Purpose: This study aimed to identify the effects of clinical nurses' ethical climate and ethical nursing competence on moral distress. Methods: The participants were clinical nurses who provided direct nursing care; nurses with more than one year of work experience in general hospitals were targeted. The data were collected between January 3 and 19, 2024, and analyzed using t-test, analysis of variance, Games-Howell test, Pearson correlation coefficient, and multiple regression. Results: Moral distress was significantly and negatively correlated with ethical climate and ethical nursing competence. Factors affecting the moral distress of clinical nurses included having a position of charge nurse or higher, total clinical experience of more than 20 years, turnover intention from current job due to ethical issues, hospital sub factors of the ethical climate, and ethical behavior sub factors of ethical nursing competence, showing 27.0% explanatory power. Conclusion Establishing a positive ethical climate and improving ethical nursing competence providing opportunities for nurses to raise and solve ethical issues will contribute to resolving nurses' ethical conflicts and reducing moral distress.

Purpose: This study aimed to identify the effects of clinical nurses' ethical climate and ethical nursing competence on moral distress. Methods: The participants were clinical nurses who provided direct nursing care; nurses with more than one year of work experience in general hospitals were targeted. The data were collected between January 3 and 19, 2024, and analyzed using t-test, analysis of variance, Games-Howell test, Pearson correlation coefficient, and multiple regression. Results: Moral distress was significantly and negatively correlated with ethical climate and ethical nursing competence. Factors affecting the moral distress of clinical nurses included having a position of charge nurse or higher, total clinical experience of more than 20 years, turnover intention from current job due to ethical issues, hospital sub factors of the ethical climate, and ethical behavior sub factors of ethical nursing competence, showing 27.0% explanatory power. Conclusion Establishing a positive ethical climate and improving ethical nursing competence providing opportunities for nurses to raise and solve ethical issues will contribute to resolving nurses' ethical conflicts and reducing moral distress.

Purpose: This study aimed to identify the effects of clinical nurses' ethical climate and ethical nursing competence on moral distress. Methods: The participants were clinical nurses who provided direct nursing care; nurses with more than one year of work experience in general hospitals were targeted. The data were collected between January 3 and 19, 2024, and analyzed using t-test, analysis of variance, Games-Howell test, Pearson correlation coefficient, and multiple regression. Results: Moral distress was significantly and negatively correlated with ethical climate and ethical nursing competence. Factors affecting the moral distress of clinical nurses included having a position of charge nurse or higher, total clinical experience of more than 20 years, turnover intention from current job due to ethical issues, hospital sub factors of the ethical climate, and ethical behavior sub factors of ethical nursing competence, showing 27.0% explanatory power. Conclusion Establishing a positive ethical climate and improving ethical nursing competence providing opportunities for nurses to raise and solve ethical issues will contribute to resolving nurses' ethical conflicts and reducing moral distress.

Purpose: This study aimed to identify the effects of clinical nurses' ethical climate and ethical nursing competence on moral distress. Methods: The participants were clinical nurses who provided direct nursing care; nurses with more than one year of work experience in general hospitals were targeted. The data were collected between January 3 and 19, 2024, and analyzed using t-test, analysis of variance, Games-Howell test, Pearson correlation coefficient, and multiple regression. Results: Moral distress was significantly and negatively correlated with ethical climate and ethical nursing competence. Factors affecting the moral distress of clinical nurses included having a position of charge nurse or higher, total clinical experience of more than 20 years, turnover intention from current job due to ethical issues, hospital sub factors of the ethical climate, and ethical behavior sub factors of ethical nursing competence, showing 27.0% explanatory power. Conclusion Establishing a positive ethical climate and improving ethical nursing competence providing opportunities for nurses to raise and solve ethical issues will contribute to resolving nurses' ethical conflicts and reducing moral distress.

Background and Objectives: The number of people with heart failure (HF) is increasing worldwide, and the social burden is increasing as HF has high mortality and morbidity. We aimed to provide updated trends on the epidemiology of HF in Korea to shape future social measures against HF. Methods: We used the National Health Information Database of the National Health Insurance Service to determine the prevalence, incidence, hospitalization rate, mortality rate, comorbidities, in-hospital mortality, and healthcare cost of patients with HF from 2002 to 2020 in Korea. Results: The prevalence of HF in the total Korean population rose from 0.77% in 2002 to 2.58% (1,326,886 people) in 2020. Although the age-standardized incidence of HF decreased over the past 18 years, the age-standardized prevalence increased. In 2020, the hospitalization rate for any cause in patients with HF was 1,166 per 100,000 persons, with a steady increase from 2002. In 2002, the HF mortality was 3.0 per 100,000 persons, which rose to 15.6 per 100,000 persons in 2020. While hospitalization rates and in-hospital mortality for patients with HF increased, the mortality rate for patients with HF did not (5.8% in 2020), and the one-year survival rate from the first diagnosis of HF improved. The total healthcare costs for patients with HF were approximately $2.4 billion in 2020, a 16-fold increase over the $0.15 billion in 2002. Conclusions The study’s results underscore the growing socioeconomic burden of HF in Korea, driven by an aging population and increasing HF prevalence.

