Neutrophils are considered to play a central role in ventilator-induced lung injury (VILI). However, the pulmonary consequences of neutrophil accumulation have not been fully elucidated. Matrix metalloproteinase-9 (MMP-9) had been postulated to participate in neutrophil transmigration. The purpose of this study was to investigate the role of MMP-9 in the neutrophilic inflammation of VILI. Male Sprague-Dawley rats were divided into three groups: 1) low tidal volume (LVT), 7 ml/kg of tidal volume (VT); 2) high tidal volume (HVT), 30 ml/kg of VT; and 3) HVT with MMP inhibitor (HVT+MMPI). As a MMPI, CMT-3 was administered daily from 3 days before mechanical ventilation. Degree of VILI was assessed by wet-to-dry weight ratio and acute lung injury (ALI) scores. Neutrophilic inflammation was determined from the neutrophil count in the lung tissue and myeloperoxidase (MPO) activity in the bronchoalveolar lavage fluid (BALF). MMP-9 expression and activity were examined by immunohistochemical staining and gelatinase zymography, respectively. The wet-to-dry weight ratio, ALI score, neutrophil infiltration, and MPO activity were increased significantly in the HVT group. However, in the HVT+MMPI group, pretreatment with MMPI decreased significantly the degree of VILI, as well as neutrophil infiltration and MPO activity. These changes correlated significantly with MMP-9 immunoreactivity and MMP-9 activity. Most outcomes were significantly worse in the HVT+MMPI group compared with the LVT group. In conclusion, VILI mediated by neutrophilic inflammation is closely related to MMP-9 expression and activity. The inhibition of MMP-9 protects against the development of VILI through the downregulation of neutrophil-mediated inflammation.

BackgroundWith the recent growth of multicultural families in the Korean society, the importance of the role of qualified visiting nurses in the delivery of culturally sensitive health care has grown dramatically. As the primary health care provider for multicultural families enrolled in public community-based health care centers, the cultural competence of visiting nurses is an essential qualification for the provision of quality health care for multicultural families, especially in rural areas. Cultural competence of visiting nurses is based on their cultural awareness and empathetic attitude toward multicultural families. This study aimed to examine the levels of cultural competence, empowerment, and empathy in visiting nurses, and to verify the factors that affect the cultural competence of visiting nurses working with rural multicultural families in South Korea.MethodsEmploying a cross-sectional descriptive study design, data from 143 visiting nurses working in rural areas were obtained. Data collection took place between November 2011 and August 2012. The measurement tools included the modified Korean version of the Cultural Awareness Scale, the Text of Items Measuring Empowerment, and the Interpersonal Reactivity Index to measure the level of empathy of visiting nurses. Analyses included descriptive statistics, a t-test, an ANOVA, a Pearson correlation coefficient analysis, and a multiple linear regression analysis.ResultsThe cultural competence score of the visiting nurses was 3.07 on a 5-point Likert scale (SD = 0.30). The multiple regression analysis revealed that the cultural competence of visiting nurses was significantly influenced by experience of cultural education, empathy, and scores on the meaning subscale of the empowerment tool (R2 = 10.2%).ConclusionsInstitutional support to enhance visiting nurses’ empowerment by assuring the significance of their job and specific strategies to enhance their empathy would be helpful to improve the cultural competence of visiting nurses. Additionally, regular systematic education on culturally sensitive care would be helpful to enable visiting nurses to provide culturally sensitive care for multicultural families.

Introduction Poly (ADP-ribose) polymerase (PARP) participates in inflammation by cellular necrosis and the nuclear factor-kappa-B (NF-κB)-dependent transcription. The purpose of this study was to examine the roles of PARP in ventilatorinduced lung injury (VILI) in normal mice lung.

The study results suggest that depression is prevalent in older COPD patients in South Korea. The presence of depression negatively impacts on the HRQoL of the COPD patients. Considering the importance of the relationship between psychological problems and HRQoL in caring for and promoting the welfare of COPD patients, this study provides fundamental information and a basis for further evaluation of this issue in developing and non-developed countries.

Purpose: The purposes of this study were to check the obesity of middle and high school students in the nation and identify factors influencing their obesity. Methods: The present study is a secondary analysis research that obtained permission to use the primitive data of 10th (2014) Online Survey on Adolescents' Health Behaviors by the Korea Centers for Disease Control and Prevention and analyzed the primitive data according to the purposes. Results: The findings show that the BMI of middle and high school students in the nation was 20.7 kg/m 2 with the obesity and non-obesity group recording 27.0 kg/m 2 and 19.9 kg/m 2 , respectively. Factors influencing the obesity of adolescents include gender, grade, educational background of parent, school grades for the last 12 months, satisfaction with sleep, fast food consumption, ramen consumption, intense and muscle exercise three times a week or more, subjective sense of health, stress, suicidal ideation, and hours of Internet usage per week. Conclusion: For the management of adolescent obesity, there is a need for obesity management programs taking the characteristics of male students into consideration. The possibilities of obesity grow according to the grades, which means that both the teachers and parents should offer more guidance on weight control in upper grades. The adjustment of adolescent obesity requires psychological health management including stress and suicidal ideation as well as diet control and exercise. It is also needed to apply a stepwise obesity management program according to the hours of internet usage and dependence on the internet.

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This study compared parental cognitions and relationship characteristics of mothers of children with atopic disease with those of mothers of children without atopic disease. These factors include child-rearing attitudes, parental locus of control, parental sense of competence, attachment security, and maternal sensitivity. Preplanned subanalyses were carried out according to specific disease, mothers' perception of disease severity, and presence of concurrent atopic diseases. The descriptive comparative study of 233 Korean mothers included 102 mothers of children aged six years or younger with atopic dermatitis, asthma, and/or allergic rhinitis. Data were collected from 2007 to 2008 from local clinics and day care centers. Parental cognitions and relationship characteristics did not differ significantly between groups of mothers, except that mothers of children with atopic dermatitis showed less affection. However, subanalyses showed that mothers who perceived their child's disease to be severe were less likely to encourage autonomy and had a lower sense of competence, more rejecting attitudes, and an external locus of control. Although we should be cautious in generalizing these results, special care plans are strongly recommended for mothers of children with severe atopic disease to provide support and education, help mothers develop an internal locus of control, and increase parental sense of competence.

Parenting attitude is the most important factor to contribute to the healthy socio-emotional development in children with attention deficit hyperactivity disorder. Health care providers need to develop and apply a parenting skills improvement program to improve positive parenting attitudes, which will benefit self-esteem and social competence in children with attention deficit hyperactivity disorder.