Purpose: This report describes the development of a simulation scenario for medical student that incorporates cultural diversity within the context of family presence during resuscitation (FPDR). Methods: Using a hybrid simulation approach, we designed a scenario focusing on communication with a family that immigrated from Korea to the United States during cardiopulmonary resuscitation (CPR). The scenario objectives were for learners to perform CPR with family presence, communicate with the family, and understand and negotiate cultural needs. Following a pilot scenario with two inexperienced volunteer medical students as learners, the program was evaluated through anonymous surveys and informal focus group feedback. Results: Students noted that this simulation differed from previous experiences as compared with emphasizing family communication rather than patient diagnosis or treatment. Students valued experiencing the practical application of cultural competence concepts. The suggestions for scenario improvement included balancing two student participation roles, adjusting the timeline, and utilizing a standardized family member. Conclusion This pilot study suggests that an FPDR simulation program can be effectively repeated with multiple medical students and applied to CPR simulations involving diverse cultural backgrounds.

Purpose: This report describes the development of a simulation scenario for medical student that incorporates cultural diversity within the context of family presence during resuscitation (FPDR). Methods: Using a hybrid simulation approach, we designed a scenario focusing on communication with a family that immigrated from Korea to the United States during cardiopulmonary resuscitation (CPR). The scenario objectives were for learners to perform CPR with family presence, communicate with the family, and understand and negotiate cultural needs. Following a pilot scenario with two inexperienced volunteer medical students as learners, the program was evaluated through anonymous surveys and informal focus group feedback. Results: Students noted that this simulation differed from previous experiences as compared with emphasizing family communication rather than patient diagnosis or treatment. Students valued experiencing the practical application of cultural competence concepts. The suggestions for scenario improvement included balancing two student participation roles, adjusting the timeline, and utilizing a standardized family member. Conclusion This pilot study suggests that an FPDR simulation program can be effectively repeated with multiple medical students and applied to CPR simulations involving diverse cultural backgrounds.

Purpose: This report describes the development of a simulation scenario for medical student that incorporates cultural diversity within the context of family presence during resuscitation (FPDR). Methods: Using a hybrid simulation approach, we designed a scenario focusing on communication with a family that immigrated from Korea to the United States during cardiopulmonary resuscitation (CPR). The scenario objectives were for learners to perform CPR with family presence, communicate with the family, and understand and negotiate cultural needs. Following a pilot scenario with two inexperienced volunteer medical students as learners, the program was evaluated through anonymous surveys and informal focus group feedback. Results: Students noted that this simulation differed from previous experiences as compared with emphasizing family communication rather than patient diagnosis or treatment. Students valued experiencing the practical application of cultural competence concepts. The suggestions for scenario improvement included balancing two student participation roles, adjusting the timeline, and utilizing a standardized family member. Conclusion This pilot study suggests that an FPDR simulation program can be effectively repeated with multiple medical students and applied to CPR simulations involving diverse cultural backgrounds.

Purpose: This report describes the development of a simulation scenario for medical student that incorporates cultural diversity within the context of family presence during resuscitation (FPDR). Methods: Using a hybrid simulation approach, we designed a scenario focusing on communication with a family that immigrated from Korea to the United States during cardiopulmonary resuscitation (CPR). The scenario objectives were for learners to perform CPR with family presence, communicate with the family, and understand and negotiate cultural needs. Following a pilot scenario with two inexperienced volunteer medical students as learners, the program was evaluated through anonymous surveys and informal focus group feedback. Results: Students noted that this simulation differed from previous experiences as compared with emphasizing family communication rather than patient diagnosis or treatment. Students valued experiencing the practical application of cultural competence concepts. The suggestions for scenario improvement included balancing two student participation roles, adjusting the timeline, and utilizing a standardized family member. Conclusion This pilot study suggests that an FPDR simulation program can be effectively repeated with multiple medical students and applied to CPR simulations involving diverse cultural backgrounds.

The aim of this study was to investigate the relaxant effect of ethanol extract, fractions from Epimedium koreanum (E. koreanum) on penile corpus cavernosum smooth muscle (PCCSM) in a rabbit. The contractility on PCCSM was also evaluated with icariin, active major compound, from E. koreanum quantified using HPLC analysis. The pre-contracted PCCSM with 10 μM phenylephrine (Phe) was accumulatively treated with extract and fractions (n-hexane, ethyl acetate and n-butanol) from E. koreanum at concentrations of 1, 2, 3 and 4 mg/mL. Icariin was performed with final concentrations of 0.1, 1, 10 and 100 μM. The interaction of icariin with phosphodiesterase-5 (PDE-5) inhibitor, udenafil, was also examined on PCCSM contractility. Extract and three fractions had the relaxant effect on PCCSM in a dose-dependent manner and the maximum relaxation was obtained in ethyl acetate fraction. Icariin dose-dependently relaxed the PCCSM and efficiently enhanced the udenafil-induced relaxation at least two-fold. These results indicate the possibility that icariin fromE. koreanum may be a candidate for a new or alternative medicine in erectile dysfunction patients who do not completely respond to PDE-5 inhibitors.

