Effects of Continuous Glucose Monitoring on Glycemic Control in Type 2 Diabetes: A Systematic Review and Meta-Analysis

As the prevalence of diabetes is rapidly increasing, the use of continuous glucose monitoring, which is effective in improving glycemic control in type 2 diabetes, is increasing.

METHODS

Systematic review was performed according to PRISMA criteria. The search was conducted for articles published until 31 May 2023 in PubMed, CINAHL, Cochrane Library, EMBASE, ClinicalKey, etc. The meta-analysis involved the synthesis of effect size; tests of homogeneity and heterogeneity; trim and fill plot; Egger's regression test; and Begg's test for assessing publication bias.

RESULTS

491 studies were searched, of which 17 studies that met the selection criteria were analyzed. The overall effect on HbA1c was -0.37 (95% CI, -0.63~-0.11, p < 0.001), with HbA1c decreasing significantly after CGM interventions. Sub-analyses showed that the study was statistically significant in those aged 60 years or older, when rt-CGM was used and when the study was performed in multiple centers.

CONCLUSION

The results of this study showed that intervention using CGM was effective in reducing HbA1c in type 2 diabetes. The factors identified in this study can be used as guidelines for developing future CGM intervention programs.

Effects of an empathy enhancement program using patient stories on attitudes and stigma toward mental illness among nursing students

Objective

This study aims to explore the impact of an empathy intervention through patients' stories and investigate its impact on attitudes and stigma toward mental illness among nursing students prone to hold prejudices against this condition.

Methods

Using a quasi-experimental pretest-posttest design, this study focused on nursing students and examined the effects of an empathy enhancement program targeting individuals with mental illnesses on communication, social distance, and prejudice. Ninety third-year nursing students from S and C cities and H and C universities enrolled in psychiatric nursing courses participated in the study. The intervention lasted 4 weeks and used the patient's story to facilitate a participatory approach to understanding the patient's life and encouraging mutual growth and expansion of consciousness in the therapeutic relationship. Age was treated as a covariate and analyzed using a two-way repeated-measure analysis of covariance.

Results

The Empathy Enhancement Program Using Patient Stories (EEP-PS) group and the clinical practicum group showed no significant differences in communication, social distance, and empathy scores between the two groups or across different time points. However, variations were observed when examining specific subdomains within each group and across time points. Informative communication (F = 10.34, p = 0.002) and affiliative communication (F = 21.60, p < 0.001), which are subcategories of communication, increased significantly in the posttest compared to the pretest. Among social distances, interpersonal-physical distance decreased significantly in the posttest compared to the pretest (F = 31.02, p < 0.001). Prejudice of incompetence (F = 6.52, p = 0.012) and prejudice of risk (F = 14.37, p < 0.001) were significantly lower in the posttest than in the pretest.

Conclusion

Both the EEP-PS and clinical practicum groups experienced improvements in communication, social distance, and prejudice toward individuals with mental illness. This study suggests that direct patient interactions and the use of patient narratives as indirect methods are effective approaches for enhancing attitudes and reducing stigma toward mental illness among nursing students.

Factors influencing the intention for lung cancer screening in high-risk populations for lung cancer

Objective

Utilizing low-dose computed tomography for lung cancer screening has proven effective in reducing lung cancer mortality among high-risk individuals. This study aimed to investigate the health beliefs, knowledge of lung cancer, and cancer prevention behaviors in adults at high risk for lung cancer, with the goal of identifying predictors influencing their intention to undergo lung cancer screening.

Methods

The study utilized a descriptive cross-sectional design. Online questionnaires, including assessments of lung cancer screening health beliefs, knowledge of lung cancer, cancer prevention behaviors, intention to undergo lung cancer screening, and participant characteristics, were distributed to 186 individuals at high risk of lung cancer through a survey link. The data collection period spanned from April 26 to May 3, 2023. Analytical procedures encompassed descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlations, and hierarchical multiple regression.

Results

The mean score for the intention to undergo lung cancer screening in our study was 3.66 out of 5. The regression model explaining the intention to undergo lung cancer screening accounted for 34.7% of the variance. Significant factors identified included stress level (β = 0.20, P = 0.002), perceived risk (β = 0.13, P = 0.040), self-efficacy (β = 0.35, P < 0.001), and engagement in cancer prevention behavior (β = 0.26, P < 0.001).

Conclusions

Healthcare providers should implement psychological interventions and provide education about cancer screening for high-risk individuals, aiming to enhance their perceived risk and self-efficacy, thus promoting a higher likelihood of undergoing screening.

Factors Affecting the Sexual Behavior of Korean University Students

Recent incidents in Room n, sexual harassment by social leaders, and the #MeToo movement showed Korea's immature and distorted sexual culture. This cross-sectional descriptive study investigated the factors affecting the sexual behavior of Korean university students. The participants comprised 258 university students from S and C. The data collection period was from 29 November 2021 to 3 December 2021, and an online survey was conducted on sexual behavior, sexual attitudes, and subject characteristics. The collected data were analyzed using PASW Statistics 25.0. The average age of the participants was 21.38 ± 1.62 years old; the average age when they first watched a pornographic video on YouTube was 14.25 ± 2.55 years old. Sexual behavior was statistically significantly higher for men over 21 and under 14 when they first watched a pornographic video. As the age of the subjects increased, the younger the age of viewing pornographic videos and the thumbnail viewing path of the pornographic videos affected sexual behavior, with an explanatory power of 11.0% (F = 6.27, p < 0.001). Higher sexual attitudes in the communion and permissiveness domains showed greater influence on sexual behavior; the explanatory power was 24.0% (F = 10.02, p < 0.001). Korean university students must be educated on sex early to develop correct sexual attitudes and engage in correct and responsible sexual behaviors in their youth.

Concept Analysis of Nursing Surveillance Using a Hybrid Model

This study aims to analyze the concept of nursing surveillance among nurses caring for patients in acute care hospitals in Korea. The conceptual analysis was conducted using the hybrid model proposed by Schwartz-Barcott and Kim. In the theoretical phase, the attributes of nursing surveillance were explored through a literature review. In the fieldwork phase, the attributes of nursing surveillance were derived by analyzing interview materials. In the final analysis phase, nursing surveillance attributes and the related factors were integrated and confirmed. The attributes of nursing surveillance were systematic assessment, pattern recognition, the anticipation of problems, effective communication, decision-making, and performing nursing practice. Based on the theoretical basis of the nursing surveillance concept, this study identified the nursing surveillance concept as perceived by Korean nurses, and examined strategies to promote nursing surveillance.

