Association between registered nurse staffing levels and in-hospital mortality in craniotomy patients using Korean National Health Insurance data

The level of registered nurse (RN) staffing is a fundamental factor influencing patient safety. Craniotomy patients need intensive care after surgery, the majority of which is provided by RNs. This study was conducted to investigate the relationship of the RN staffing level of general wards and intensive care units (ICUs) with in-hospital mortality after craniotomy using Korean National Health Insurance claim data. The RN staffing level was categorized based on the bed-to-RN ratio. The in-hospital mortality rate of craniotomy patients was elevated at hospitals with a high bed-to-RN ratio in general wards, ICUs, and hospitals overall. It was determined that in-hospital mortality of craniotomy patients could be decreased by more than 50% by reducing the bed-to-RN ratio from 4.5 or more to less than 3.5 in general wards, from 1.25 or more to less than 0.88 in ICUs, and from 2.5 or more to less than 1.67 in hospitals overall. Since the RN staffing level is related to the in-hospital mortality rate of craniotomy patients, a sufficient staffing level of RNs should be ensured to reduce the mortality of craniotomy patients.This study was supported by the Basic Science Research Program through National Research Foundation of Korea (NRF) funded by the Ministry of Education in 2017 (grant number: 2017R1D1A1B03033771). The funder was not involved in conducting this study and did not play any role in the design of the study, the collection, analysis, and writing of the manuscript

Effects of a newborn care education program using ubiquitous learning on exclusive breastfeeding and maternal role confidence of first-time mothers in Vietnam: a quasi-experimental study

Purpose This study aimed to examine the effect of a newborn care education program using ubiquitous learning (UL-NCEP) on exclusive breastfeeding and maternal role confidence of first-time mothers in Vietnam. Methods This quasi-experimental study with a nonequivalent control group design was conducted at a university hospital in Hue city, Vietnam, between June and July 2018. Eligible first-time mothers were conveniently allocated to the experimental (n=27) and the control group (n=25). Mothers in the control group received only routine care, whereas mothers in the experimental group received UL-NCEP through tablet personal computers in addition to routine care in the hospital. Then, the educational content was provided to mothers by their smartphone for reviewing at home. UL-NCEP was developed based on the World Health Organization’s “Essential Newborn Care Course” guidelines. The exclusive breastfeeding rate and maternal role confidence level after birth and at 4 weeks postpartum were assessed in both groups to assess the effect of UL-NCEP. Results At 4 weeks postpartum, the experimental group showed a significantly higher level than the control, for exclusive breastfeeding rate (p<.05) as well as mean maternal role confidence (p<.05). Conclusion UL-NCEP was a feasible and effective intervention in increasing first-time Vietnamese mothers’ exclusive breastfeeding rate and maternal role confidence level. This program may be integrated into routine care for postpartum mothers to promote mother and infant health among first-time mothers in Vietnam

A Survey on the Educational Needs and Competence of Nurses in Maternal Fetal Intensive Care Unit

PURPOSE: Maternal Fetal Intensive Care Unit (MFICU), which provides intensive care to high-risk mothers with increasing maternal age and high-risk newborns, has become a new field of nursing work in South Korea. The present study was conducted to identify the educational needs and self-assessing clinical competence of nurses in MFICU. METHODS: The education needs and competencies of MFICU nurses were measured through prepared questionnaires by researchers based on the previous studies on job analysis of nurses in MFICU. Data were collected from January 2019 to March 2019. The study involved 168 nurses working in MFICUs at 12 hospitals nationwide as study subjects. The data were analyzed using the SPSS WIN 23.0 program. RESULTS: The education needs of nurses in MFICU had an average of 4.21 points (±0.50) and their nursing competence was average 3.38 points (±0.60). The items reported as high education needs but low competency by nurses in MFICU were as following: ‘postpartum hemorrhage and shock,’ ‘cardiopulmonary resuscitation (CPR) for neonate,’ ‘CPR during pregnancy,’ ‘disseminated intravascular coagulation,’ ‘sepsis,’ and ‘mechanical ventilation during pregnancy.’ CONCLUSION: Based on these results, it is proposed that a comprehensive education program for nurses in MFICU should be developed by considering low capabilities among MFICU nurses as a priority factor

4-Isopropyl-2,6-bis(1-phenylethyl)aniline 1, an Analogue of KTH-13 Isolated from Cordyceps bassiana

The Cordyceps species has been a good source of compounds with anticancer and anti-inflammatory activities. Recently, we reported a novel compound (4-isopropyl-2,6-bis(1-phenylethyl)phenol, KTH-13) with anticancer activity isolated from Cordyceps bassiana and created several derivatives to increase its pharmacological activity. In this study, we tested one of the KTH-013 derivatives, 4-isopropyl-2,6-bis(1-phenylethyl)aniline 1 (KTH-13-AD1), with regard to anti-inflammatory activity under macrophage-mediated inflammatory conditions. KTH-13-AD1 clearly suppressed the production of nitric oxide (NO) and reactive oxygen species (ROS) in lipopolysaccharide (LPS) and sodium nitroprusside- (SNP-) treated macrophage-like cells (RAW264.7 cells). Similarly, this compound also reduced mRNA expression of inducible NO synthase (iNOS) and tumor necrosis factor-α (TNF-α), as analyzed by RT-PCR and real-time PCR. Interestingly, KTH-13-AD1 strongly diminished NF-κB-mediated luciferase activities and nuclear translocation of NF-κB family proteins. In accordance, KTH-13-AD1 suppressed the upstream signaling pathway of NF-κB activation, including IκBα, IKKα/β, AKT, p85/PI3K, and Src in a time- and dose-dependent manner. The autophosphorylation of Src and NF-κB observed during the overexpression of Src was also suppressed by KTH-13-AD1. These results strongly suggest that KTH-13-AD1 has strong anti-inflammatory features mediated by suppression of the Src/NF-κB regulatory loop

