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Background: Every person should engage in exercise or physical activity for health benefits. Primary healthcare physicians should assess the physical activity levels of patients and encourage them to exercise. Current Concepts: World Health Organization physical activity guidelines for adults include 150 to 300 minutes of moderate-intensity aerobic physical activity per week and muscle-strengthening activities for at least two days per week. People over 65 years of age should engage in adult physical activities and exercises to improve balance and prevent falls at least three times per week. Children and adolescents should engage in physical activity for at least 60 minutes daily and high-intensity aerobic physical activity for at least three days per week. Muscle and bone strengthening activities should be performed at least three days per week. Pregnant and postpartum women should regularly engage in physical activity, including moderate-intensity aerobic activity, muscle-strengthening activities, and light stretching exercises. Discussion and Conclusion: Only 16.9% of adults in Korea met the physical activity guidelines in 2020. The percentage was even lower for adolescents, older adults, and women. Therefore, primary healthcare physicians should monitor and encourage physical activity among their patients, although ensuring that they engage in sufficient physical activity is difficult. During clinical practice, counseling methods to improve compliance should be appropriately utilized. Physical activity is part of a healthy lifestyle that should be implemented along with smoking cessation, a reduction in alcohol consumption, and dietary control. Primary healthcare physicians should encourage improvement in patients' physical activity levels through counseling. [ABSTRACT FROM AUTHOR]

Background: Human immunodeficiency virus (HIV) infection presents a major global health challenge. According to the World Health Organization, approximately 39.0 million people have HIV, as of 2022, with 1.3 million new infections annually. In Korea, the first HIV cases were reported in 1985, and the number of cases has increased continuously since 1988. In 2022, 1,066 cases were newly diagnosed, increasing the total number of cases to approximately 15,880. Current Concepts: Diagnostics play a crucial role in the management of HIV, for early diagnosis and initiation of antiretroviral therapy. Approval of the first HIV antibody test in 1985 by the US Food and Drug Administration marked a notable advance in the ability to diagnose HIV infection. The screening test for HIV infection typically consists of a two-step approach, in which a fourth-generation combination HIV-1/2 immunoassay is followed by a confirmatory Western blot. Despite its high accuracy for chronic infections, the window period and the early-stage of HIV infections are problematic, and populations with low HIV prevalence show a low positive predictive value. A false positive result can occur from blood transfusions, vaccinations, and autoantibodies. Novel diagnostic tools, such as nucleic acid testing for viral RNA/DNA and antigen testing for p24 antigen have reduced the window period, allowing for earlier detection and differentiation between HIV-1 and HIV-2. Point- of-care tests are beneficial in resource-limited settings although their lower sensitivity and specificity require additional confirmatory follow-up testing. Discussion and Conclusion: In this review, we provide a historical perspective on the evolution of HIV diagnostics (serological and molecular) and describe the roles of conventional and point-of-care testing within the laboratory diagnostic network. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and satura- tion of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict the success for high-flow nasal cannula (HFNC) treatment applied to patients with hematologic neoplasms. Methods: A total of 167 patients who were admitted to the hematology intensive care unit were included in this study. Data were collected from electronic nursing records and were analyzed using the χ² test, independent t-test, Mann-Whitney U test, logistic regression, Receiver Operating Characteristic curve, and Area Under the Curve (AUC). Results: Eighty-nine (53.3%) patients were successfully weaned from HFNC, while 78 (46.7%) were unsuccessful. Considering specificity and sensitivity, the optimal cut-off points for predicting the success and failure of HFNC oxygen therapy were 4.50 and 14.16 (ROX index), 3.78 and 15.05 (ROX-HR index), and 119.95 and 278.06 (SF ratio), respectively. Time measurement showed that the most significant AUC was recorded before HFNC interruption occurred. Conclusion: Nurses caring for critically ill patients with hematologic neoplasms should closely observe and periodically check patients' breathing patterns. It is crucial to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time. [ABSTRACT FROM AUTHOR]