Reliability and Validity of the Korean Version of Lung Cancer Screening Health Belief Scale

The purpose of this study was to verify the validity and reliability of the LCSHBS-K. This was a methodological study. The participants were adults aged between 50 and 74 years old, according to the selection criteria for lung cancer screening presented by the Comprehensive Cancer Network clinical practice guidelines in oncology recommendations. This study included 204 high-risk individuals who had not been diagnosed with lung cancer. The collected data were analyzed using the IBM SPSS Statistics software 26.0 version (IBM, New York, NY, USA). The reliability was analyzed by Cronbach's α for internal consistency, and the concurrent validity was analyzed by Pearson's correlation coefficients to identify the correlations with the health belief scale for Korean adults. To test the convergent validity, the average variance extracted (AVE) and composite reliability (CR) were calculated using confirmatory factor analysis. In addition, the model fit for a tool was CMIN (χ²/df), SRMR, RMSEA, GFI, and CFI as a comparative fit index. The discriminant validity was tested based on AVE > r². The average age of the participants was 55.49 (SD = 5.07), the average smoking history was 29.55 (SD = 8.12) years, and the average number of cigarettes smoked per day was 12.18 (SD = 7.77). The goodness of fit met the criteria with GFI = 0.81 (criteria > 0.9), CMIN = 1.69 (criteria < 2), SRMR = 0.06 (criteria < 0.08), RMSEA = 0.058 (criteria < 0.06), and CFI = 0.91 (criteria > 0.9). The LCSHBS-K showed a statistically significant positive correlation with the HBS (r = 0.32 (p < 0.001)). Cronbach's α was 0.80 for all the items in the LCSHBS-K. Therefore, the validity and reliability of the LCSHBS-K tool were confirmed. Based on the results of this study, the Korean version of the LCSHBS tool was found to be suitable for screening lung cancer in high-risk groups in Korea.

Factors Affecting Delirium in ICU Patients

This study examined delirium severity using a delirium screening tool and analyzed the predictors, including pain, acuity, level of consciousness, fall risk, and pain score, to increase understanding of delirium and present foundational data for developing nursing interventions for delirium prevention. This was a retrospective study of 165 patients admitted to three intensive care units (ICUs). the Nursing Delirium Screening Scale (Nu-DESC) was used as a research tool to screen for delirium and measure the degree of delirium. The incidence of delirium in patients was 53.3%, and the average delirium score in the delirium group was 2.40 ± 0.56. Nu-DESC scores were significantly correlated with ICU days, ventilator days, restraint applications, the number of catheters inserted, sedative medication use, the Simplified Acute Physiology Score (SAPS III), the Morse Fall Scale (MFS), the Glasgow Coma Scale (GCS) scores, pain scores, and blood urea nitrogen (BUN). Stepwise multiple linear regression showed that the number of restraint applications, GCS score, ICU days, and BUN levels were factors influencing delirium. Based on the findings, ICU nurses should use delirium screening tools to ensure accurate delirium screening and work to reduce the incidence and degree of delirium by observing factors affecting delirium in patients.

Factors Affecting Nursing Surveillance Activity among Clinical Nurses

Nursing surveillance is a defense mechanism that protects patients from adverse events, as it is a systematic process that contributes to nurses' detection of and intervention in dangerous situations. This descriptive cross-sectional study examined the degree of nursing surveillance activity performed by clinical nurses, nurses' perceived importance of nursing surveillance, and their perception of patient safety culture. The study aimed to identify the predictors of nursing surveillance activity. Participants included 205 clinical nurses from two secondary hospitals and two tertiary hospitals in Changwon-si and Cheongju-si, South Korea, who had at least one year of clinical experience. Nursing surveillance activity was high among nurses who were assigned fewer than 1.88 patients, who worked in a tertiary hospital, and those who scored 7.0 or higher in nurses' perceived expertise. Nursing surveillance activity was significantly positively correlated with nurses' perceived importance of nursing surveillance and patient safety culture. A hierarchical multiple regression analysis was performed to identify the predictors of nursing surveillance activity. Nurses' perceived expertise, perceived importance of nursing surveillance, patient safety culture, and type of hospital explained 65.3% of the variance of nursing surveillance activity. This study is significant as it provides an assessment of the extent and key predictors of nursing surveillance activity.

Educational needs of people with type 1 diabetes mellitus and their parents: A cross-sectional study

AIMS

To investigate the educational needs of type 1 diabetes patients and their parents.

DESIGN

A cross-sectional design was employed.

METHODS

Data were collected via an online survey and analysed by descriptive statistics and an independent t-test. Statistical analyses were performed using IBM SPSS version 25.0. Participants comprised type 1 diabetes patients (100) and their parents (93).

RESULTS

Complications management, disease characteristics and exercise were found to be the highest educational needs of type 1 diabetes patients and their parents. The following educational needs differed between patients and parents: complication management, exercise, continuous management, psychosocial needs and risk factors. Regarding psychosocial needs, social life was the most needed in terms of disease management and how to have a social life with the disease.

Factors Associated with Student Satisfaction and Self-Confidence in Simulation Learning among Nursing Students in Korea

This study aimed to examine the relationships between student satisfaction and self-confidence in learning (SCLS), the simulation design scale (SDS), and educational practices in simulation (EPSS) and to identify the influencing factors on SCLS in nursing students undergoing simulation learning. Of the fourth-year nursing students, 71 who were taking a medical-surgical nursing simulation course and voluntarily provided informed consent to participate in the study were enrolled. Data on SCLS, SDS, and EPSS were collected via an online survey after the simulation, from 1 October 2019 to 11 October 2019. The mean SCLS score was 56.31 ± 7.26, the mean SDS score was 86.82 ± 10.19 (range: 64~100), and the mean EPSS score was 70.87 ± 7.66 (range: 53~80). SCLS was positively correlated with SDS (r = 0.74, p < 0.001) and EPSS (r = 0.75, p < 0.001). The regression model for SCLS in nursing students revealed that SCLS increased with increasing EPSS and SDS, and that SDS and EPSS explained 58.7% of the variance in SCLS (F = 50.83, p < 0.001). Therefore, to improve the learning satisfaction and learning confidence of nursing students in simulation classes, it is necessary to consider simulation design and practice considering educational factors.

Factors Affecting Depression and Its Relation to Sleep Quality among Parents of Type 1 Diabetes Patients

This study investigated factors affecting depression (CES-D) among parents of patients with type-1 diabetes mellitus (T1DM), a chronic disease that requires constant management. A complex set of factors influence depression in parents and thus requires further research. This is a cross-sectional descriptive study. A survey on related variables was conducted on 217 parents of patients with T1DM. The collected data were analyzed using the PASW Statistics program, and factors influencing participants’ depression were identified through stepwise multiple regression. The results show that three variables exerted a significant effect on depression (source of information, resilience–personal competence, and Pittsburgh sleep quality index score), and all the variables explained a majority of the variance in depression. The results indicate that the parents of patients with T1DM were less depressed when the source of information was personal, when their resilience–personal competence was high, and when their Pittsburgh sleep quality index (PSQI) score was low. Interventions targeting parents of patients with T1DM should be performed with positive information on how to overcome diabetes in their children, increase resilience–personal competence, and increase sleep quality.

