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Ways of interdisciplinary approaches to advocating for nursing home residents with dementia

JOURNAl OF ADVANCED NURSING 2025年第1期81卷 463-474页

作者： Kim, Dayeong Hong, Youjung Chang, Sung Ok Korea Univ Coll Nursing 145 Anam Ro Seoul 02841 South Korea Korea Univ L HOPE Program Community Based Total Learning Hlth Seoul South Korea

AimTo explore how nursing home staff advocate for residents with *** qualitative *** nursing home staff from four disciplines (six nurses, four physical therapists, five social workers and five care workers) were purposively recruited from three different nursing homes. Data were collected through semi-structured interviews conducted from February 2023 to March 2023, and the analysis followed the sequential steps of phenomenographic *** analysis identified five categories of description: focusing on what happened, finding the gaps in perspectives, how to bridge for finding a common perspective, how to tailor care such that each resident receives equitable care and how to establish interdisciplinary sharing for a consistent advocative pattern. Their structural relationship was also identified as an outcome *** cyclical advocacy structure illustrated that nursing home staff engage in an ongoing process of advocacy during conflict situations as part of interdisciplinary care, emphasizing continuity of care rather than separate occurrences of *** for the ProfessionThis study revealed that, in advocating for residents with dementia, nursing home staff adopted an approach that fosters consistent care and proactive prevention, achieved through the formation of shared knowledge applicable uniformly across similar *** study contributes significantly to the continuing education or training of interdisciplinary staff in nursing homes. The revelations of the study hold significance not only for the practical application but also for the theoretical advancement of concepts related to safeguarding the dignity, human rights and personhood of residents with dementia, with the ultimate goal of enhancing their quality of life within nursing *** MethodReporting complied with the COREQ criteria for qualitative *** or Public ContributionNursing home dir

关键词： advocacy dementia interdisciplinary care nursing homes phenomenography

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How Nursing Home Nurses Who Care for Residents With Dementia Experience the Moral Distress? A Phenomenography Study

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NURSING OPEN 2025年第3期12卷 e70171页

作者： Kim, Eun Young lee, Ye-Na Chang, Sung Ok Soonchunhyang Univ Dept Nursing Cheonan South Korea Univ Suwon Dept Nursing Hwaseong South Korea Korea Univ Coll Nursing Seoul South Korea Korea Univ L HOPE Program Community Based Total Learning Hlth Seoul South Korea

Aim: Exploring how nursing home nurses who care for residents with dementia experience moral distress. Design: A qualitative phenomenography design. Methods: Phenomenography was used in this qualitative study. In-depth interviews were conducted with 20 nurses caring for residents with dementia at three nursing homes using phenomenographic analysis. Results: Six categories were divided into two groups. The 'reflection on my nursing' group included the categories 'anguish over qualifications to care for residents', 'uncertainty about the adequacy of the care provided', and 'internal conflict over whether to compromise with unsatisfactory outcomes'. The 'moral awareness' group included 'being aware of deviations from the standards I set and the care I provide', 'recognising when I become insensitive to things I should not do', and 'ruminating about whether it would be okay if I have no choice'. Comprehensively, it was found that moral distress occurs when reflecting on nursing and moral awareness conflicts. Conclusion: This study provides insight into the various ways in which nursing home nurses experience moral distress when caring for residents with dementia. This study can provide a basis and direction for various strategies to reduce moral distress. Implication for the Profession and/or Patient Care: Considering the growing interest in the moral distress experienced by nurses, along with the importance of the human rights of residents with dementia in an aging society, these research results will have a positive impact on improving the quality of care provided by nursing home nurses to residents with dementia. Patient or Public Contribution: No patient or public contribution. Reporting Method: We have adhered to relevant COREQ guidelines.