Purpose: Cancer patients need ongoing care from healthcare providers to maintain continuity of treatment. Much research has been conducted on digital health services for providing continuous management of discharged cancer patients. This review aimed to identify nurse-led digital health interventions for discharged cancer patients. Methods: This scoping review was conducted using JBI methodology. The population was post-discharge adult cancer patients, the concept was nurse-led digital health intervention, and the context was open. Databases including PubMed, Embase, CINAHL, Cochrane Library, KoreaMed, and RISS were searched. Data were summarized about the general characteristics of the article, participants, interventions, and outcomes. Results: Fifty-seven studies were included, with ten studies that focused on the elderly. One third of the participants included in this review had colorectal cancer (32.7%). Telephone was the most frequently used format, while the others were applications, the internet, and telemonitor- ing. The nurses' main roles consisted of counseling, symptom monitoring, and education. Conclusion: The development of nurse-led digital health intervention for the elderly will be necessary, and studies using more diverse technologies will need to be conduct- ed. Digital health interventions for post-discharge colorectal cancer patients could be applied in practice. Nurses should provide emotional support while providing digital health interventions. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is one of the leading causes of cancer-related mortality worldwide. Most CRCs arise through carcinogenesis pathways from precancerous lesions, such as adenoma and sessile serrated lesions (SSLs). Understanding the characteristics of such precancerous colorectal polyps and the carcinogenesis pathways helps to develop CRC preventive strategies via screening, colonoscopic polypectomy, and surveillance. Current Concepts: Benign colorectal tumors can be classified as conventional adenomatous and serrated polyps. Conventional adenoma is one of the most prevalent precancerous polyps detected on screening colonoscopy, but most are small. Small colorectal adenomas are less likely to contain advanced histology, such as villous features, high-grade dysplasia, or invasive cancer. A small adenoma may progress slowly over 10 years to become an invasive cancer via the chromosomal instability pathway. SSL is a recently established precancerous lesion and is estimated to account for approximately 15% of sporadic CRC. Most SSLs are not dysplastic and progress very slowly through the serrated carcinogenesis pathway. Conversely, SSL with dysplasia (SSLD) may progress more rapidly, as a mismatch repair gene product is defective. According to colonoscopy studies, SSLD comprises only 4% to 8% of SSLs, with a prevalence of 0.1% to 0.9%. Most precancerous lesions detected on colonoscopy progress slowly to CRC and are appropriate targets for colonoscopic polypectomy for the prevention of CRC. Discussion and Conclusion: Colorectal adenoma and SSL are representative precancerous lesions of CRC and most are slow progressing enough to be detected and removed via colonoscopy before CRC development. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the mediating effect of work engagement and job crafting on the relationship between nurses' Grit on nursing performance. Methods: The data were collected using structured questionnaires through online surveys from 142 clinical nurses in five hospitals. Data were analyzed using SPSS 24.0, Hayes's SPSS Process Macro 4.0 version program. Results: Nursing performance was significantly associated with Grit, work engagement and job crafting. The mediating effect of job crafting on the Grit on nursing performance was confirmed. Conclusion: These results suggest that it is necessary to develop an intervention program that focuses on improving job crafting. Further, job crafting needs to be considered in developing nursing interventions to nurses' Grit and improve nursing performance for nurses. [ABSTRACT FROM AUTHOR]

Biological pump processes generated by diatom production in the surface water of the Southern Ocean play an important role in exchanging CO2 gas between the atmosphere and ocean. In this study, the biogenic opal content of the sediments was measured to elucidate the variation in the primary production of diatoms in the surface water of the Southern Ocean since the last glacial period. A piston core (COR-1bPC) was collected from the Conrad Rise, which is located in the Indian sector of the Southern Ocean. The sediments were mainly composed of siliceous ooze, and sediment lightness increased and magnetic susceptibility decreased in an upward direction. The biogenic opal content was low (38.9%) during the last glacial period and high (73.4%) during the Holocene, showing a similar variation to that of Antarctic ice core ΔT and CO2 concentration. In addition, the variation of biogenic opal content in core COR-1bPC is consistent with previous results reported in the Antarctic Zone, south of the Antarctic Polar Front, in the Southern Ocean. The glacial-interglacial biogenic opal production was influenced by the extent of sea ice coverage and degree of water column stability. During the last glacial period, the diatom production was reduced due to the penetration of light being limited in the euphotic zone by the extended sea ice coverage caused by the lowered seawater temperature. In addition, the formation of a strong thermocline in more extensive areas of sea ice coverage led to stronger water column stability, resulting in reduced diatom production due to the reduction in the supply of nutrient-rich subsurface water caused by a decrease in upwelling intensity. Under such environmental circumstances, diatom productivity decreased in the Antarctic Zone during the last glacial period, but the biogenic opal content increased rapidly under warming conditions with the onset of deglaciation. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit. Methods: A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ² test, Mann--Whitney U test, and area under the curve (AUC). Results: Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption. Conclusion: The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time. [ABSTRACT FROM AUTHOR]

Purpose To investigate the MRI markers for the prediction of amyloid β (Aβ)-positivity in mild cognitive impairment (MCI) and Alzheimer's disease (AD), and to evaluate the differences in MRI markers between Aβ-positive (Aβ [+]) and -negative groups using the machine learning (ML) method. Materials and Methods This study included 139 patients with MCI and AD who underwent amyloid PET-CT and brain MRI. Patients were divided into Aβ (+) (n = 84) and Aβ-negative (n = 55) groups. Visual analysis was performed with the Fazekas scale of white matter hyperintensity (WMH) and cerebral microbleeds (CMB) scores. The WMH volume and regional brain volume were quantitatively measured. The multivariable logistic regression and ML using support vector machine, and logistic regression were used to identify the best MRI predictors of Aβ-positivity. Results The Fazekas scale of WMH (p = 0.02) and CMB scores (p = 0.04) were higher in Aβ (+). The vol-umes of hippocampus, entorhinal cortex, and precuneus were smaller in Aβ (+) (p < 0.05). The third ventricle volume was larger in Aβ (+) (p = 0.002). The logistic regression of ML showed a good accuracy (81.1%) with mini-mental state examination (MMSE) and regional brain volumes. Conclusion The application of ML using the MMSE, third ventricle, and hippocampal volume is helpful in predicting Aβ-positivity with a good accuracy. [ABSTRACT FROM AUTHOR]