Associated factors with depression and sleep quality in T1DM patients: a cross-sectional descriptive study

BACKGROUND

Individuals with type 1 diabetes (T1DM) may experience sleep problems, usually due to low blood sugar levels during sleep or performance of blood sugar management (e.g., blood sugar monitoring). This study aimed to identify the disease-related characteristics, psychosocial aspects, and related factors underlying sleep quality in patients with T1DM.

METHODS

This study employed a descriptive research design. The participants were 159 individuals with T1DM who completed online questionnaires. The data were analyzed using descriptive statistics, correlations, and multiple regression analyses.

RESULTS

The average score for depression in T1DM patients was 23.77 (SD 5.31), and sleep quality received a score of 4.58 (SD 3.22). Depression was positively correlated with sleep quality and negatively correlated with the total resilience score. The factors linked to depression in T1DM patients were duration of disease, sleep latency, sleep duration, sleep disturbance, and resilience-acceptance of self and life sub-factors, with an explanatory power of 44.4% for the depression variance. The associated factors with sleep quality in T1DM patients were complications, resilience-personal competence sub-factors, and depression, with an explanatory power of 37.4% for sleep quality variance.

CONCLUSIONS

The results of this study suggest that to improve sleep quality in patients with T1DM, it is necessary to develop and support disease management to prevent complications and implement interventions for improving resilience and reducing negative emotions such as depression.

The Effect of Nurse Support Programs on Job Satisfaction and Organizational Behaviors among Hospital Nurses: A Meta-Analysis

The purpose of this study was to calculate the combined effect size of nurse support programs on job satisfaction among hospital nurses. The PICO framework was used in this methodological study of systematic review and meta-analysis. Using nine electronic databases of four international and five Korean databases and applying the eligibility criteria, articles published from database inception through October 2022 were collected. A total of 24 Korean and international articles were selected following the PRISMA guidelines. The keywords of nurse, mentoring (preceptorship, internship, or residency) program, and job satisfaction were selected based on the PICO. The checklists for RCTs and quasi-experimental studies provided in the Joanna Briggs Institute of Critical Appraisal Tool were used for the quality assessment. The coded data were analyzed using MIX 2.0 statistical software. We analyzed the combined effect sizes, heterogeneity, funnel plot, Egger's regression test, Begg's test, subgroup analyses, and univariate meta-regression. The overall effects of the program on job satisfaction and organizational behavior such as organizational commitment, interpersonal relationships, self-efficacy, motivation, burnout, and turnover intention for hospital nurses were statistically significant. The results of this study may explain the effect of the nurse support program on job satisfaction and organizational behaviors for hospital nurses.

Role of Perception, Health Beliefs, and Health Knowledge in Intentions to Receive Health Checkups among Young Adults in Korea

Regular health checkups allow early treatment when problems occur and prevent disease progression, but the rate of health checkups among young adults is low. This study aimed to investigate the factors affecting the intentions to receive health checkups among young adults in their 20s in Korea. The study design was a descriptive cross-sectional study and examined their intentions to receive health checkups, their health beliefs (perceived sensitivity, perceived severity, perceived benefit, perceived barrier, cue to action, self-efficacy), their attitude toward health checkups, and their knowledge of health checkups. The participants were 252 adults in their 20s in South Korea who were eligible for national health checkups. The intentions to receive check-ups model identified five variables, including sex, perceived sensitivity, cue to action, self-efficacy, and attitudes toward health checkups, were as significant influencing factors for the intentions to receive health checkups with 51.0% explanatory power (F = 53.18, p < 0.001). Different approaches must be adopted according to past experiences with health checkups when attempting to improve the intentions to receive health checkups in young adults.

Effect of Treatment Adherence Improvement Program in Hemodialysis Patients: A Systematic Review and Meta-Analysis

Herein, we performed a meta-analysis evaluating the effects of treatment adherence enhancement programs on treatment adherence and secondary outcomes for hemodialysis patients. Twenty-five Korean and international articles published prior to 31 March 2022 were selected following the PRISMA and Cochrane Systematic Review guidelines. We calculated summary effect sizes, conducted homogeneity and heterogeneity testing, constructed a funnel plot, and performed Egger's regression test, Begg's test, trim-and-fill method, subgroup analyses, and univariate meta-regression. The overall effect of treatment adherence enhancement programs for hemodialysis patients was statistically significant (Hedges' g = 1.10, 95% CI: 0.77, 1.43). On performing subgroup analysis to determine the cause of effect size heterogeneity, statistically significant moderating effects were found for a range of input variables (Asian countries, study centers, sample size, study design, intervention types, number of sessions, quality assessment scores, funding, and evidence-based interventions). On univariate meta-regression, larger synthesized effect sizes were found for a range of study characteristics (Asian populations, single-center studies, studies with <70 participants, quasi-experimental studies, educational interventions, studies with >12 sessions, studies with quality assessment scores above the mean, unfunded studies, and non-theory-based interventions). Our results provide evidence-based information for enhancing program efficacy when designing treatment adherence enhancement programs for hemodialysis patients.

Factors Affecting the Global Health and Cultural Competencies of Nursing Students

Recently, various global health issues, including coronavirus disease 2019 (COVID-19), have been observed in relation to rapid changes in world health conditions; consequently, nurses’ global health and cultural knowledge have become increasingly important. Therefore, this study aimed to identify factors affecting the global health and cultural competencies of nursing students. The study design was a cross-sectional study with 108 participants; all participants were fourth-year nursing college students in S and C cities. Global health competency, cultural competency, global health confidence, cultural nursing confidence, and metacognition were surveyed online, and the data were collected from October 30 to November 7, 2018. The collected data were analyzed using descriptive statistics, independent t-test, Pearson’s correlation, and hierarchical multiple regression. The total mean scores for global health competency and the cultural nursing competency were 63.01 ± 8.78 and 134.94 ± 17.78, respectively. Global health competency had a positive correlation with cultural competency (r = 0.49, p < 0.001), cultural nursing confidence (r = 0.26, p = 0.006), and metacognition (r = 0.22, p = 0.023). Cultural competency showed a positive correlation with global health confidence (r = 0.31, p = 0.001), cultural nursing confidence (r = 0.51, p < 0.001), and metacognition (r = 0.40, p < 0.001). Cultural competency was found to be a significant factor affecting global health competency, with an explanatory power of 23.1% (F = 17.10, p < 0.001). Cultural nursing confidence and metacognition had significant effects on cultural competency, with an explanatory power of 34.3% (F = 14.97, p < 0.001). Cultural confidence and metacognition were important factors influencing cultural competency, and cultural competency was shown to be an important factor influencing global health competency.