The hygiene hypothesis, first proposed in 1989, suggested that reduced exposure to infections in early life leads to allergic diseases by the defects in the establishment of immune tolerance. Although many studies provided evidence that some exposure conditions, including family size, antibiotics, probiotics, and viral or bacterial infections, are strongly related to the prevalence of allergic diseases, thereby supporting the hygiene hypothesis, some evidence does not provide acceptable results for the hygiene hypothesis. Further, most studies have focused on patients with asthma or atopic dermatitis, not allergic rhinitis. In this review, we summarize the recent studies for and against the ‘hygiene hypothesis’ and identify causal association with the prevalence of allergic rhinitis.

Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has been spreading since 2019, causing a worldwide pandemic. Amid the COVID-19 pandemic, tuberculosis, AIDS, and malaria have adversely affected the quality of life of patients and killed millions of people. In addition, COVID-19 continues to impede the delivery of health services, including those for the control of neglected tropical diseases (NTDs). Furthermore, NTDs have been reported as possible co-pathogens among patients infected with COVID-19. However, studies regarding parasitic co-infection among these patients have been limited. This review aimed to explore and describe the cases and reports of parasitic infections in the backdrop of COVID-19 to provide comprehensive knowledge regarding this aspect. We reviewed seven cases of patients who had parasitic co-infection and tested positive for COVID-19, and summarized the literature on the importance of controlling parasitic diseases. In addition, we identified recommendations for the control of parasitic diseases under possible difficulties, such as declining funding for parasitic diseases in 2020. This review highlights the growing burden of NTDs under COVID-19 that may be caused by the deficiency of healthcare infrastructure and human resources as the main reasons. Clinicians should remain vigilant for possible co-infections with parasites in COVID-19 patients, while policymakers are urged to reinforce a balanced and long-term health strategy that addresses both NTDs and COVID-19.

Allergic rhinitis (AR) is a type of rhinitis accompanied by sensitization to allergens. One of the most clinically important allergens is pollen. Recently, due to climate change and CO 2 air pollution, the flowering period starts earlier and persists longer. In addition, antigenicity due to environmental pollution is also being strengthened. As a result, the sensitization rate to pollen antigens is on the rise. It is known that the prevalence of AR especially caused by pollen is rapidly escalating. Although the causal relationship between pollen exposure and the severity of rhinitis is not precisely established, an association of rhinitis symptoms with the time of pollen scattering exists. In addition, the mixed effect of environmental pollution and pollen may play a role in the development of rhinitis symptoms. Therefore, in order to avoid pollen, it is necessary to constantly improve pollen forecast and minimize the contact with pollen indoors and outdoors. Treatment of AR should be performed according to guidelines. Also, continuous efforts to solve the environmental problems affecting the ecology of pollen are needed.

Open reduction in an AO 33-A3 class distal femur transverse and comminuted fracture is often difficult due to frequent reduction loss during surgery, leading to longer operative time and increased blood loss intra-operation. In this study, the authors report a case in which the use of an offset grid plate (OsteoMed, USA) using 2.4 mm HPS (hand plating system) eased the process of fracture reduction and achieved a stable internal fixation, ultimately leading to successful osteosynthesis. The authors experienced no need for temporary fixation devices such as K-wires or screws, which are otherwise required to stabilize the reduction. The fracture reduction was stable throughout the primary fixation of the fracture using a locking plate and screws. The authors report that the advantage of the HPS plate is fitting into the cortical contour and providing stable maintenance of fracture reduction intra-operation, which would be beneficial in certain distal femoral fracture patterns.

Previous studies have shown that tricuspid regurgitation (TR) can be developed in patients with atrial fibrillation (AF) due to annular dilatation. This study aimed to investigate the incidence and predictors of the progression of TR in patients with persistent AF. A total of 397 patients (66.9±11.4 years, 247 men; 62.2%) with persistent AF were enrolled between 2006 and 2016 in a tertiary hospital, and 287 eligible patients with follow-up echocardiography were analyzed. They were divided into two groups according to TR progression (progression group [n=68, 70.1±10.7 years, 48.5% men] vs. non-progression group [n=219, 66.0±11.3 years, 64.8% men]). Among 287 patients in the analysis, 68 had worsening TR severity (23.7%). Patients in the TR progression group were older and more likely to be female. Patients with left ventricular ejection fraction ＜50% were less frequent in the progression group than those in the non-progression group (7.4% vs. 19.6%, p=0.018). Patients with mitral valve disease were more frequent in the progression group. Multivariate analysis with COX regression demonstrated independent predictors of TR progression, including left atrial (LA) diameter ＞54 mm (HR 4.85, 95%CI 2.23-10.57, p＜0.001), E/e’ (HR 1.05, 95%CI 1.01-1.10, p=0.027), and no use of antiarrhythmic agents (HR 2.20, 95%CI 1.03-4.72, p=0.041). In patients with persistent AF, worsening TR was not uncommon. The independent predictors of TR progression turned out to be greater LA diameter, higher E/e’, and no use of antiarrhythmic agents.