Background: This study aimed to identify the incidence rate of post-coronavirus disease-2019 (COVID-19) conditions in the Republic of Korea (ROK) Army and to investigate the trend of the incidence rate according to changes in dominant variants. Methods: We used the results of a 19-item, self-completed survey of those who had recovered from COVID-19 in the ROK Army between March 24, 2020, and April 30, 2022. We used both descriptive and multiple logistic regression analyses to identify factors associated with the incidence rate of post-COVID-19 conditions. Results: Among the total of 48,623 COVID-19 episodes in the ROK Army, the overall incidence rate of post- COVID-19 conditions was 32.9%. Based on the survey, the incidence of cough was the highest at 15.4%, followed by fatigue (15.1%) and sputum (13.8%). The delta variant had the highest incidence rate of post- COVID-19 conditions at 50.7%, whereas the omicron variant had the lowest at 19.7%. Concerning the type of post-COVID-19 condition, the neuropsychiatric symptoms had the highest incidence at 27.4% when the delta variant was dominant, and the respiratory symptoms were highest at 37.3% when the omicron variant was dominant. In the case of smell and taste symptoms, the incidence rate was high at 21.1% only when the delta variant was predominant. Conclusion: The overall incidence rate of post-COVID-19 conditions in the ROK Army was 32.9%. When the delta variant was dominant, the overall incidence as well as the proportion of neuropsychiatric symptoms were high. However, as the omicron variant became dominant, the overall incidence decreased, but the proportion of respiratory symptoms increased. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to develop a scale to measure distress in patients with ischemic stroke and verify its validity and reliability. Methods: Preliminary items were developed from literature review and in-depth interviews. The final preliminary scale was confirmed through a content validity test of eight experts and a preliminary survey of 10 stroke patients. The participants for psychometric testing were 305 stroke patients in the outpatient clinic. Validity and reliability analyses included item analysis, exploratory and confirmatory factor analysis, convergent validity, known-group validity, and internal consistency of the scale. Results: The final scale consisted of 17 items and 3 factors. The three distinct factors were 'self-deprecation, worry about future health, and withdrawal from society' and this structure was validated using a confirmatory factor analysis. Convergent validity was supported by comparison with the Center for Epidemiologic Studies Depression Scale (r = .54, p < .001) and Brief Illness Perception Questionnaire (r = .67, p < .001). Known-groups validity was verified by dividing groups according to 'duration since diagnosis' (t = 2.65, p = .009), 'presence of sequela' (t = 10.16, p < .001), and 'awareness of distress' (t = 12.09, p < .001). The internal consistency of the scale using Cronbach's α for the total items was .93. Conclusion: The Ischemic Stroke Distress Scale is a valid and reliable tool that reflects stroke distress effectively. It is expected to be used as a basic tool to develop various intervention strategies to reduce distress in ischemic stroke patients. [ABSTRACT FROM AUTHOR]

Purpose To compare the sensitivities of T2-weighted image (T2WI) and susceptibility-weighted imaging (SWI) in detecting cerebral arteriovenous fistula (AVF), cerebral arteriovenous malformation (AVM), and carotid-cavernous sinus fistula (CCF), and to qualitatively evaluate single-echo SWI (s-SWI) and multi-echo SWI (m-SWI) in characterizing vascular lesions. Materials and Methods From January 2016 to December 2021, cerebral angiography-proven lesions were recruited. The sensitivities of T2WI and SWI in detecting vascular lesions were compared using McNemar's test. Qualitative evaluations of s-SWI and m-SWI were categorized to be of poor, average, or good quality and compared using Fisher's exact test. Results A total of 24 patients (mean age: 61 years, 12 female, and 12 male) were enrolled. Twenty patients underwent s-SWI or m-SWI, and four patients underwent both. AVF, AVM, and CCF were diagnosed in 10, 11, and 3 patients, respectively. SWI demonstrated higher sensitivity compared to that of T2WI (82.1% vs. 53.6%, p = 0.013). m-SWI showed better image quality compared to that of s-SWI (good quality, 83.3% vs. 25.0%, p = 0.009). Conclusion SWI demonstrated a higher sensitivity for detecting cerebral arteriovenous shunts com-pared to that of T2WI. m-SWI exhibited better image quality compared to that of s-SWI in characterizing vascular lesions. [ABSTRACT FROM AUTHOR]