Factors Influencing Self-Care Behavior and Treatment Adherence in Hemodialysis Patients

Low self-care and treatment adherence are found among hemodialysis patients. We aimed to identify the factors influencing self-care behavior and treatment adherence and examine the mediating effect of treatment adherence on self-care behavior. A questionnaire was administered through a social media community from 11 July to 13 August 2021. The data collected from 100 participants were analyzed using the independent t-test, one-way analysis of variance, Pearson’s correlation, multiple linear regression analysis, and hierarchical multiple regression analysis. The mean self-care behavior and treatment adherence scores were 3.52 ± 0.57 and 4.01 ± 0.48, respectively. The mean age and hemodialysis duration were 51.70 ± 9.40 and 7.57 ± 7.21 years, respectively. The common primary cause of end-stage renal disease was glomerulonephritis (n = 39, 39%). Self-care behavior varied with education, frequency of self-care behavior education, and social support and was positively correlated with treatment adherence and social support. Treatment adherence was positively correlated with social support. Treatment adherence, social support, and health status were influenced self-care behavior (54.5%. Self-care behavior and frequency of self-care behavior education influenced treatment adherence (61.3%). Treatment adherence partially mediated the relationship between social support and self-care behavior. Intervention strategies that increase both social support and treatment adherence can promote self-care behavior.

Associations of particulate matter with atopic dermatitis and chronic inflammatory skin diseases in South Korea

BACKGROUND

Particulate matter (PM) is a mixture of solid and liquid particles suspended in air, which originates from industrial plants or vehicle emissions. Although the skin is the primary body area of contact with air pollutants, the associations between PM and chronic inflammatory skin diseases has not been well established.

AIM

To investigate associations between PM and atopic dermatitis (AD) and between PM and other chronic inflammatory dermatoses, using data from the Korean Health Insurance Review and Assessment Service.

METHODS

Monthly disease statistics from the seven largest cities in South Korea (Seoul, Busan, Daegu, Incheon, Gwangju, Daejeon, Ulsan) and from Jeju Island (in total, a population of 23 288 000 for all eight areas) were included. Based on daily air pollution level and weather forecast from 2015 to 2019, multivariate negative binomial regression analysis was conducted to estimate monthly visits of AD with respect to outdoor air pollutants: coarse PM with a diameter of ≤ 10 μm (PM10) and fine PM with a diameter of ≤ 2.5 μm (PM2.5) ozone (O₃ ), nitrogen dioxide (NO₂ ), sulphur dioxide (SO₂ ) and carbon monoxide (CO).

RESULTS

Increases in the levels of PM2.5, PM10, SO₂ and CO were associated with significant increases in monthly patient visits for AD. Every 10 μg/m³ increase in PM2.5 and PM10 resulted in patient visit increases of 2.71% (95% CI 0.76-4.71; P < 0.01) and 2.01% (95% CI 0.92-3.11, P < 0.001), respectively, while every 1 part per billion (ppb) increase in SO₂ and every 100 ppb increase in CO resulted in visit increases of 2.26% (95% CI 1.35-3.17; P < 0.001) and 2.86% (95% CI 1.35-4.40; P < 0.001), respectively. O₃ and NO₂ were not associated with increased patient visits for AD. Increases in PM2.5 and PM10 concentrations were also significantly associated with increases in patient visits for psoriasis, seborrhoeic dermatitis and rosacea.

CONCLUSION

Our data suggest that PM is associated with AD and other chronic inflammatory skin diseases.

Factors Affecting Learning Satisfaction in Face-to-Face and Non-Face-to-Face Flipped Learning among Nursing Students

Factors influencing students’ learning satisfaction may differ between face-to-face and non-face-to-face flipped learning. For non-face-to-face flipped learning, which was widely employed during the COVID-19 pandemic, it is necessary to examine the impacts on learning satisfaction, which may vary depending on professor–student interaction rather than individual competencies, such as SDL readiness. This descriptive study, conducted 2 March 2019 to 24 June 2020, included 89 s-year, flipped-learning nursing students (28 face-to-face, 61 non-face-to-face). Students completed questionnaires about learning satisfaction, SDL readiness, and professor–student interaction. The data, collected using e-surveys, were analyzed using descriptive statistics, t-test, ANOVA, Pearson’s correlation, and multiple stepwise regression with IBM’s SPSS Statistics 25.0 program. The total average score of learning satisfaction (38.19 ± 6.04) was positively correlated with SDL readiness (r = 0.56, p < 0.001) and professor–student interaction (r = 0.36, p = 0.001), although total learning satisfaction was significantly different between the face-to-face and the non-face-to-face groups (t = 5.28, p = 0.024). They were also significant influencing factors, along with face-to-face flipped learning, for total learning satisfaction (F = 18.00, p < 0.001, explanatory power = 36.7%), suggesting flipped learners in non-face-to-face contexts must increase engagement beyond professor–student interaction.

Do Alcohol Prevention Programs Influence Adolescents' Drinking Behaviors? A Systematic Review and Meta-Analysis

This study analyzed the effects of various alcohol prevention programs on the drinking behavior of adolescents. There were seven electronic databases used for the literature search. A systematic review and meta-analysis are employed for works published in Korean and English from January 2010 to April 2021, with strict inclusion criteria yielding 12 papers in the review. The type of alcohol prevention interventions included educational and motivational interventions. Six studies had more than 500 participants each, and five studies had more than 10 participating schools. The programs did not effectively reduce the frequency of drinking or binge drinking of adolescents but significantly reduced the amount of alcohol consumed. Based on the results of this study, when planning alcohol prevention programs for adolescents, it is necessary to adopt a multi-level approach, including the engagement of parents and the community.

Development and effectiveness of a global health competency promotion program for Korean undergraduate nursing students

Aim

This study aimed to assess the effectiveness of a programme designed to promote global health competency among nursing students.

Design

It used a randomized pre–post‐test comparison group design to compare the effects of a global health competency programme among nursing students.

Methods

Data collection for the pre‐test was carried out for 2 days (25–26 October 2018) and that of post‐test was conducted for 2 days (23–24 December 2018). A total of 38 fourth‐year nursing students participated in this study (14 in the international nursing group, 11 in the transcultural nursing group and 13 in the complementary and alternative medicine group). The participants were from the nursing department of a university in Cheongju.

Results

There were no statistically significant differences between the groups in the pre‐test homogeneity test. The international nursing group showed statistically significant improvements between the pre‐ and post‐tests in global health competency, cultural competency, global health confidence and cultural nursing confidence.

What Affects Quality of Life for People with Type 1 Diabetes?: A Cross-Sectional Observational Study

This study investigated the association between the quality of life (QOL) and type 1 diabetes mellitus (DM), a lifelong disease that requires constant management. A complex set of factors influence the QOL of people with type 1 DM, and understanding these factors requires further research. This research is a cross-sectional descriptive study. A survey on related variables such as acceptance of disease and efficacy for self-management of diabetes, was conducted among 111 participants with type 1 DM. The collected data were analyzed using PASW Statistics program, and factors influencing participants' QOL were identified through hierarchical multiple regression. The study followed the Guidelines of Systematic Reporting of Examination in the STROBE checklist. The results showed that four variables exerted a significant effect on QOL (blood glucose level at hypoglycemia and complications in Model 1; efficacy for self-management of diabetes and acceptance and action in Model 2), and all the variables explained a majority of the variance in QOL. The results indicate that management of severe hypoglycemia and prevention of complications is crucial. Interventions should be developed to enhance coping abilities to improve efficacy for self-management for those with diabetes and promote their acceptance of the disease.

