Seungmi Park

Predictors of Physical Activity in Korean Older Adults: Distinction between Urban and Rural Areas

PURPOSE The aim of this study was to compare the predictors of physical activity between urban and rural dwelling Korean older adults. METHODS This study was a cross-sectional descriptive survey. A self-report questionnaire or face to face interviews were used to collect data from 336 older adults (urban: 129, rural: 207) who visited public health centers or welfare centers in 2008. RESULTS About half of the participants (urban: 50.4%, rural: 47.3%) were classified as the minimally active group. Cognitive function (odds ratio [OR]=1.106, p=.004) and loneliness (OR=0.965, p=.044) were predicting factors for physical activity in rural elderly. Age (OR=0.326, p=.037), gender (OR=2.841, p=.021) and depression (OR=0.799, p<.001) were significant factors predicting physical activity in urban elders. CONCLUSION These findings provide information that is relevant in designing interventions to enhance physical activity in older adults. There is a need to develop effective mutifaceted physical activity interventions that include reducing psychological barriers such as depression, loneliness.

Factors affecting ostomy-related complications in Korea.

PURPOSE We sought to determine the type and incidence of ostomy-related complications and identify associated factors in Korean ostomy patients. METHODS A retrospective analysis of medical records of 1,170 patients who underwent end colostomy in Samsung Medical Center between October 1994 and February 2005 was completed. Complications were classified as stomal or peristomal. Stomal complications included bleeding, necrosis, mucocutaneous separation, prolapsed stoma, retracted stoma, and stenosis. Peristomal complications included varices, hernia, irritant contact dermatitis, allergic contact dermatitis, maceration, folliculitis, hyperplastic granulation, bacterial infection, candidal infection, malignancy in the peristomal area, mechanical damage, and pyoderma gangrenosum. A flat (flush) stoma was the most common stomal complication, occurring in 8.5% of subjects. Irritant contact dermatitis, occurring in 15.5%, was the most common peristomal complication. Gender and body mass index were associated with irritant contact dermatitis, hyperplasia, peristomal hernias, flat stomas, and retracted stomas. CONCLUSIONS Education for preventing irritant contact dermatitis, such as proper pouching and peristomal skin protection, and for weight control, should be emphasized in a self-care program for persons living with an ostomy. Preoperative marking by a WOC nurse is needed to reduce the prevalence of flat (flush) stomas.

Gender Difference in Risk Factors for Depression in Community-dwelling Elders

PURPOSE This study was conducted to compare the degree of depression between men and women and to identify factors influencing their depression. METHODS Participants in this cross-sectional descriptive study were 263 persons over 65 years old (men: 103, women: 160). Data were collected through face to face interviews using questionnaires and were done in two urban areas in 2010. Research instruments utilized in this study were SGDS, MMSE-K, SRH, FILE, sleep pattern scale, family and friend support scale, and social support scale. Multivariate regression analysis was performed to identify factors influencing depression in elders. RESULTS The proportions of participants with depression were significantly different between men and women (52.4% vs. 67.5%). Regression model for depression in elderly men significantly accounted for 54%; disease stress (32%), economic stress (10%), perceived health status (4%), and family support, educational level, age, and hypertension. Regression model for depression in elderly women significantly accounted for 47%; disease stress (25%), perceived social loneliness (8%), friend support (5%), family stress (4%), and sleep satisfaction, and family support. CONCLUSION Results demonstrate that depression is an important health problem for elders, and show gender differences for factors influencing depression. These results could be used in the developing depression prevention programs.

Comparison of Job Stress, Hardness, and Burnout of Nurses between Advanced general Hospitals and general Hospitals

This study was conducted to compare nurses` job stress, hardness and burnout between general hospitals and advanced general hospitals. Data were obtained through structured questionnaires from 394 nurses(general 198, upgrade general 196) in the C and S city between April and May, 2010. Data analysis was done with independent t test, ANCOVA, ANOVA, Scheffe & Eacute test and Pearson correlation coefficient with SPSS WIN v 17.0. Job stress, hardness, and burnout of nurses in general hospitals were 2.45, 2.11 and 3.70 respectively. Those in advanced general hospitals were 2.69, 2.70 and 3.70 respectively. Job stress and hardness were significantly higher in general hospitals. There was no significant difference of burnout between general and advanced general hospitals. Burnout of nurses in both hospitals was positively correlated with job stress and negatively correlated with hardness. Further studies are necessary for identify factors influencing job stress of general hospitals. Program for enhancing hardness of nurses in upgrade general hospitals should be developed.