关键词： dementia morals nurses nursing homes qualitative research

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lessons from national biobank projects utilizing whole-genome sequencing for population-scale genomics

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Genomics and Informatics 2025年第1期23卷 1-16页

作者： lee, Hyeji Kim, Wooheon Kwon, Nahyeon Kim, Chanhee Kim, Sungmin An, Joon-Yong Department of Integrated Biomedical and Life Science Korea University Seoul 02841 South Korea L-HOPE Program for Community-Based Total Learning Health Systems Korea University Seoul 02841 South Korea School of Biosystem and Biomedical Science College of Health Science Korea University Seoul 02841 South Korea Division of Genome Science Department of Precision Medicine National Institute of Health Cheongju 28159 South Korea

large-scale national biobank projects utilizing whole-genome sequencing have emerged as transformative resources for understanding human genetic variation and its relationship to health and disease. These initiatives, which include the UK Biobank, All of Us Research program, Singapore’s PRECISE, Biobank Japan, and the National Project of Bio-Big Data of Korea, are generating unprecedented volumes of high-resolution genomic data integrated with comprehensive phenotypic, environmental, and clinical information. This review examines the methodologies, contributions, and challenges of major WGS-based national genome projects worldwide. We first discuss the landscape of national biobank initiatives, highlighting their distinct approaches to data collection, participant recruitment, and phenotype characterization. We then introduce recent technological advances that enable efficient processing and analysis of large-scale WGS data, including improvements in variant calling algorithms, innovative methods for creating multi-sample VCFs, optimized data storage formats, and cloud-based computing solutions. The review synthesizes key discoveries from these projects, particularly in identifying expression quantitative trait loci and rare variants associated with complex diseases. Our review introduces the latest findings from the National Project of Bio-Big Data of Korea, which has advanced our understanding of population-specific genetic variation and rare diseases in Korean and East Asian populations. Finally, we discuss future directions and challenges in maximizing the impact of these resources on precision medicine and global health equity. This comprehensive examination demonstrates how large-scale national genome projects are revolutionizing genetic research and healthcare delivery while highlighting the importance of continued investment in diverse, population-specific genomic resources. © The Author(s) 2025.

关键词： Biobank Multi-omics integration Population genetics Precision medicine Whole-genome sequencing

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Differences in Mental health Symptoms and Inequities in Mental health Service Use Among Black and White Populations and Asian and latine Subpopulations

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JOURNAl OF GENERAl INTERNAl MEDICINE 2025年第3期40卷 569-578页

作者： Park, Sungchul Alegria, Margarita Bustamante, Arturo Vargas Chen, Jie Fung, Vicki Ortega, Alexander N. Korea Univ Coll Hlth Sci Dept Hlth Policy & Management Seoul South Korea Korea Univ L HOPE Program Community Based Total Learning Hlth 145 Anam Ro Seoul 02841 South Korea Massachusetts Gen Hosp Dispar Res Unit Boston MA USA Harvard Med Sch Dept Med Boston MA USA Harvard Med Sch Dept Psychiat Boston MA USA UCLA Dept Hlth Policy & Management Fielding Sch Publ Hlth Los Angeles CA USA UCLA Latino Policy & Polit Inst Los Angeles CA USA Univ Maryland Sch Publ Hlth Dept Hlth Policy & Management College Pk MD USA Massachusetts Gen Hosp Mongan Inst Hlth Policy Res Ctr Boston MA USA Univ Hawaii Manoa Thompson Sch Social Work & Publ Hlth Honolulu HI USA

BackgroundWhile studies have observed mental health inequities across aggregated Asian and latine populations, a critical gap exists in our understanding of inequities within and across Asian and latine *** examined the prevalence of mental health symptoms and variations in mental health service use across Black and White populations and Asian and latine subpopulations at a more granular *** conducted a cross-sectional study using data from the 2016-2021 Medical Expenditure Panel Survey. Outcomes included mental health symptoms (mild and serious) and mental health service use (outpatient mental health visits and psychotropic medication fills). The primary independent variable was the category of 13 racial/ethnic groups: Black and non-latine White individuals and Asian (Asian Indian, Chinese, Filipino, and Other Asian) and latine (Central/South American, Cuban, Dominican, Mexican, Other latine, and Puerto Rican) subpopulation *** found modest differences in mental health symptoms by race/ethnicity. However, significant differences were observed in mental health service use among individuals with mental health symptoms. These differences were pronounced across Asian subpopulations with serious mental health symptoms. The likelihood of having any outpatient mental health visit was lower among Asian Indian (- 12.2 percentage points [95% CI - 18.2, - 6.2], Chinese (- 11.7 [- 21.6, - 1.7]), and Filipino individuals (- 16.1 [- 22.5, - 9.8]) than White individuals. The likelihood of having psychotropic medication fill was lower among Asian Indian (- 23.3 [- 34, - 12.7]), Chinese (- 19.8 [- 30.7, - 8.9]), Filipino (- 27.6 [- 40.2, - 14.9]), and other Asian individuals (- 22.5 [- 29.4, - 15.6]) than White individuals. On the other hand, some of these differences were observed in certain latine subpopulations but not in *** is a heterogeneity in inequities in mental health service use among Asian and lati