Effect of aromatherapy on sleep quality of adults and elderly people: A systematic literature review and meta-analysis

PURPOSE

The purpose of this study was to characterize studies on aromatherapy and sleep quality and to identify the measurable effects of aromatherapy on the sleep quality of adults and elderly people.

METHODS

We searched eight electronic databases for relevant studies published between January 2011 and December 2019 using the medical subheadings, "adult or elderly," "aromatherapy or aroma intervention," and "sleep quality or sleep satisfaction." Statistical analyses of the combined effect sizes, homogeneity, heterogeneity, and trim-and-fill method were performed using MIX 2.0 Pro.

RESULTS

Based on the combined results of the 30 included studies, the overall effect size of sleep quality was 0.74, which was statistically significant. A subgroup analysis was performed to assess the overall improvement in sleep quality based on country, study design, and type of intervention: the effect size of aromatherapy in East Asia, quasi-experimental studies, and aroma massage therapy studies was 1.02, 1.24, and 1.30, respectively, with higher sleep quality in each subgroup. The effect size was 0.86 and 0.80 for ≤12 interventions and for an intervention period of ≤4 weeks, respectively. Aromatherapy interventions lasting >20 min per session had an effect size of 1.28, with no significant difference in sleep quality. Quality evaluation revealed that the sleep quality after aromatherapy was significantly high in studies with methodological quality scores >8, with an effect size of 0.93. Moreover, significant combined effects of aromatherapy were observed with other variables such as stress, pain, anxiety, depression, and fatigue.

CONCLUSION

Aromatherapy improves sleep quality and reduces stress, pain, anxiety, depression, and fatigue in adults and elderly people.

Effect of self-care intervention for controlling interdialytic weight gain among patients on haemodialysis: A systematic review and meta-analysis

AIMS AND OBJECTIVES

This study aims to identify the combined effects of self-care or self-management nursing interventions on primary (interdialytic weight gain) and secondary (potassium, phosphorous, self-care and self-efficacy) outcomes in haemodialysis patients with chronic kidney disease.

BACKGROUND

Prior systematic reviews and meta-analyses revealed inconclusive evidence regarding the effects of self-care or self-management nursing interventions among the patients on haemodialysis. Also, insufficient or unclear descriptions of methods resulted in weak empirical evidence of such effects.

DESIGN

Systematic review and meta-analysis were used.

METHODS

Four databases were searched to identify 36 articles published from 2000 to 2020. Keywords were selected according to the Population Intervention Comparison Outcome format using MeSH terms and text words. The meta-analysis involved synthesis of effect size, tests of homogeneity and heterogeneity, and funnel plot, Egger's regression test, and Begg's test for assessing publication bias. This study was performed based on the Guidelines of Systematic Reporting of Examination presented in the PRISMA checklist (Appendix S1) and the Cochrane Handbook for Systematic Reviews of Interventions. The search protocol has been registered at the PROSPERO International Prospective Register of Systematic Reviews.

RESULTS

The overall effect on interdialytic weight gain was -0.26, suggesting a small effect size, with the interdialytic weight gain after nursing interventions decreasing significantly. Among the type of nursing interventions, the overall effect on interdialytic weight gain of education programmes and fluid and sodium control programmes was -0.36 and 0.25, respectively, a small effect size, and was statistically significant.

CONCLUSIONS

Based on the results of this study, healthcare professionals may encourage the patients on haemodialysis to engage in self-directed management of their symptoms, such as health contract, and promote health literacy through improving their self-efficacy.

RELEVANCE TO CLINICAL PRACTICE

This meta-analysis could provide fundamental data to assist with the development of an evidence-based practice guideline.

Factors Affecting the Eating Behavior Disorders of Korean College Students

Background:

University students are exposed to environments that may negatively influence their physical and mental health. New trends such as cooking shows may affect their eating habits.

Objective:

This study investigated factors such as general characteristics, diet, eating habits, and eating attitudes that may be associated with eating behavior disorders among university students in Korea.

Methods:

This descriptive research was conducted on 207 students who attend A University located in C city using an online self-administered questionnaire including questions on their general characteristics, eating habits, eating attitudes, and eating behavior disorders. Data were analyzed using descriptive statistics, t-test, one-way ANOVA and Scheffé test, Pearson’s correlation, and multiple linear regression (hierarchical) using SPSS.

Results:

Two independent variables and seven factors under general characteristics were analyzed using hierarchical multiple regression analysis. In Model 1, the degree of eating behavior disorders was significantly higher among women (β = .17, p = .016) and those on diet compared to those not on diet (β = -.38, p < .001). Eating alone led to a higher degree of eating behavior disorders than eating with friends (β = -.23, p = .001). In Model 2, eating habits (β = -.24, p < .001) and eating attitudes (β = .27, p < .001) accounted for 27.4% of the explanatory power as factors affecting eating behavior disorders (F = 8.06, p < .001).

Conclusion:

Eating habits and attitudes affect the eating behavior of university students.

Factors Influencing SDL Readiness and Self-Esteem in a Clinical Adult Nursing Practicum after Flipped Learning Education: Comparison of the Contact and Untact Models

This study aimed to evaluate the effects of a flipped learning contact model and a flipped learning “untact” model with Korean nursing students undergoing a clinical practicum, and to examine the factors of self-directed learning readiness and self-esteem considering these learning models. The participants included 85 students. Participants were randomly allocated to two models. This study measured self-directed learning readiness, self-esteem, learner motivation, professor–student and clinical instructor–student interactions, confidence in performing core skills, participating in online activities, clinical practice stress, and the friendliness of the two models. Participants’ characteristics were analyzed using frequencies and percentages, and between-group differences regarding characteristics were analyzed using the χ² test, independent t-test, and one-way ANOVA with a Scheffe test. This study conducted independent t-tests for comparison of the between-group adjusted mean difference of the pretest and posttest scores. The influence of the dependent variables on self-directed learning readiness and self-esteem was measured using a stepwise multiple regression method. Among the two models in the practicum, the flipped-mastery contact model (FMCM) showed higher self-directed learning (SDL) readiness and professor–student interaction than those of the flipped-mastery untact model (FMUM) after the clinical practicum was completed. The three influencing factors of SDL readiness were FMCM, learner motivation, and ward friendliness, with an explanatory power of 31.6% (F = 13.96, p < 0.001). Learner motivation, professor–student interaction, and ward friendliness influenced self-esteem, with an explanatory power of 54.7% (F = 34.86, p < 0.001).