The high latitude scleractinian coral Alveopora japonica Eguchi, 1965 occurs in high density in the shallow rocky subtidal in Jeju Island, forming coral carpets. Despite its ecological role providing a unique habitat for other benthic organisms, the benthic fauna associated with the A. japonica coral carpet is poorly known. To identify fauna associated with the coral carpet, we explored three sites dominated by A. japonica and one control site on northwestern Jeju Island in May 2013. Using SCUBA, we collected A. japonica and the epibenthic mega-fauna associated with the colonies in 1×1 m2 and identified them to the species level. At a depth of 10 to 15 m, A. japonica colonies heavily covered the seafloor, forming a layer called a coral carpet, with a density of 94 (Keumneung-ri), 133 (Biyangdo), and 155 (Gwidok-ri) colonies/m2. Thirty-four molluscan species were identified from the four sites, including 20 bivalves and 14 gastropods. The coral carpets were enriched with sessile bivalves compared to the control site, as we identified twenty bivalve and eight gastropod species from the coral carpets. Most bivalve species associated with the coral carpets had tropical-subtropical affinities, while gastropods were mainly subtropical and subtropical-low boreal species. Leiosolenus lischkei M. Huber, 2010, in the family Mytilidae and Barbatia steamsi (Pilsbry, 1895), in the family Arcidae, were the two most abundant bivalve species in the coral carpet, L. lischkei being a borer, and B. stearnsi a nestler. The tropical to subtropical Pacific star shell Astralium haematragum (Menke, 1829)was the most abundant gastropod at the study sites. The bivalves and gastropods associated with the coral carpet were small-sized juveniles or sub-adults, suggesting that the coral carpet provides a micro-habitat for the bivalves and gastropods. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to determine nursing students' orientation toward patient-centered care (PCC) and identify its influencing factors: their personality traits, empathy, and psychological capital (PsyCap). A mediating model was used to test the role of PsyCap in the association between empathy and PCC. Methods: This cross-sectional study included 300 nursing students from seven universities in South Korea. Their orientation toward PCC was measured using the Patient-Practitioner Orientation Scale (PPOS). Moreover, we analyzed the data using independent t-tests, ANOVA, Pearson's r, and SPSS PROCESS macro. Results: The overall mean score on the PPOS was 3.82±0.43, with the Caring and Sharing subscales accounting for 3.95±0.68 and 3.69±0.50, respectively. Nursing students' satisfaction with their majors, practicums, and motivation for choosing this profession was significantly related to Caring-not Sharing. Nevertheless, PsyCap positively influenced both Caring (β=.24, p<.001) and Sharing (β=.18, p=.002). While empathy failed to significantly impact both Caring (β=.12, p=.087) and Sharing (β=.01, p=.931). PsyCap mediated the association of empathy with Caring (β=.20, p=.004); however, the same was not true for Sharing (β=.07, p=.366). Conclusion: The findings indicate that the orientation of Korean nursing students toward PCC is not high. Therefore, to improve the PPOS Caring subscale, nurse educators should formulate better strategies to enhance nursing students' satisfaction with their major and practicums, empathy, and PsyCap. The importance of sharing health-related information with patients and family caregivers should be emphasized in the nursing curriculum. [ABSTRACT FROM AUTHOR]