Antimicrobial Activity of a Halocidin-Derived Peptide Resistant to Attacks by Proteases

ABSTRACT Cationic antimicrobial peptides (AMPs) have attracted a great deal of interest as a promising candidate for a novel class of antibiotics that might effectively treat recalcitrant infections caused by a variety of microbes that are resistant to currently available drugs. However, the AMPs are inherently limited in that they are inevitably susceptible to attacks by proteases generated by human and pathogenic microbes; this vulnerability severely hinders their pharmaceutical use in human therapeutic protocols. In this study, we report that a halocidin-derived AMP, designated HG1, was found to be resistant to proteolytic degradation. As a result of its unique structural features, HG1 proved capable of preserving its antimicrobial activity after incubation with trypsin, chymotrypsin, and human matrix metalloprotease 7 (MMP-7). Additionally, HG1 was observed to exhibit profound antimicrobial activity in the presence of fluid from human skin wounds or proteins extracted from the culture supernatants of Staphylococcus aureus and Pseudomonas aeruginosa. Greater understanding of the structural motifs of HG1 required for its protease resistance might provide feasible ways to solve the problems intrinsic to the development of an AMP-based antibiotic.

Clinical Misconduct Among South Korean Nursing Students

This study examines the extent and predictors of unethical clinical behaviors among nursing students in South Korea. From survey data of 345 undergraduate nursing students, unethical clinical behaviors were examined with respect to 11 individual characteristics, frequency and perceived seriousness of classroom cheating, two factors of individual attitude, and four contextual factors. Qualitative data from two focus group interviews were analyzed to explore reasons for and contexts of unethical clinical behaviors. About sixty-six percent of the participants engaged in one or more unethical clinical behaviors over a one-semester period. The prevalence of such behaviors varied widely from 1.7% to 40.9% and was related to the type of nursing program, the number of clinical practicum semesters completed, ethical attitudes toward cheating behaviors, the frequency of cheating on assignments, the frequency of cheating on exams, the perceived prevalence of cheating by peers, and prior knowledge of academic integrity. According to the regression analysis, the last four variables explained 29.4% of the variance in the prevalence of unethical clinical behaviors. In addition, multiple reasons and possible interventions for clinical misconduct were reported during the focus group interviews. Unlike cheating in the classroom, clinical misconduct was strongly induced by clinical nurses and poor clinical practice environments. In sum, unethical clinical behaviors were widespread among the participants and need to be corrected.

Therapeutic Efficacy of Halocidin-Derived Peptide HG1 in a Mouse Model of Surgical Wound Infection with Methicillin-Resistant Staphylococcus aureus

ABSTRACT We evaluated the therapeutic potential of HG1, an antimicrobial peptide, as a novel topical antibiotic by the use of a mouse surgical wound model of infection with methicillin-resistant Staphylococcus aureus. First, we attempted to determine whether or not HG1 infiltrated into the dermis when topically administered. Second, we evaluated the antibiotic effects of HG1 on skin infection via bacterial-enumeration and microscopic analyses. The results showed that topically administered HG1 was capable of penetrating into the dermis at the infection site, where it exerted its antimicrobial effects.

Characterization of Kunitz-type protease inhibitor purified from hemolymph of Galleria mellonella larvae.