Physicochemical factors that affect electroporation of lung cancer and normal cell lines

Electroporation is used for cancer therapy to efficiently destroy cancer tissues by transferring anticancer drugs into cancer cells or by irreversible tumor ablation without resealing pores. There is growing interest in the electroporation method for the treatment of lung cancer, which has the highest mortality rate among cancers. Improving the cancer cell selectivity has the potential to expand its use. However, the factors that influence the cell selectivity of electroporation are debatable. We aimed to identify the important factors that influence the efficiency of electroporation in lung cells. The electropermeabilization of lung cancer cells (H460, A549, and HCC1588) and normal lung cells (MRCS, WI26 and L132) was evaluated by the transfer of fluorescence dyes. We found that membrane permeabilization increased as cell size, membrane stiffness, resting transmembrane potential, and lipid cholesterol ratio increased. Among them, lipid composition was found to be the most relevant factor in the electroporation of lung cells. Our results provide insight into the differences between lung cancer cells and normal lung cells and provide a basis for enhancing the sensitivity of lung cancers cells to electroporation. (C) 2019 Elsevier Inc. All rights reserved.N

Impact of Nurse&ndash;Physician Collaboration, Moral Distress, and Professional Autonomy on Job Satisfaction among Nurses Acting as Physician Assistants

Although there is considerable literature on job satisfaction among nurses in various settings, there is little research about contributing factors, including moral distress to job satisfaction among a certain group of nurses, such as nurses acting as physician assistants. The purpose of this study was to verify the impact of nurse&ndash;physician collaboration, moral distress, and professional autonomy on job satisfaction among nurses acting as physician assistants. Descriptive and correlational research was conducted on a convenience sample of 130 nurses from five general hospitals in South Korea. In the final regression model, the adjusted R square was significant, explaining 38.2% of the variance of job satisfaction (F = 8.303, p &lt; 0.001), where &lsquo;cooperativeness&rsquo; (&beta; = 0.469, p = 0.001) from nurse&ndash;physician collaboration, &lsquo;institutional and contextual factor&rsquo; from moral distress (&beta; = &minus;0.292, p = 0.014), and professional autonomy (&beta; = 0.247, p = 0.015) were included. In hospital environments, a more cooperative inter-professional relationship between nurses and physicians led to less moral distress caused by organisational constraints. A higher level of professional autonomy among nurses acting as physician assistants is required to increase their job satisfaction

Relationship between Anemia and Falls among Postmenopausal Women in Korea

This study was conducted to explore the relationship between anemia and falls in postmenopausal women. The relationships between energy, protein, iron, and vitamin C intake were also checked. The data of this study are a combination of data from the Korea National Health and Nutrition Examination Survey (KNHANES) collected from the KNHANES VI-2,3 (2014&ndash;2015) and VII-1,2,3 (2016&ndash;2018). Falls and anemia were compared according to the subjects&rsquo; characteristics. Phi and Cramer&rsquo;s V coefficient were applied to find the strength of association. Energy, protein, iron, and vitamin C intake and anemia were investigated. The relationship between the status as anemic and the occurrence of falls was analyzed using binary logistic regression. Of the 6665 subjects, 274 had a fall, and 596 had anemia. If the energy intake did not meet the estimated energy requirements, the state of anemia was significantly higher with a weak association. When protein, iron, and vitamin C did not meet the recommended nutrient intake, the anemia state was considerably higher with a weak to moderate association. Postmenopausal women with anemia were more likely to fall than subjects without anemia (OR = 1.88, p = 0.003). Additionally, anemia was confirmed to be related to insufficient energy, protein, iron, and vitamin C intake

Retention Rates and the Associated Risk Factors of Turnover among Newly Hired Nurses at South Korean Hospitals: A Retrospective Cohort Study

This retrospective cohort study analyzed the turnover rate and the risk factors of turnover among newly hired nurses at tertiary and secondary hospitals in South Korea. Using National Health Insurance Service data, this study created a cohort of 21,050 newly hired nurses across 304 hospitals in 2018, with a follow-up period of 18 months. Retention and turnover risk factors were analyzed at 6-month intervals. Differences in retention period according to hospitals’ organizational characteristics and nurses’ individual characteristics were analyzed using the chi-squared test. The likelihood of staying at work was analyzed using Kaplan–Meier survival curves with the log-rank test, and the hazard ratios of turnover at each retention period were analyzed using multilevel Cox proportional hazards analysis. The turnover rate of newly hired nurses within 1 year of employment was 26.4%, with 20.1% resigning within 6 months, and 6.3% resigning between 7 and 12 months. For all retention periods, turnover risk was associated with a higher bed-to-nurse ratio and older age. Higher standardized monthly income was associated with lower turnover between 13 and 18 months. Hospitals should develop nurse-retention strategies that consider risk factors for turnover. To reduce turnover, adequate nursing personnel should be maintained and fair compensation should be offered