Background: Pulmonary embolism is associated with reduced survival and considerable economic burden worldwide. In Korea, the incidence of pulmonary embolism has been gradually increasing. Older individuals are at an increased risk for pulmonary embolism and anticoagulation-related bleeding events. Typically, heparin and vitamin K antagonists are employed to treat pulmonary embolism; however, these agents present numerous limitations. Hence, novel anticoagulants with improved safety and efficacy profiles are urgently needed. Current Concepts: Direct oral anticoagulants (DOACs), including direct thrombin (coagulation factor II) inhibitors and selective inhibitors of coagulation factor Xa, have emerged as alternative agents. Phase III, large-scale clinical trials have revealed that DOACs are non-inferior to standard therapy during initial and long-term treatment of pulmonary embolism, considering the safety profile. Evidence-based clinical guidelines recommend that primary care clinicians employ DOACs over warfarin to achieve anticoagulation. Discussion and Conclusion: For over 70 years, the standard therapy for most patients with pulmonary embolism has involved heparin administration, overlapped and followed by a vitamin K antagonist. Recently developed DOACs against coagulation factor Xa or thrombin might overcome limitations of standard therapy, including the need for injection and regular dose adjustment with laboratory monitoring. These limitations hinder the management of patients with pulmonary embolism and negatively impact the patient's quality of life. Four DOACs, including apixaban, dabigatran, edoxaban, and rivaroxaban, are currently available for treating pulmonary embolism in Korea, which could simplify the therapeutic strategy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the effects of an advanced practice nurse-led psychoeducational program on distress, anxiety, depression, coping with cancer (CWC), health promotion behavior (HPB), and quality of life (QOL) among colorectal cancer survivors. Methods: This study was designed as a quasi-experimental study with a non-equivalent control group pretest-posttest. The participants were survivors of colorectal cancer who underwent follow-up care. There were 39 survivors: 19 in the experimental group and 20 in the control group. The experimental group performed a psychoeducational program for 120 minutes per session, once a week for a total of six weeks, while the control group received routine education and counseling. Distress, anxiety, depression, CWC, HPB, and QOL were investigated before, immediately after, and 4 weeks after the intervention. The data were analyzed with SPSS/WIN ver. 24.0, using repeated measures ANOVA. Results: There were significant interactions between time and group for distress and anxiety. In addition, CWC interacted with the total of CWC and interpersonal coping, and QOL interacted with the total of QOL and functional status. However, there were no significant differences in the depression or HPB scores. Conclusion: Based on the results of this study, we expect that this program can be used as an effective intervention for colorectal cancer survivors. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to construct and test a predictive model for the quality of life (QOL) in mothers of children with developmental disabilities (DB). The hypothesized model included severity of illness, distress, uncertainty, self-help, and parenting efficacy as influencing factors, QOL as a consequence based on the Braden's Self-Help Model. Methods: The data were collected through a direct and online surveys from 206 mothers in 8 locations, including welfare or daycare centers, developmental treatment centers, and The Parents' Coalition for the Disabled located in two provinces of Korea. Data were analysed using SPSS/WIN 23.0 and AMOS 21.0 program. Results: The fit indices of the predictive model satisfied recommended levels; χ² = 165.79 (p < .001), normed χ² (χ²/df) = 2.44, RMR = .04, RMSEA = .08, GFI = .90, AGFI = .85, NFI = .91, TLI = .93, CFI = .95. Among the variables, distress (β = - .46, p < .001), parenting efficacy (β = .22, p < .001), and self-help (β = .17, p = .018) had direct effects on QOL. Severity of illness (β = - .61, p = .010) and uncertainty (β = - .08, p = .014) showed indirect effects. The explanatory power of variables was 61.0%. Conclusion: The study results confirm the utility of Braden's Self-Help Model. They provide a theoretical basis for improving QOL in mothers of children with DB. Nursing intervention strategies that can relieve mothers' distress and uncertainty related to disease and enhance parenting efficacy and self-help behavior should be considered. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to identify the mediating effect of happiness on the relationship between gratitude disposition and psychological well-being among nurses working at general hospitals. Methods: The participants were 200 nurses working at general hospitals. A structured questionnaire was administered, and data were collected from November 20, 2020 to December 10, 2020. Data were analyzed using hierarchical linear regression with SPSS for Windows 25.0. Results: Gratitude disposition (β=62, p<.001) and happiness (β=66, p<.001) were identified as significant predictors of the psychological well-being of clinical nurses. These variables explained 64% of the variance in nurse's psychological well-being. Moreover, happiness had a partial mediating effect on the relationship between gratitude disposition and psychological well-being. Conclusion: In order to improve the psychological well-being of clinical nurses, an emotion management program related to gratitude disposition and happiness should be developed and provided. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the incidence and risk factors associated with the unplanned removal of nasogastric (NG) tubes in neurocritical patients. Methods: Data were collected retrospectively from the medical records of 479 patients admitted to the tertiary hospital's neuro-intensive care units (NCU). Subjects were divided into two groups depending on whether there was unplanned NG tube removal. Multivariate logistic regression analysis was used to identify risk factors. Results: Unplanned removal of NG tubes occurred in 35.9% of patients. The incidence of unplanned NG tube removal was 47.2 per 1,000 patient days. Intubated time of the NG tube was 3.96 days in patients with unplanned removal. Risk factors associated with unplanned removal were men (Odds Ratio [OR]=2.19), epilepsy (OR=9.99), traumatic brain injury (OR=5.50), stroke (OR=4.42), improvement of Glasgow Coma Scale (GCS) (OR=1.08), delirium (OR=1.88), physical restraint (OR=2.44), and drainage or decompression purpose (OR=1.67). Conclusion: Unplanned removal of NG tubes occurred very frequently in neurocritical patients. Care should be taken for patients with neurological diseases who show improvement in their level of consciousness but are still confused due to brain lesions or delirium to reduce it. The application of physical restraints cannot guarantee the prevention of unplanned NG tube removal. Therefore, nurses need to assess the condition of patients and NG tubes frequently. In particular, more attention should be paid to using NG tubes for decompression or drainage purposes. It is also proposed to actively review the NG tube removal plan through periodic evaluation. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the association between maternal knowledge and social support on pregnancy stress among pregnant women in Korea. Methods: The participants in this study were 148 pregnant women in Korea, recruited from online communities on pregnancy and/or childbirth, from June 2019 to April 2020. The collected data were analyzed using the independent t-test, one-way analysis of variance, Pearson correlation coefficient, and multiple regression. Results Participants were at average 18.25±8.28 weeks gestation, 56% were in the second trimester, 31% had one or more health issues in the current pregnancy (e.g., hyperemesis gravidarum), and 76% were first-time mothers. Participants had moderate levels of pregnancy stress (mean, 23.09±7.11 points out of 48) and maternal knowledge (mean, 14.42±4.67 points out of 21), whereas social support was somewhat high (mean 45.88±7.81 points out of 60). Pregnancy stress was weakly negatively correlated with social support (r=-.37, p<.001). Main source of pregnancy information (p=-,21, β=.011), marital satisfaction ((β=-. 18, p=.036), and social support (β=-.19, p=.038) were identified as significant factors affecting pregnancy stress, and these variables had an explanatory power of 22.7% for pregnancy stress. Conclusion Based on these findings, nurses should assess pregnancy-related stress during pregnancy and consider main source of pregnancy information and marital satisfaction when providing education or counseling. Moreover, strategies to reduce pregnancy stress through social support are needed to improve the quality of life for pregnant women. [ABSTRACT FROM AUTHOR]

Background: Application of robotic surgery in the field of general surgery has been increasing. This paper is an overview of the current uses and future perspectives of robotic surgery in four major divisions--endocrine, upper gastrointestinal, hepato-biliary-pancreatic (HBP), and colorectal surgery. Current Concepts: In endocrine surgery, cosmetic advantage is the highest priority when selecting a surgical approach for thyroidectomy. Currently, the transaxillary route is the most common approach. The introduction of the single-port system could maximize the advantages of this technique. In upper gastrointestinal surgery, the use of robots has the advantage of better retrieval of lymph nodes, less bleeding, earlier discharge, and less complications than the laparoscopic approach. However, a more prospective comparative trial is required to confirm those findings. In the HBP field, the indications of robotic surgery have expanded, starting with cholecystectomy to more challenging procedures, such as donor hepatectomy and pancreaticoduodenectomy. Meticulous dissection using robots could provide benefits to patients. In colorectal surgery, robotic surgery is an excellent technical tool for minimally invasive surgeries for rectal cancers, especially in male patients with narrow, deep pelvises. However, further studies are required to confirm the impact of robotic surgery on rectal cancers. Discussion and Conclusion: Robots are used to provide optimal surgical outcomes. Investigating new technologies and innovative surgical procedures is the highly important for a surgeon in the era of minimally invasive surgery. [ABSTRACT FROM AUTHOR]