Factors Affecting Problem Drinking Among Korean Adolescents Based on an Ecological Model

PURPOSE

The purpose of this study was to identify the factors affecting problem drinking among adolescents in Korea.

METHODS

This survey involved 68,043 adolescents who participated in the Korea Youth Risk Behavior Web-Based Survey conducted in 2015. The data were analyzed using the PASW Statistics 23.0 program.

RESULTS

The subjects were aged 14.96 ± 1.74 years (mean ± standard deviation), including 52.1% male subjects and 53.0% high school students. Most of the drinkers started drinking during their middle school years (13,906 students, 51.6%). Among the 11,021 adolescent drinkers, 7,391 (67.1%) reported at least one of six behavioral problems related to drinking. Problem drinking behaviors involved (a) drinking alcohol to relieve stress; (b) drinking alcohol alone; (c) receiving advice from family or friends to reduce alcohol consumption; (d) driving a motorcycle or riding a bicycle after drinking alcohol, or riding on a motorcycle or a car with a drunk driver at the steering wheel; (e) memory loss after drinking alcohol; and (f) arguing with others after drinking alcohol. The overall problem-drinking score was 1.36 ± 1.42 (range: 0-6). A regression model that included individual (5.7%), interpersonal (3.6%), social (0.3%), contextual (11.7%), and drinking (6.6%) behaviors as predictors accounted for 27.9% of the variance in problem drinking (Wald F = 70.10, p < .001).

CONCLUSION

The drinking levels as well as method and ease of alcohol purchase were the most significant variables predicting problem drinking by adolescents in Korea.

Factors Related to Self-care in Patients with Type 2 Diabetes

Purpose:

The prevalence of diabetes and the personal and national burden from diabetes, a serious health issue around the globe, continues to increase. The purpose of this study was to identify factors influencing self-care among patients with type 2 diabetes.

Methods:

We conducted a cross-sectional descriptive survey of 118 outpatients with type 2 diabetes in national university hospital C in Korea. Data were collected from self-report questionnaires covering information on demographics, self-care, and self-efficacy. Additional data were collected from medical records including information on HbA1c, fasting blood glucose levels, and cholesterol levels. Collected data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and multiple regression using SPSS/WIN version 22.0 software.

Results:

Factors affecting self-care were the following four: self-efficacy, HbA1c, occupation status, and smoking status. Higher engagement in self-care was associated with higher self-efficacy (β = .53, p < .001), lower HbA1c (β = -0.33, p < .001), unemployment (β = -0.20, p < .001), and non-smoking status (β = -0.15, p = .011). The regression model of self-care among the type 2 diabetes patients was statistically significant (F = 67.15, p < .001), and the explanatory power of the adjusted R2 was 69%.

Conclusion:

Type 2 diabetes patients with high self-efficacy and self-care scores showed good glycemic control. Therefore, this finding suggests that nursing interventions should be developed to enhance self-efficacy, which is the greatest influencing factor for self-care.

Gender-Based Experiences of Verbal Bullying in Adolescents: Application of Giorgi's Method

Verbal bullying among adolescents, which has become increasingly prevalent in recent years, often involves swearing or sexually ridiculing one's family members or peers. Because many factors underlying the initiation of verbal bullying remain unknown, Giorgi's phenomenological method was used to examine the essence and meaning of verbal bullying among adolescents, which is an urgent issue in the field of nursing in South Korea. In this descriptive phenomenological study, researchers examined the behavior of 16 adolescents. Four themes emerged from examination: Egocentric Relational Violence, Learning Through Observation and Imitation, The Synchronization of Stigma and Aggression, and The Dilemma of Deviance and Habituation. Findings indicated that a confluence of factors impact verbal bullying among adolescents. To prevent verbal bullying, it is necessary to understand the progress of offenders' deviance and develop intervention activities through mental health services. [Journal of Psychosocial Nursing and Mental Health Services, 57(6), 45-51.].

Effects of Gargling with an Aroma Solution on Xerostomia, Halitosis, and Salivary pH in Hemodialysis Patients – A Randomized Controlled Trial

Background:

Despite developments in renal replacement therapy, therapeutic fluid restriction reportedly induces xerostomia in 28.2~85.5% of hemodialysis patients, which causes serious inconveniences in their daily living and is detrimental to their quality of life.

Objective:

The purpose of this study was to identify the effects of gargling with an aroma solution (A-Solution) on xerostomia, halitosis, and salivary pH in hemodialysis patients.

Methods:

This study design was a randomized controlled trial. The participants of this study were 56 hemodialysis patients of E General Hospital in Seoul, Korea. They were divided into an experimental group (n=28) treated by gargling with 20 ml of A-Solution for 15 seconds and a control group (n=28) where pateints did not gargle with A-Solution, and data were collected from October 1 to November 15, 2013. The outcome variables were measured in the pretest and at 5, 30, 60, and 120 minutes in the two groups. The collected data were analyzed using SPSS (version 18.0 for Windows).

Results:

Xerostomia was lower in the experimental group than in the control group at each time point apart from the pretest and differed significantly in the interaction between groups and time points. Salivary pH and halitosis differed significantly between the experimental and control groups, across time points, and in the interaction between group and time point.

Conclusion:

The findings of this study suggest that aroma gargling is a useful oral-care intervention for solving oral problems experienced by hemodialysis patients such as xerostomia and halitosis.

Differences in SBP, BMI, and Stress with AUDIT Score in Adolescents

Background:

Consumption of alcohol by adolescents is known to have negative effects on their psychological health (ie.g., depression and stress) and physical health.

Objective:

To investigate factors influencing systolic blood pressure, body mass index, and stress according to Alcohol Use Disorders Identification Test scores among adolescents.

Methods:

This descriptive study included 535 adolescents younger than 20 years who participated in the Sixth National Health and Nutrition Survey conducted in middle and high schools in 2013. Data collected were analyzed using PASW Statistics version 23.0.

Results:

Mean age of these subjects was 15.20 ± 0.08 years. There were 268 (51.0%) male students and 286 (48.6%) middle-school students. Their systolic blood pressure, body mass index, and stress scores were 108.79 ± 0.54 mmHg, 21.22 ± 0.19 kg/m2, and 2.06 ± 0.04, respectively. In low-risk group (Alcohol Use Disorders Identification Test scores ≤ 7), sex (male) and body mass index explained 22.9% of the variance in systolic blood pressure model (Wald F = 35.28, p < 0.001). Systolic blood pressure was the only significant factor influencing body mass index, with an explanatory power of 16.4% (Wald F = 13.91, p < 0.001). Depression was a significant influencing variable for the stress model, with an explanatory power of 15.1% (Wald F = 16.20, p < 0.001). Stress was the only significant factor influencing the body mass index model in the high-risk group (Alcohol Use Disorders Identification Test scores > 7), with the explanatory power of 14.3% (Wald F = 4.14, p = 0.018).