关键词： mental health symptoms mental health service use Asian latine race and ethnicity health disparity

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How Nursing Home Professionals Frame the Perspective on Residents' Safety Management: A Q-Methodology Approach

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JOURNAl OF ADVANCED NURSING 2024年第0期 2024 Dec 26页

作者： Hong, You Jung Chang, Sung Ok Korea Univ Coll Nursing L HOPE Program Community Based Total Learning Hlth Seoul South Korea

AimTo identify a frame of reference for resident safety management in nursing *** study was conducted using Q-methodology to identify shared perspectives about resident safety management among nursing home professionals. Data were collected from 13 May 2023, through 29 August 2023. Thirty-four professionals, including nurses, care workers, social workers and physical therapists, classified Q-samples into a normal distribution grid through Q-sorting. Data analysis was performed using the PQmethod programme. Q-factors were interpreted by integrating interview transcripts, demographic data and factor arrays that organised the analysis *** analysis included the Q-sort of 33 professionals, with an average age of 46.03 years and 6.53 years of nursing home experience, after excluding one individual who did not fit any Q-factor. Four Q factors explaining 63% of the total variance were identified: constructing individualised possible risk trajectories, utilising ingrained safety principles, creating supportive safety environments and coordinating safety principles with individual *** the diverse subjectivities of professionals can help develop strategies that promote collaboration among nursing home professionals and support preventive safety management *** for Profession and/or Patient CareThe frame of reference derived from nursing home professionals' perspectives suggests a resident-tailored *** study supports the development of interprofessional education tailored to the specific needs of nursing home settings by identifying shared perspectives among nursing home professionals. The findings highlight the need for clear guidelines to help professionals balance resident autonomy with safety and assess the impact of family *** MethodReporting involved qualitative and quantitative approaches, in compliance with the MMAT criteria for mixed-method re

关键词： nursing homes Q-methodology safety subjectivity

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Per- and polyfluoroalkyl substances exposures are associated with non-alcoholic fatty liver disease, particularly fibrosis

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ENVIRONMENTAl POllUTION 2025年 372卷 126085页

作者： Hwang, Se-Hyun Choi, Yun-Hee Huh, Da-An Kim, lita Park, Kangyeon lee, Jiyoun Choi, Hyeon Jeong lim, Woohyun Moon, Kyong Whan Baylor Univ Dept Environm Sci Waco TX USA Korea Univ Res Inst Inflammat Coll Med Seoul 02841 South Korea Korea Univ Sch Hlth & Environm Sci Seoul 02841 South Korea Korea Univ Inst Hlth Sci Anam Ro 145 Seoul 02841 South Korea Korea Univ Grad Sch Dept Hlth & Safety Convergence Sci Seoul 02841 South Korea L HOPE Program Community Based Total Learning Hlth Seoul South Korea Wonkwang Univ Dept Safety & Hlth Iksan 54538 South Korea

Per- and polyfluoroalkyl substances (PFAS) have been reported to exert hepatotoxic effects;however, their impact on nonalcoholic fatty liver disease (NAFlD) remains unclear. This study aimed to investigate the association between PFAS exposure and NAFlD in Korean adults, thereby contributing to the generalization of PFAS's hepatotoxic effects. Using data from the 2018-2020 Korean National Environmental health Survey (KoNEHS), we analyzed 2635 Korean adults. PFAS exposure levels were estimated based on the serum concentrations of five PFAS. NAFlD was assessed using two steatosis-related indices (hepatic steatosis index [HSI] and fatty liver index [FlI]) and two fibrosis-related indices (fibrosis-4 index [FIB-4] and aspartate aminotransferase to platelet ratio index [APRI]). The models included these indices as continuous and dichotomous variables, the latter based on diagnostic criteria from previous studies. Associations with PFAS exposure were examined using multiple linear regression and robust Poisson regression models. Positive associations were observed between PFAS exposure and three of the four continuous indices, excluding the FlI, as well as the prevalence of NAFlD diagnosed using these indices. Specifically, the HSI showed a significant association only with perfluorononanoic acid, whereas fibrosis-related indices (FIB-4 and APRI) were significantly associated with all five individual PFAS. The associations were stronger in female and non-obese groups when stratified by sex and obesity status. The results of the Bayesian kernel machine regression analysis evaluating the health effects of PFAS mixtures indicated an association between PFAS mixtures and NAFlD, particularly fibrosis-related indices. Additionally, significant associations with NAFlD indices were mostly observed in females and non-obese groups, supporting the findings from the individual PFAS exposure analyses. Our findings suggest that PFAS are associated with NAFlD, particularly for fibrosis.