Background: Inflammatory bowel disease (IBD) is a disease of unknown origin that causes chronic inflammation of the intestines and is classified as either ulcerative colitis or Crohn's disease. The incidence and prevalence of IBD in Korea have been rapidly increasing during the past three decades. This paper describes the current status of IBD in Korea. Current Concepts: Compared with western countries, genotypes and phenotypes of IBD in Korea demonstrate some distinct features, which may have an impact on the diagnosis, treatment, and prognosis of IBD. We continue to experience some difficulties in making early and accurate diagnoses of IBD in Korea due to a low awareness of the disease and the high prevalence of infectious enterocolitis, such as intestinal tuberculosis, which needs to be differentiated from IBD. The treatment of IBD can be influenced by differences in genetic, environmental, and social factors. NUDT15 variants limit the use of thiopurines. Infectious diseases, including tuberculosis, hepatitis B, and cytomegalovirus colitis, are usually more common in Asia than in western countries and can adversely influence the management of IBD. Biologic agents, which have changed the treatment paradigm of IBD, are equally efficacious in Asian patients as in Western patients. However, their use is limited due to a strict Korean government health insurance reimbursement policy. The prognosis of ulcerative colitis in Korea may be better than that in western countries, as indicated by a lower colectomy rate. However, this difference is less distinct in Crohn's disease. Discussion and Conclusion: IBD in Korea differs from that in western countries in many respects. With rapid increase in the prevalence of IBD in Korea, medical costs for IBD are expected to become a significant financial burden. Koreans need to be prepared for this eventuality. [ABSTRACT FROM AUTHOR]

Purpose: This descriptive investigative study was done to identify health literacy, knowledge and self-care behavior of patients with pulmonary tuberculosis. Methods: The patients were 206 adults over the age of 19 who were diagnosed with pulmonary tuberculosis, taking anti-tuberculosis drugs and receiving care at one of the following: health centers, health center branches, public or privately affiliated hospitals in six cities nationwide. Tools used for the study were health literacy, knowledge and self-care behavior scales regarding pulmonary tuberculosis. Data were analyzed using SPSS/WIN 21.0 to identify frequency and percentages, means and standard deviation using t-test, ANOVA, Scheffe test, Pearson correlation coefficient, and multiple-regression analysis. Results: Health literacy in pulmonary tuberculosis patients was found to be lower for men, patients over 60, high school graduation or less, having no religion and no family members living together. For knowledge on tuberculosis, the tuberculosis symptom field was lowest, and self-care behavior was lowest for examinations and drug intake. Factors affecting self-care behavior were knowledge related to tuberculosis prevention examinations, education, health literacy, and living together with family members. Conclusion: In order to completely cure pulmonary tuberculosis and prevent recurrence, customized education is needed according to the patient's educational background or health literacy, and assertive countermeasures are needed to enhance self-care behavior for examinations and drug intake. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the difficulties in end-of-life care and end-of-life care competency in nurses who take care of cancer patients. Methods: In the mixed method, a structured questionnaire on end-of-life care stress and competency was conducted on 115 nurses caring for cancer patients, and 19 were interviewed for qualitative research. For the collected quantitative data, descriptive statistics were used. For the qualitative study, the contents of the interview were summarized and systematized using the content analysis method to derive the main themes. Results: The mean end-of-life care stress was 4.08 points (out of 5) and the mean end-of-life care competency was 3.43 points (out of 5). Four themes and 11 sub-themes for the difficulties in end-of-life care were identified, and the four themes are as follows: (1) regret over limited end-of-life nursing, (2) different aspects of persistent emotional distress, (3) overloaded duty at the end-of-life (4) conflicts encountered in decision-making for life-sustaining treatment. Four themes and eight sub-themes for end-of-life care competency were identified, and the four themes are as follows: (1) empathy and listening skills, (2) communication skills, (3) clinical nursing experience and education, (4) clinical nursing competency. Conclusion: It was confirmed that nurses caring for cancer patients had a high level of end-of-life care stress, and it is necessary to develop a program to reduce difficulties in end-of-life care and increase end-of-life care competency. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to propose appropriate nurse staffing of adult intensive care units considering patients' nursing care needs according to the Workload Management System for Critical Care Nurses (WMSCN). Methods: In a cross-sectional survey conducted in September 2017, 1,786 patients' WMSCN scores, surveys from 2,145 nurses, and administrative data from 118 units in 41 hospitals were analyzed. The means (standard deviations) of the aforementioned scores and nursing hours per patient day were presented. Nurse-to-patient ratios and nurse-to bed ratios for staffing to meet patients' nursing care needs were calculated. Results: The mean WMSCN scores were 109.50 ± 17.17 in tertiary hospitals and 96.38 ± 19.26 in general hospitals. Nursing hours per patient day were 12.47±2.80 in tertiary hospitals and 11.01 ±2.45 in general hospitals. Nursing hours per patient day correlated with WMSCN scores. Nurse-to-bed ratios required for the provision of ICU nursing care ranged from 1: 0.36 to 1: 0.48. Conclusion : Our findings provide evidence that current ICU nurse staffing is insufficient for meeting patients' nursing care needs. We suggest adjusting the legal standards for adequate nurse staffing considering these needs. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to understand and describe the diabetes self-management experience of visually impaired people with diabetes. Methods: Ten participants were recruited through a website used by the visually impaired from February to March 2020. Data were collected through two focus group interviews conducted in June 2020; each group consisted of five participants. All interviews were recorded with the consent of the participants and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. Results: Seven categories were as follows; a two-faced, lifelong companion, an unprepared encounter, struggle to live, love-hate relationship with family, strategies to adapt, lessening attention to self-management, the desire to learn properly. Conclusion: It can be concluded that the visually impaired have fewer opportunities for receiving diabetes self-management education than general diabetic patients. Consequently, plans to improve the education available to such patients are required. Additionally, psychological counseling and diabetes education for patients' families are necessary, and improving the perception of medical workers regarding the visually impaired will be prove useful. [ABSTRACT FROM AUTHOR]