Conclusion:

This study found that systolic blood pressure was an influencing factor of body mass index model in both groups while depression was the main factor influencing stress in low-risk group adolescents.

Effects of Cyberbullying Experience and Cyberbullying Tendency on School Violence in Early Adolescence

BACKGROUND

School violence in early adolescence, whose frequency and status have recently changed significantly.

OBJECTIVE

This study attempts to detect the cyber bullying inclination of youth in early adolescence when aggressiveness reaches its peak, to identify school violence, and to develop a school violence prevention program. Method: This study was a survey research, investigating participants who were 470 middle school students in South Korea. For the analysis, independent t-test, one-way ANOVA and hierarchical regression analysis.

RESULTS

It is suggested that the school violence victimization experience and cyber bullying infliction experience has an influence in the school violence infliction. And the cyber bullying victimization experience and school violence victimization experience variables exert effects.

CONCLUSION

The results of this study suggest that school nurses who are connecting to the community-school-home should take an active part in the development of school violence mediation education program, considering the cultural characteristics of the country.

Factors influencing the quality of life of haemodialysis patients according to symptom cluster

AIMS AND OBJECTIVES

To identify the characteristics in each symptom cluster and factors influencing the quality of life of haemodialysis patients in Korea according to cluster.

BACKGROUND

Despite developments in renal replacement therapy, haemodialysis still restricts the activities of daily living due to pain and impairs physical functioning induced by the disease and its complications.

DESIGN

Descriptive survey. Two hundred and thirty dialysis patients aged >18 years. They completed self-administered questionnaires of Dialysis Symptom Index and Kidney Disease Quality of Life instrument-Short Form 1.3.

METHODS

To determine the optimal number of clusters, the collected data were analysed using polytomous variable latent class analysis in R software (poLCA) to estimate the latent class models and the latent class regression models for polytomous outcome variables. Differences in characteristics, symptoms and QOL according to the symptom cluster of haemodialysis patients were analysed using the independent t test and chi-square test. The factors influencing the QOL according to symptom cluster were identified using hierarchical multiple regression analysis.

RESULTS

Physical and emotional symptoms were significantly more severe, and the QOL was significantly worse in Cluster 1 than in Cluster 2. The factors influencing the QOL were spouse, job, insurance type and physical and emotional symptoms in Cluster 1, with these variables having an explanatory power of 60.9%. Physical and emotional symptoms were the only influencing factors in Cluster 2, and they had an explanatory power of 37.4%.

CONCLUSIONS

Mitigating the symptoms experienced by haemodialysis patients and improving their QOL require educational and therapeutic symptom management interventions that are tailored according to the characteristics and symptoms in each cluster.

RELEVANCE TO CLINICAL PRACTICE

The findings of this study are expected to lead to practical guidelines for addressing the symptoms experienced by haemodialysis patients, and they provide basic information for developing nursing interventions to manage these symptoms and improve the QOL of these patients.

TLR2-dependent amelioration of allergic airway inflammation by parasitic nematode type II MIF in mice

In our previous studies, the recombinant type II macrophage migration inhibitory factor homologue (rAs-MIF) secreted from Anisakis simplex suppressed experimental inflammation mouse model through IL-10 production and CD4(+)CD25(+)Foxp3(+) T-cell recruitment. Also, TLR2 gene expression was significantly increased following rAs-MIF treatment. To know the relation between TLR2 and amelioration mechanisms of rAs-MIF, we induced allergic airway inflammation by ovalbumin and alum with or without rAs-MIF under TLR2 blocking systems [anti-TLR2-specific antibody (α-mTLR2 Ab) treatment and using TLR2 knockout mice]. As a result, the amelioration effects of rAs-MIF in allergic airway inflammation model (diminished inflammation and Th2 response in the lung, increased IL-10 secretion, CD4(+)CD25(+)Foxp3(+) T-cell recruitment) were diminished under two of the TLR2 blocking model. The expression of TLR2 on the surface of lung epithelial cell was significantly elevated by rAs-MIF treatment or Pam3CSK (TLR2-specific agonist) treatment, but they might have some competition effect on the elevation of TLR2 expression. In addition, the elevation of IL-10 gene expression by rAs-MIF treatment was significantly inhibited by α-mTLR2 Ab or Pam3CSK pretreatment. In conclusion, anti-inflammatory effects of the rAs-MIF on OVA-induced allergic airway inflammation might be closely related to TLR2.

The effect of a Foley catheter balloon on cervical ripening

The Foley catheter balloon may affect cervical ripening through changes in biochemical mediators by immunoassay and immunohistochemistry, when it is used for pre-induction cervical ripening. The aim of the study was to evaluate the changes in the biochemical mediators from the extra-amniotic space and immunohistochemistry in ripened cervical tissue after the insertion of a Foley catheter balloon (FCB) for pre-induction cervical ripening. A total of 18 pregnant women with a Bishop's score < 6, who were undergoing labour induction, were evaluated in this prospective study. The FCB was irrigated with 10 ml of phosphate buffered saline and the irrigant was collected 0, 2, 4 and 8 h after placement of the FCB or until spontaneous expulsion of the FCB occurred. Irrigant specimens were also collected from 10 spontaneous labouring (SL) women in the active phase of labour. The levels of interleukin (IL)-6, IL-8, matrix metalloproteinase (MMP)-8 and NO were measured. Cervical specimens were obtained from 12 women, including four undergoing induction; four SL and four non-pregnant (NP) women. Immunohistochemical staining was performed to localise hyaluronic acid synthase (HAS)-1, IL-6, IL-8, MMP-8, endothelial nitric oxide synthase (eNOS) and inducible NOS (iNOS). Results showed that the levels of IL-6, IL-8, and MMP-8 significantly increased over time in FCB group (p < 0.01). In the immunohistochemical analysis of cervical tissues, immunoreactivity of HAS-1 in the after FCB group was stronger than any of the other groups. The protein expressions of IL-6, IL-8, MMP-8, eNOS and iNOS were more prominent in the after FCB and SL groups than in the NP and the before FCB groups. iNOS was only observed in the after FCB and SL groups. It was concluded that FCB may affect cervical ripening through changes in biochemical mediators by immunoassay and immunohistochemistry, when it is used for pre-induction cervical ripening.

Best ethical practices for clinicians and laboratories in the provision of noninvasive prenatal testing

OBJECTIVE

The goal of this study is to provide an ethical framework for clinicians and companies providing noninvasive prenatal testing using cell-free fetal DNA or whole fetal cells.

METHOD

In collaboration with a National Institutes of Health-supported research ethics consultation committee together with feedback from an interdisciplinary group of clinicians, members of industry, legal experts, and genetic counselors, we developed a set of best practices for the provision of noninvasive prenatal genetic testing.