关键词： Bayesian kernel machine regression (BKMR) Korean National Environmental health Survey (KoNEHS) liver steatosis liver fibrosis Non-alcoholic fatty liver disease (NAFlD) Per-and polyfluoroalkyl substances (PFAS)

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Dietary exposure to environmental phenols and phthalates in Korean adults: data analysis of the Korean National Environmental health Survey (KoNEHS) 2018–2020

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International Journal of Hygiene and Environmental health 2025年 267卷 114597-114597页

作者： Kim, lita Huh, Da-An Park, Kangyeon lee, Jiyoun Hwang, Se-Hyun Choi, Hyeon Jeong lim, Woohyun Moon, Kyong Whan Department of Health and Safety Convergence Science Graduate School Korea University Seoul South Korea L-HOPE Program for Community-Based Total Learning Health Systems South Korea Institute of Health Sciences Korea University Seoul South Korea Department of Environmental Science Baylor University Waco TX USA School of Health and Environmental Science Korea University Seoul South Korea

AbstractEnvironmental phenols and phthalates, endocrine-disrupting chemicals, are linked to dietary intake, highlighting the need to identify sources to prevent exposure-related diseases. This study investigates dietary patterns associated with urinary concentrations of environmental phenols and phthalate metabolites in Korean adults using data from 4201 adults in the Korean National Environmental health Survey Cycle 4 (2018–2020). Exploratory factor analysis identified three dietary patterns: Western-style, traditional Korean, and seafood-rich. We analyzed metabolites with a ≥80 % detection rate, specifically environmental phenols (BPA, BPF, BPS, TCS, MP, EP, BP) and phthalates (MEHHP, MEOHP, MnBP, MECPP, MBzP, MCPP, MEP, MMP). The Western-style or processed food diet showed a significant negative association with MP (β [95 % CI] = −0.14 [−0.24, −0.03]), but no positive association. The traditional Korean diet showed significant positive associations with TCS (β [95 % CI] = 0.09 [0.02, 0.15]), EP (β [95 % CI] = 0.08 [0.01, 0.16]), BP (β [95 % CI] = 0.09 [0.05, 0.12]), MEHHP (β [95 % CI] = 0.04 [0.003, 0.08]), MECPP (β [95 % CI] = 0.06 [0.02, 0.09]), and MMP (β [95 % CI] = 0.11 [0.06, 0.15]). In comparison, it had a significant negative association with BPS (β [95 % CI] = −0.15 [−0.22, −0.09]). The seafood-rich dietary pattern exhibited a significant negative association with BP (β [95 % CI] = −0.07 [−0.11, −0.03]). Certain dietary patterns, including those traditionally regarded as healthy, may be associated with exposure to environmental phenols and phthalates, highlighting the need for further research to understand dietary sources of exposure before drawing implications for public health guidance.

关键词： Environmental health Environmental phenols Food packaging Phthalate Dietary patterns Processed food

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Genomic patterns in the schizophrenia brain

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SCIENCE 2024年第6718期386卷 146-148页

作者： An, Joon-Yong Kim, Yujin Korea Univ Coll Hlth Sci Sch Biosyst & Biomed Sci Seoul South Korea Korea Univ Dept Integrated Biomed & Life Sci Seoul South Korea Korea Univ L HOPE Program Community Based Total Learning Hlth Seoul South Korea

Human germline mutations—genetic changes in an egg or sperm—are inherited, present in every cell, and play roles in early development (1), whereas somatic mutations arise postzygotically and may or may not affect developmental trajectories. Neurons accumulate hundreds to thousands of somatic mutations throughout development, with distinct mutational processes and rates occurring at various developmental stages (2). Whole-genome sequencing studies characterizing somatic mosaicism in early human brain development indicate that the mutation rate is relatively low during early pregastrulation (the first 2 weeks after fertilization) but increases substantially during late neurogenesis in the prenatal period (starting at 22 weeks of gestation), primarily owing to oxidative damage (3). On page 217 of this issue, Maury et al. (4) report that somatic mutations in the brains of individuals with schizophrenia occurred during neogenesis . This suggests that intrauterine factors might influence mutational mechanisms and brain development in utero.