Purpose: To determine psychometric properties of the Caring Behaviors Inventory-24 (CBI-24) among Korean clinical nurses. Methods: A methodological design was used. Data were collected from 408 clinical nurses. Construct validity analysis was performed, including factorial, convergent, and discriminant validity. Internal consistency was tested by Cronbach's α coefficients, inter-item correlation, and corrected item-total correlation. Results: Exploratory factor analysis produced three factors: 'empathy and supporting', 'knowledge and skills', and 'providing comfort'. In confirmatory factor analysis results, model fit indices were acceptable (χ²/df=3.50, RMR=.05, RMSEA=.08, CFI=.90). The values obtained for the AVE ranged from .53 to .68, and for the CR ranged from .53 to .68. Convergent validity coefficients were noticeably greater in magnitude than discriminant validity coefficients: .53 (AVE1 value) and .68 (AVE2 value)≥.45 (r12² value) and .68 (AVE2 value) and .63 (AVE3 value)≥.61 (r23² value). Internal consistency (Cronbach's α) of CBI-K was .95. Conclusion: The CBI-K was shown to have acceptable construct validity and good internal consistency. Study findings imply that CBI-K could be a useful instrument for clinical administrators and nursing researchers to assess caring behaviors among Korean clinical nurses. Utilization of CBI-K might contribute to the building of empirical knowledge and the understanding of caring behaviors from nurses' perspectives. [ABSTRACT FROM AUTHOR]

Purpose : This study examined the effects of an integrated management program on physical function, cognitive function, and depression in patients with subacute stroke. Methods: A nonequivalent control group design was adopted. The participants were assigned to either the experimental group (n=20) or control group (n=23). The experimental group received an 8-week integrated management program and standard rehabilitation service (i.e., physical therapy and occupational therapy), while the control group received the standard rehabilitation service only. Physical function was measured as gait speed and balance ability using the Berg Balance Scale (BBS). Cognitive function was measured with neuro-behavioral cognitive status examination (NCSE), and depression was measured using the Beck Depression Inventory-II (BDI-II). Repeated measure ANOVA was used to determine changes in physical function, cognitive function, and depression over 8-weeks. Results: The interaction between group and time was significant, indicating that the experimental group showed improvement in gait speed, balance ability, cognitive function (linguistic ability, linguistic memory, reasoning), and a decrease in depression compared to the control group. Conclusion : These results indicate that the integrated management program developed herein was beneficial in restoring physical function, cognitive function, and depression in subacute stroke patients. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to compare two different sedation protocols for brain magnetic resonance imaging (MRI) in preterm infants. One protocol used chloral hydrate (CH) with monitoring conducted by non-anesthesiologists, and the other used a continuous infusion of propofol (PF) with monitoring by anesthesiologists. Methods: A total of 250 preterm infants born between January 2011 and December 2015 who received brain MRI during hospitalization in our neonatal intensive care unit (NICU) were included in this retrospective study. In period 1, sedation for brain MRI was done using a single dose or multiple doses of CH with monitoring conducted by NICU medical staff. In period 2, an anesthesiologist prescribed a continuous infusion of PF and titrated the dosage for minimal and adequate sedation. Data on the adverse events, including desaturation and bradycardia, were collected and compared between periods 1 and 2. Results: Despite similar gestational ages of the patients in periods 1 and 2, the infants in period 1 showed a higher risk of developing bradycardia after sedation compared to those in period 2 (30.2% vs. 14.8%; an adjusted odds ratio of 2.35; 95% confidence interval of 1.12 to 4.91). Infants who had an adverse event after sedation had a lower gestational age and corrected age at the time of MRI (26.8 weeks vs. 27.9 weeks, P=0.004; 37.3 weeks vs. 38.3 weeks, P=0.023). The duration of MRI was significantly longer in infants that had an adverse event than those that did not (70.9 minutes vs. 64.3 minutes). After adjusting for various clinical factors, lower gestational age, lower corrected age at the time of MRI, and period 1 increased the risk of developing adverse events after sedation for MRI. Conclusion: The use of a continuous PF infusion with dose titration and monitoring by an anesthesiologist is safe and feasible as a sedation protocol for brain MRI in prematurely born infants. [ABSTRACT FROM AUTHOR]

