 (37%) reached consensus, though overall pre-treatment assessments showed weak agreement (Kendall’s W = 0.319). Key areas of agreement included the use of the visual analogue scale, numeric rating scale, and validated questionnaires for pre-treatment evaluation. Five statements, such as the use of computed tomography, magnetic resonance imaging, and angiography for diagnosing pulsatile tinnitus, achieved over 90% agreement. For treatment outcome measurements, 8 of 12 statements (67%) reached a consensus, with moderate agreement (Kendall’s W = 0.513). Validated questionnaires and psychoacoustic tests were recommended for evaluating treatment effects within 12 weeks. While standardized imaging for pulsatile tinnitus and additional clinical tests were strongly recommended, full consensus was not achieved across all imaging modalities. Conclusion This study provides actionable recommendations for tinnitus assessment and treatment evaluation, emphasizing the use of standardized tools and individualized approaches based on patient needs. These findings offer a practical framework to enhance consistency and effectiveness in tinnitus management within Korean clinical settings.

Background: Shortage of organ donors in the Republic of Korea has become a major problem. To address this, it has been questioned whether heart transplant (HTx) allocation should be modified to reduce priority of older patients. We aimed to evaluate post-HTx outcomes according to recipient age and specific pre-HTx conditions using a nationwide prospective cohort. Methods: We analyzed clinical characteristics of 628 patients from the Korean Organ Transplant Registry who received HTx from January 2015 to December 2020. Enrolled recipients were divided into three groups according to age. We also included comorbidities including ambulatory status. Non-ambulatory status was defined as pre-HTx support with either extracorporeal membrane oxygenation, continuous renal replacement therapy, or mechanical ventilation. Results: Of the 628 patients, 195 were < 50 years, 322 were 50–64 years and 111 were ≥ 65years at transplant. Four hundred nine (65.1%) were ambulatory and 219 (34.9%) were nonambulatory. Older recipients tended to have more comorbidities, ischemic cardiomyopathy, and received older donors. Post-HTx survival was significantly lower in older recipients (P = 0.025) and recipients with non-ambulatory status (P < 0.001). However, in contrast to non-ambulatory recipients who showed significant survival differences according to the recipient’s age (P = 0.004), ambulatory recipients showed comparable outcomes (P = 0.465). Conclusion Our results do not support use of age alone as an allocation criterion. Transplant candidate age in combination with some comorbidities such as non-ambulatory status may identify patients at a sufficiently elevated risk at which suitability of HTx should be reconsidered.

Korea has undergone rapid transformation, achieving significant advancements in both economic development and social security. Notably, the country achieved universal health coverage within a remarkably short period, representing a significant institutional milestone in healthcare. However, the healthcare system faces substantial challenges due to limited resources, a reliance on private healthcare providers, and a rapidly aging population which threatens its sustainability. Various efforts have been made to strengthen Korea’s primary care environment. This study aims to examine the multifaceted healthcare landscape surrounding primary care in Korea, analyze associated systems to identify institutional limitations, and propose strategies to enhance primary care in the future. Additionally, it seeks to raise awareness of the current state of primary care in Korea and serves as an example for other countries striving to improve their primary care systems. Furthermore, this review provides a comprehensive overview of key data sources relevant to primary care research in Korea, such as the National Health Insurance Service claims data and the Korea Health Panel Survey. It also outlines practical research methodologies—from epidemiological studies to policy analyses—serving as a valuable reference for both domestic and international scholars seeking to enhance primary care systems.

Acne is a chronic inflammatory condition affecting the sebaceous glands, with approximately 80% of individuals experiencing it at some point in their lives. Among adolescents, the incidence is reported to exceed 85%. The disease can significantly impact both physical and emotional aspects of a person’s quality of life, leading to permanent scarring, poor self-image, depression, and anxiety. The standard first-line treatment for acne vulgaris includes conventional pharmacological approaches such as keratolytics, topical or oral antibiotics, retinoids, and hormonal agents. However, these treatments are not universally effective due to patient noncompliance, adverse drug effects, and the emergence of antibiotic resistance in Cutibacterium acnes, often resulting in high rates of recurrence. Consequently, non-pharmacological therapies have been developed as safe and effective alternatives or supplements to pharmacological treatment. These non-pharmacological approaches can serve as standalone treatment modalities, adjuncts to pharmacological therapy, or maintenance treatments. Current literature lacks comprehensive data on the classification of these non-pharmacological treatment options. This paper aims to provide a brief overview of recent research on the practical applications and potential mechanisms of nonpharmacological therapies for both acne and acne scars. Through elucidating the distinct mechanisms and therapeutic roles of these treatments, we aim to assist dermatologists and other healthcare providers in formulating more effective disease management strategies, thereby encouraging further research in this area.

Background: Tinnitus is a bothersome condition associated with various mechanisms of action. Although treatment methods vary according to these mechanisms, standardized guidelines would benefit both patients and clinicians. We conducted a Delphi study, a method that collects expert opinions through multiple rounds of questionnaires, to reach a consensus on tinnitus treatment with professional experts. Methods: A two-round modified Delphi survey was conducted to develop a clinical consensus on tinnitus treatment. The experts scored each statement on a scale of 1 (highest disagreement) to 9 (highest agreement) for their level of agreement on tinnitus treatment.Consensus was defined when 75% or more of the participants scored 7–9, and 15% or less scored 1–3. To ensure reliability of the responses, the content validity ratio and Kendall’s coefficient of concordance were evaluated. Results: Approximately 19 of 31 statements reached a consensus. All 3 statements reached a consensus regarding the candidates for treatment. Regarding treatment, 3 of 8 statements on medication, 2 of 2 statements on tinnitus retraining therapy/cognitive behavioral therapy, and 5 of 7 statements on auditory rehabilitation reached a positive consensus. Although all 6 statements regarding miscellaneous treatment reached a consensus, most were negatively agreed. For treatment with neuromodulation, none of the 5 statements reached a consensus. Conclusion The experts reached a high level of consensus on treatment candidates, tinnitus retraining therapy/cognitive behavioral therapy, and auditory rehabilitation in this modified Delphi study. The results of this study can provide beneficial and practical information for clinicians regarding the treatment of tinnitus.