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Patient-Provider Communication and Access, Use, and Financial Burden of Care

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AMERICAN JOURNAl OF PREVENTIVE MEDICINE 2024年第5期67卷 740-745页

作者： Park, Sungchul Kim, David D. Korea Univ Coll Hlth Sci Dept Hlth Policy & Management Seoul South Korea Korea Univ L HOPE Program Community Based Total Learning Hlth Seoul South Korea Univ Chicago Dept Med & Publ Hlth Sci Div Biol Sci 5841 S Maryland Ave Chicago IL 60637 USA

Introduction: Effective patient-provider communication is a critical component of optimal patient care, but its potential impact on the delivery of healthcare services remains unclear. This study examines the association of patient-provider communication with access to care, healthcare utilization, and fi nancial burden of care. Methods: Using the 2013-2021 Medical Expenditure Panel Survey longitudinal data, the level of patient-provider communication was measured across four domains (attentive listening, clear explanation, respectfulness, and time allocation) as a primary independent variable, categorized into low, moderate, and high. A lagged dependent model was employed to examine the associations of patient-provider communication at baseline with subsequent access to care, healthcare utilization, and fi nancial burden of care, controlling for baseline sample characteristics and outcomes measured at the baseline. Analysis was conducted in February 2024. Results: Among 28,955 analytic samples (representing 709,547,678 U.S. adults), 5.3%, 50.2%, and 44.3% reported low, moderate, and high levels of patient-provider communication. Marginalized populations, including racial/ethnic minorities, those with low education and income, and those lacking insurance, were more likely to report low patient-provider communication. Compared with adults with high patient-provider communication, those with low patient-provider communication were more likely to encounter difficulties in accessing medical care (2.6 percentage points;95% CI: 1.2-3.9), experience delays in obtaining necessary medical care (2.8 percentage points;1.3-4.4), have emergency room visits (4.2 percentage points;1.9-6.4), and face difficulties paying medical bills (4.0 percentage points;2.2-5.8) in the subsequent year. Conclusions: Encouraging effective patient-provider communication is essential for advancing patient-centered care and mitigating health inequities. Am J Prev Med 2024;67(5):740-745. (c) 2024 Else

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How do nurses advocate for the remaining time of nursing home residents? A critical discourse analysis

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INTERNATIONAl JOURNAl OF NURSING STUDIES 2024年 156卷 104807页

作者： Kim, Dayeong Chang, Sung Ok Korea Univ Coll Nursing 145 Anam Ro Seoul 02841 South Korea Korea Univ L HOPE Program Community Based Total Learning Hlth Seoul South Korea

Introduction: Due to the global aging trend, the number of older people who will spend the last years of their lives in nursing homes is increasing. However, nursing homes have long confronted negative social and public discourses, including stigmas on dementia and life in such facilities. Nevertheless, the remaining time of residents with dementia holds signi ficance, for them and their families, as they seek respect and the ability to make meaningful end -of -life decisions. Objective: To explore how nursing home nurses advocate for the remaining lifetimes of residents with dementia. Design: A qualitative research design. Setting(s): Four nursing homes in Korea from January 2023 to February 2023. Participants: Twenty nurses who provide direct caregiving for residents with dementia and have a minimum of two years' experience in nursing homes were recruited. Methods: This study employed a critical discourse analysis. Twenty interviews conducted with nursing home nurses were examined to explore the connections between the grammatical and lexical aspects of the language used by the nurses to construct their identities as advocates for residents with dementia and the broader sociocultural context. Findings: Four discourses regarding nursing home nurses advocating for the value of life of residents with dementia were identi fied: (1) Bridging perspectives: I am a negotiator between medical treatment and residents' families with differing views;(2) Embracing a shared humanity: Residents are no different from me;they just need professional help;(3) Af firming belongingness: Residents still belong to their families, even when care has been delegated;and (4) Empowering voices for change: We are struggling to provide better care in a challenging reality. Conclusions: This paper highlights the importance of nursing advocacy in safeguarding the remaining time and dignity of individuals with dementia, challenging the stigma surrounding dementia and nursing homes and calling for

关键词： Critical discourse analysis Dementia Nursing advocacy Nursing homes Remaining time

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