This study was conducted to investigate the correlations between social–emotional competence (SEC) and academic achievement (AA) among nursing students and to compare students’ level of each core skill of SEC (critical thinking disposition, self-directed learning, creativity, emotional intelligence, problem-solving, and collaboration) and academic achievement (clinical performance and subjective academic achievement). A cross-sectional design was adapted. Data were collected from 195 nursing students in the junior and senior years who had participated in clinical practicum from four universities in South Korea. General characteristics, levels of critical thinking disposition, self-directed learning, creativity, emotional intelligence, problem-solving, collaboration, and academic achievement were collected via self-reported questionnaire. Canonical correlation analysis was performed to evaluate the relationship between SEC and AA. The canonical correlation coefficient between SEC and AA was 0.762. Critical thinking disposition (Rs = 0.89), problem-solving (Rs = 0.86), and cooperation (Rs = 0.80) made the most important contributions to SEC. Clinical performance (Rs = 0.95) and subjective AA (Rs = 0.57) were correlated with AA. SEC should be addressed to improve the AA of nursing students. All core skills of SEC should be regularly promoted. It is particularly urgent for nursing students to improve their creativity.

Alum, used as an adjuvant in injected vaccines, promotes T helper 2 (Th2) and serum antibody (Ab) responses. However, it fails to induce secretory immunoglobulin (Ig) A (SIgA) in mucosal tissues and is poor in inducing Th1 and cell-mediated immunity. Alum stimulates interleukin 1 (IL-1) and the recruitment of myeloid cells, including neutrophils. We investigated whether neutrophil elastase regulates the adjuvanticity of alum, and whether a strategy targeting neutrophil elastase could improve responses to injected vaccines. Mice coadministered a pharmacological inhibitor of elastase, or lacking elastase, developed high-affinity serum IgG and IgA antibodies after immunization with alum-adsorbed protein vaccines, including the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2). These mice also developed broader antigen-specific CD4⁺ T cell responses, including high Th1 and T follicular helper (Tfh) responses. Interestingly, in the absence of elastase activity, mucosal SIgA responses were induced after systemic immunization with alum as adjuvant. Importantly, lack or suppression of elastase activity enhanced the magnitude of anti–SARS-CoV-2 spike subunit 1 (S1) antibodies, and these antibodies reacted with the same epitopes of spike 1 protein as sera from COVID-19 patients. Therefore, suppression of neutrophil elastase could represent an attractive strategy for improving the efficacy of alum-based injected vaccines for the induction of broad immunity, including mucosal immunity. Significance We report that suppression of the serine protease elastase reshapes innate responses induced by injected vaccines containing alum adjuvant. This reprogramming improves the induction of protective antibodies in the bloodstream and stimulates innate signals, which support the development of antibody responses in mucosal tissues. Our findings identify elastase as the innate regulator that blunts the adjuvant activity of alum. They also demonstrate that vaccination via mucosal routes is not an absolute requirement for antibody responses in mucosal tissues and secretions. Supplementation of an alum-based vaccine containing SARS-CoV-2 spike protein subunit 1 as antigen increased anti–SARS-CoV-2 immunity in the blood and mucosal secretions in mice. Thus, this strategy could help in the development of future protein-based vaccines against SARS-CoV-2.

Kim SH. J Korean Acad Nurs. 2013 Feb;43(1):102-113. https://doi.org/10.4040/jkan.2013.43.1.102

Kim SH, et al. J Korean Acad Nurs. 2018 Feb;48(1):70-84. https://doi.org/10.4040/jkan.2018.48.1.70

This study aimed to identify factors associated with maternal attachment of breastfeeding mothers, with a focus on the mothers' breastfeeding characteristics. Data were collected from 217 mothers who breastfed their healthy baby for 1 month after childbirth and had no postpartum complications. The data were analyzed by hierarchical regression analysis. The factors significantly associated with maternal attachment were an emotional exchange with one's baby (β=.41, p<.001), breastfeeding confidence (β=.20, p=.022), depression ('quite a bit or more', β=-.18, p=.005), and depression ('a little', β =-.14, p=.024). The model explained 38.4% of variance in maternal attachment. In order to improve attachment, nurses should be actively supported in helping mothers in the first month postpartum adapt to breastfeeding. Interventions to prevent postpartum depression should also be conducted.

Kim SH. J Korean Acad Nurs. 2010 Apr;40(2):225-235. http://dx.doi.org/10.4040/jkan.2010.40.2.225