RESULTS

Principal recommendations include the amendment of current informed consent procedures to include attention to the noninvasive nature of new testing and the potential for a broader range of results earlier in the pregnancy. We strongly recommend that tests should only be provided through licensed medical providers and not directly to consumers.

CONCLUSION

Prenatal tests, including new methods using cell-free fetal DNA, are not currently regulated by government agencies, and limited professional guidance is available. In the absence of regulation, companies and clinicians should cooperate to adopt responsible best ethical practices in the provision of these tests.

Effect of health contract intervention on renal dialysis patients in Korea

This study is a randomized, controlled trial to examine the effect of the health contract intervention, based on the goal attainment theory, on the self-care behavior and physiological indices of renal dialysis patients in Korea. The experimental group (n = 21) underwent health contract intervention for 4 weeks, while the control group (n = 22) received routine care. The data were collected using questionnaires and measurement of physiological indices and analyzed using the SPSS WIN 12.0 program. A P value < 0.05 was considered statistically significant. Total score of self-care behavior (P = 0.011) and individual scores for behaviors, such as diet (P = 0.017), exercise and rest (P = 0.001), and blood pressure and body weight (P = 0.006) were higher in the experimental group. Serum potassium concentration and mean weight gain between dialysis sessions were significantly low in the experimental group (P = 0.002, P = 0.017). Therefore, the health contract intervention based on the goal attainment theory proved effective in improving self-care behavior and physiological indices (K, P, mean weight gain) in renal dialysis patients in Korea.

Amelioration of intestinal colitis by macrophage migration inhibitory factor isolated from intestinal parasites through toll-like receptor 2

In a previous study, we cloned type II MIFs (As-MIF) from Anisakis simplex 3rd stage larva and expressed a recombinant protein that suppressed allergic airway inflammation via regulatory T (CD4(+) CD25(+) Foxp3(+) T; T(reg) )-cell recruitment. In this study, in an effort to evaluate the function of rAs-MIF on another immune disease, we induced intestinal inflammation in mice using dextran sodium sulphate (DSS) with or without the application of rAs-MIF treatment to the mice. As a consequence, weight losses were recovered, and the value of disease activity index (DAI) was reduced by rAs-MIF treatment during the experimental period. The levels of TGF-β and IL-10 in the spleens and mesenteric lymph nodes (MLN) from the rAs-MIF-treated mice were higher, but the levels of IFN-γ, IL-6 and IL-13 were lower than those of the mice treated with DSS but not with rAs-MIF. Additionally, the T(reg) cells observed were greatly increased in the MLNs of the rAs-MIF-treated mice than those of mice not treated with rAs-MIF. The results of our in vitro experiments showed that the elevated IL-10 production induced by rAs-MIF was generated via toll-like receptor 2. In conclusion, rAs-MIF appears to ameliorate DSS-induced colitis and may prove useful as a therapeutic agent for the treatment of intestinal inflammatory disease.

Expression of RUNX3 in skin cancers

BACKGROUND

Expression of Runt-related transcription factor 3 (RUNX3) is reduced in a large number of cancers. However, a few studies have reported higher expression of RUNX3 in several cancers, including basal cell carcinoma (BCC). In light of this, we explored the expression of RUNX3 in skin cancers generally, to determine whether it acts as an oncogene or a tumour-suppressor gene in skin tumours.

AIM

To investigate the expression of RUNX3 in normal skin and malignant skin tumours.

METHODS

RUNX3 expression was evaluated by western blotting in 24 specimens, comprising 6 malignant melanoma (MM), 6 squamous cell carcinoma (SCC), 6 BCC and 6 normal skin specimens. Immunohistochemical staining was carried out to analyse RUNX3 expression in 16 MM, 16 SCC and 16 BCC specimens. To identify where the protein was expressed, the cytoplasmic and nuclear protein expression of RUNX3 in skin cancer tissues was determined. A cell-proliferation study was performed on an MM line (G361) by small interfering (si)RNA transfection.

RESULTS

The western blotting experiments showed that RUNX3 was not expressed in normal skin tissues, but it was overexpressed in all MM and SCC samples, and in five of the six BCC samples. Using immunochemistry, RUNX3 was found to be overexpressed in all cancer tissues analysed. Subcellular fraction analysis revealed that RUNX3 was expressed in the nuclei but not the cytoplasm of all the skin cancer tissues analysed, and RUNX3 silencing by siRNA in G361 cells resulted in a decrease in proliferation.

CONCLUSIONS

Based on these results, we suggest that RUNX3 has an oncogenic potential and does not act as a tumour suppressor in skin cancers.

Parasite excretory-secretory proteins elicit TRIF dependent CXCL1 and IL-6 mediated allergic inflammation

Currently, little information is available regarding innate immunity to helminthic parasite infection. In this study, we isolated the excretory-secretory (ES) proteins from Anisakis simplex (sea mammal intestinal parasite) third stage larva. We determined that the levels of IL-17 in the lung and lung draining lymph node of mice were increased sixfold as a result of intranasal treatment with ES proteins. The ES protein treatment elicited pro-inflammatory cytokine and chemokine secretion (especially IL-6 and CXCL1) from mouse lung epithelial cell line and primary lung epithelial cells. In addition, the expression of IL-6 and CXCL1 in mouse embryonic fibroblast (MEF) cells was significantly increased by the ES protein treatment, but we did not detect these effects in the TRIF(-/-) MEF cells. These elevations of IL-6 and CXCL1 expression were also not diminished by RNase treatment. In conclusion, the ES proteins of helminthic parasite larva may elicit TRIF dependent pro-inflammatory cytokines, and this is not double-stranded RNA.

The "how" and "whys" of research: life scientists' views of accountability

OBJECTIVES

To investigate life scientists' views of accountability and the ethical and societal implications of research.

DESIGN

Qualitative focus group and one-on-one interviews.

PARTICIPANTS

45 Stanford University life scientists, including graduate students, postdoctoral fellows and faculty.

RESULTS

Two main themes were identified in participants' discussions of accountability: (1) the "how" of science and (2) the "why" of science. The "how" encompassed the internal conduct of research including attributes such as honesty and independence. The "why," or the motivation for conducting research, was two-tiered: first was the desire to positively impact the research community and science itself, and second was an interest in positively impacting the external community, broadly referred to as society. Participants noted that these motivations were influenced by the current systems of publications, grants and funding, thereby supporting a complex notion of boundary-setting between science and non-science. In addition, while all participants recognised the "how" of science and the two tiers of "why," scientists expressed the need to prioritise these domains of accountability. This prioritisation was related to a researcher's position in the academic career trajectory and to the researcher's subsequent "perceived proximity" to scientific or societal concerns. Our findings therefore suggest the need for institutional change to inculcate early-stage researchers with a broader awareness of the implications of their research. The peer review processes for funding and publication could be effective avenues for encouraging scientists to broaden their views of accountability to society.