We characterized a Kunitz-type protease inhibitor (Gm KTPI) obtained from the hemolymph of Galleria mellonella larvae immunized with Escherichia coli. The structural analysis of the cloned cDNA showed that it consists of 56 residues derived from the precursor of 75 amino acids. The peptide was constitutively produced in the fat bodies, but not in the midgut nor the integument of larvae. In our analysis of stage-dependent expression, its transcript was detected within the midgut, the fat bodies and the integument of the prepupae, which undergo tissue remodeling. The inhibition assays showed that Gm KTPI was capable of inhibiting only the trypsin-like activity of the larval midgut extracts. Furthermore, it was determined that Gm KTPI induced the activation of extracellular signal-regulated kinase (ERK) in the fat bodies and integument cells, and this kinase is known to perform a central role in cell proliferation signaling. Its effect on ERK activation was also verified in a control experiment using a human endothelial cell culture. Collectively, it was suggested that Gm KTPI might be responsible for the protection of other tissues against proteolytic attack by trypsin-like protease(s) from larval midgut during metamorphosis, and might play a role in the proliferation of cells in the fat body and integument.

Dietary Nutrient and Food Intake and Their Relations with Serum Heavy Metals in Osteopenic and Osteoporotic Patients

Several studies have reported that heavy metals have a relation with osteoporosis and osteoporotic fractures. In this study, we investigated the association between heavy metal exposure status, as assessed by serum major heavy metals such as lead (Pb), cadmium (Cd), and mercury (Hg) and bone mineral density (BMD) status among Korean adults. A total of 64 adults participated in this study and were assigned to one of three study groups based on the T-score of spine BMD: a normal group (n = 21, T-score > -1), osteopenia group (n = 29, -2.5 < T-score ≤ -1) and osteoporosis group (n = 14, T-score ≤ -2.5). We also assessed serum levels of heavy metals (Pb, Cd and Hg) by using atomic absorption spectrometer (AAS) and daily nutrient and food intakes for 3 days by using 24-hr recall method in the subjects. The mean age was significantly higher in the osteoporosis group compared with the osteopenia and normal groups (p < 0.001). There was no significant difference in serum levels of Pb, Cd and Hg among the three groups after adjusting for age. Daily intakes of energy, nutrients were not significantly different among the three groups. The osteoporosis group consumed significantly higher fish and shellfish than the other groups (p < 0.05). In the correlation analysis controlling for age, sex, BMI, and BMD status, the serum Cd level was significantly negatively correlated with intake of cereals, milks and total food. In summary, we did not find a direct association between serum heavy metal levels and BMD status. However, negative relationships were found between serum heavy metal levels and intake of some foods.

Comparison of Standardized Peristomal Skin Care and Crusting Technique in Prevention of Peristomal Skin Problems in Ostomy Patients

PURPOSE This study was performed to compare the effects of standardized peristomal skin care (SPSC) and crusting technique (CT) on the peristomal skin of ostomates. SPSC was developed by a consensus among the expert group based on a comprehensive review of the relevant literature and hospital protocols. METHODS A randomized controlled pilot trial with 2 parallel arms was used. A total of 81 ostomates, who were recruited from a tertiary hospital, completed the baseline, 1-month, 2-month, and 3-month follow-up (SPSC group, n=45; CT group, n=36). SPSC consisted of water cleansing and direct application of ostomy appliances. CT involved crusting hydrocolloid powder and patting with water sponge or protective barrier liquid film. The outcomes of the study were assessed by skin problems, such as discoloration, erosion and tissue overgrowth; the domains of the evaluation tool used in examining the peristomal skin. A generalized estimating equation model was used to examine the effects according to time and group. RESULTS In both SPSC and CT groups, the likelihood of occurrence of discoloration (OR, 1.99; 95% CI, 1.61-2.46), erosion (OR, 1.87; 95% CI, 1.55-2.25) and tissue enlargement (OR, 1.94; 95% CI, 1.36-2.77) increased with time. There was no significant difference in discoloration between the groups, whereas the probability of erosion (OR, 0.38; 95% CI, 0.16-0.89) and tissue overgrowth (OR, 0.09; 95% CI, 0.02-0.55) was lower in the SPSC group than in CT group. CONCLUSION SPSC was sufficient in preventing peristomal skin problems of ostomates compared to the CT.