BACKGROUND/OBJECTIVES: Male hypogonadism is a condition where the body does not produce enough testosterone and significantly impacts health. Age, obesity, genetics, and oxidative stress are some physiological factors that may contribute to testosterone deficiency.Previous studies have shown many pharmacological benefits of Schisandra chinensis (S. chinensis) Baillon as an anti-inflammatory and antioxidant. However, the molecular mechanism of attenuating hypogonadism is yet to be well established. This research was undertaken to study the effects of S. chinensis extract (SCE) on testosterone deficiency.MATERIALS/METHODS: S. chinensis fruit was pulverized and extracted using 60% aqueous ethanol. HPLC analysis was performed to analyze and quantify the lignans of the SCE. RESULTS: The 2,2-diphenyl-2-picrylhydrazyl and 2,2’-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) scavenging assays confirmed that the SCE and its major lignans (schisandrol A and gomisin N) inhibit oxidative stress. Effects of SCE analysis on the testosterone level under oxidative stress conditions revealed that both schisandrol A and gomisin N were able to recover the lowered testosterone levels. Through mRNA expression of TM3 Leydig cell, we observed that the SCE lignans were able to induce the enzymes involved in testosterone biosynthesis-related genes such as 3β-HSD4 (P < 0.01 for SCE, and P < 0.001 for schisandrol A and gomisin N), 17β-HSD3 (P < 0.001 for SCE, schisandrol A and gomisin N), and 17, 20-desmolase (P < 0.01 for schisandrol A, and P < 0.001 for SCE and gomisin N). CONCLUSIONS These results support that SCE and its active components could be potential therapeutic agents for regulating and increasing testosterone production.

Background: The relationship between serum vitamin D levels and depressive symptoms has not been consistent in previous studies in Korean women. Menopause is known to be related to depression and vitamin D. Methods: This study included 11,573 women from the 5th Korea National Health and Nutrition Examination Survey. Serum vitamin D levels were divided into four groups according to quartiles, and depressive symptoms were collected into two groups. Multiple logistic regression analysis was conducted in each group of women before and after menopause. Results: Compared with the highest vitamin D group, the lowest vitamin D group did not show significant differences in all females (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.78-1.22). In premenopausal women, compared to the first quartile, ORs were presented in the second quartile (OR, 0.75; 95% CI, 0.53-1.07), third quartile (OR, 0.70; 95% CI, 0.49-1.00) and fourth quartile (OR, 0.62; 95% CI, 0.43-0.92) respectively, and they were statistically significant (P=0.016). In postmenopausal women, compared to the first quartile, ORs were presented in the second quartile (OR, 1.06; 95% CI, 0.78-1.44), third quartile (OR, 1.18; 95% CI, 0.87-1.61), and fourth quartile (OR, 1.27; 95% CI, 0.98-1.66) respectively; however, they were not statistically significant (P=0.057). Conclusions Depression symptoms increased with a decrease in serum vitamin D in premenopausal women, but the opposite trend was observed in postmenopausal women. In future studies, if the relationship between blood vitamin D and depression is studied, the menopausal status of women can be used as an important criterion.

Purpose: This study aimed to describe nurses’ perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through openended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: “children and adolescents,” “families,” “PPC management system,” and “community-based PPC.” Meanwhile, PPC barriers were divided into 3 categories: “healthcare delivery system,” “healthcare provider,” and “client.” The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion In this study, by using mixed-methods, items of nurses’ perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

Background: Complex regional pain syndrome (CRPS) is an intractable pain disease with various symptoms. Here, we investigated the disease status, work life, sleep problems, medical insurance, economic status, psychological problems, and quality of life (QOL) of CRPS patients. Methods: CRPS patients from 37 university hospitals in South Korea were surveyed.The survey questionnaire consisted of 24 questions on the following aspects of CRPS patients: sex, age, occupation, cause of injury, activities of daily living (ADL), pain severity, sleep disturbance, level of education, economic status, therapeutic effect, and suicidal ideation. Additionally, the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions, was used to identify the status of QOL. Results: A total of 251 patients completed the questionnaire. According to the survey, 54.2% patients could not perform ADL on their own. Over the previous week, the mean pain score was 7.15 ± 1.78 (out of a total of 10 points); 92.1% of patients had sleep disorders and 80.5% had suicidal ideation, with most patients suffering from psychological problems. The average for each domain of WHOQOL-BREF was as follows: 21.74 ± 14.77 for physical, 25.22 ± 17.66 for psychological, 32.02 ± 22.36 for social relationship, and 30.69 ± 15.83 for environmental (out of a total of 100 points each). Occupation, ADL, sleep time, therapeutic effect, and suicidal ideation were statistically correlated with multiple domains. Conclusions Most patients had moderate to severe pain, economic problems, limitations of their ADL, sleep problems, psychological problems, and a low QOL score.

Background: Complex regional pain syndrome (CRPS) is an intractable pain disease with various symptoms. Here, we investigated the disease status, work life, sleep problems, medical insurance, economic status, psychological problems, and quality of life (QOL) of CRPS patients. Methods: CRPS patients from 37 university hospitals in South Korea were surveyed.The survey questionnaire consisted of 24 questions on the following aspects of CRPS patients: sex, age, occupation, cause of injury, activities of daily living (ADL), pain severity, sleep disturbance, level of education, economic status, therapeutic effect, and suicidal ideation. Additionally, the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions, was used to identify the status of QOL. Results: A total of 251 patients completed the questionnaire. According to the survey, 54.2% patients could not perform ADL on their own. Over the previous week, the mean pain score was 7.15 ± 1.78 (out of a total of 10 points); 92.1% of patients had sleep disorders and 80.5% had suicidal ideation, with most patients suffering from psychological problems. The average for each domain of WHOQOL-BREF was as follows: 21.74 ± 14.77 for physical, 25.22 ± 17.66 for psychological, 32.02 ± 22.36 for social relationship, and 30.69 ± 15.83 for environmental (out of a total of 100 points each). Occupation, ADL, sleep time, therapeutic effect, and suicidal ideation were statistically correlated with multiple domains. Conclusions Most patients had moderate to severe pain, economic problems, limitations of their ADL, sleep problems, psychological problems, and a low QOL score.