Purpose: To compare respiratory outcomes between less invasive surfactant administration (LISA) and the intubation-surfactant-extubation (INSURE) technique in premature infants with respiratory distress syndrome (RDS). Methods: We performed a retrospective medical chart review for 75 premature infants who were born at a gestational age (GA) of =34 weeks (between January 2017 and December 2019) and developed RDS after birth. Data on the demographic and outcome variables, including respiratory outcomes, were collected and compared between the infants who received LISA and those who received INSURE as a rescue therapy for RDS. Results: No signifcant differences in GA, birth weight, and other demographic characteristics were found between the LISA and INSURE groups (GA: 28.7 weeks vs. 28.8 weeks, P=0.449; birth weight: 1,236 g vs. 1,124 g, P=0.714). At the delivery room, although the infants showed no significant difference in positive pressure ventilation rate after birth, the LISA group showed a higher rate of continuous positive airway pressure application than the INSURE group. The infants in the LISA group presented a higher risk of requiring multiple doses of surfactant for RDS than the infants in the INSURE group (57% vs. 17.5%, P=0.001). However, the duration of invasive and/ or noninvasive respiratory support and incidence of bronchopulmonary dysplasia showed no signifciant difference between the two groups. Conclusion: In the present study, no significant differences in the incidence of inhospital respiratory outcomes such as bronchopulmonary dysplasia were found between the LISA and INSURE groups. These results suggest that LISA can be an alternative therapeutic option for treating RDS to avoid intubation and mechanical ventilation in premature infants. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the clinical results of surgical treatment with minimally invasive plate osteosynthesis for treating displaced intra-articular fractures of the calcaneus in comparison with conventional lateral extensile approach plate osteosynthesis. Materials and Methods: Of 79 cases of Sanders type II or III calcaneus fractures, 15 cases treated with the minimally invasive calcaneal plate (group M) and 64 cases treated with lateral extensile approach calcaneal plate (group E) were identified. After successful propensity score matching considering age, sex, diabetes mellitus history, and Sanders type (1:3 ratio), 15 cases (group M) and 45 cases (group E) were matched and the demographic, radiologic, and clinical outcomes were compared between the two groups. Results: The median time of surgery from injury was 2.0 days in group M and 6.0 days in group E (p=0.014). At the six months follow-up, group M showed results comparable with those of group E in radiographic outcomes. In the clinical outcomes, group M showed better postoperative American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) scores than did group E (p=0.001, p=0.008). A greater range of subtalar motion was achieved at the six months follow-up in group M (inversion 20.0° vs. 10.0°, p=0.002; eversion 10.0° vs. 5.0°, p=0.025). Although there were no significant differences in complications between the two groups (1 [6.7%] vs. 7 [15.6%], group M vs. group E; p=0.661), there was only one sural nerve injury and no wound dehiscence and deep infection in group M. Conclusion: Minimally invasive plate osteosynthesis showed superior clinical outcomes compared with that of the conventional lateral extensile approach plate osteosynthesis in Sanders type II or III calcaneus fractures. We suggest applying minimally invasive plate osteo-synthesis in Sanders type II or III calcaneus fractures. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to develop and validate a Korean version of the Self-Care for Aspiration Pneumonia Prevention (SCAPP-K) scale in older adults at risk of dysphasia. Methods: The Hertz and Baas model of scale development and validation was used. In the development stage, items were generated via literature review and interviews with medical experts, older adults, and caregivers. Ten experts assessed the items for content validity. Subsequently, 12 older adults participated in a pilot test to determine the comprehensibility and appropriateness of the SCAPP-K scale. The validation stage involved a cross-sectional survey with 203 older adults for exploratory factor analysis (EFA) and 200 older adults for confirmatory factor analysis (CFA) and to determine convergent and discriminant validity. To test the validity and reliability of the scale, EFA using principal component analysis with varimax rotation and CFA were conducted, and convergent and discriminant validity as well as internal consistency reliability were determined. Results: As a result of EFA, three self-care factors (knowledge, resources, behaviors) with 21 items were validated. The CFA and convergent and discriminant validity indicated the applicability of the three-factor self-care scale. The reliability of the SCAPP-K scale was acceptable, with Cronbach's α=.87~.91. Conclusion: The SCAPP-K scale has acceptable validity and reliability and can contribute to clinical practice, research, and education to improve self-care for the prevention of aspiration pneumonia in older adults at risk of dysphasia. [ABSTRACT FROM AUTHOR]

As most medical facilities in Korea have been concentrated in large cities, the need to improve emergency medical services in islands and mountainous areas has emerged. Consequently, the Ministry of Health and Welfare and local governments have introduced emergency medical helicopters (known as helicopter ambulances or air ambulances) with doctors in medically vulnerable areas. Having been introduced in two regions in 2011, air ambulances are operational in seven regions as of the end of 2019. The flight time is from sunrise to sunset, except in Gyeonggi province, which is open all day. Although the criteria for transport vary depending on whether an ambulance is available for operation, it is basically intended for emergency critical diseases, such as severe trauma, stroke, and acute myocardial infarction. From September 23, 2011 to December 31, 2018, a total of 10,367 transfer requests were received, which included 534 (5.2%) interruptions, 2,657 (25.6%) rejects, and 7,176 (69.2%) transfers. A total of 7,209 patients were transferred during this period, which included 1,693 (23.5%) patients of severe trauma, 1,149 (15.9%) patients of stroke, 802 (11.1%) patients of acute myocardial infarction, and 3,565 (49.5%) patients suffering from other emergency diseases. Some economic research on air ambulances in Korea has been reported to be cost-effective, but additional research should be performed. In the future, it is necessary to widen the area of operation of air ambulances and find alternative means of transporting patients during unfavorable conditions such as night or bad weather. [ABSTRACT FROM AUTHOR]

In order to prevent sensitization to a new allergen and the development of asthma, practitioners may consider allergenspecific immunotherapy in patients with allergic rhinitis. Additionally, in patients with severe allergic rhinitis refractory to medication, practitioners can also consider surgical management for improving the patients' nasal symptoms. However, there are still no practical guidelines regarding the indications for immunotherapy, the appropriate selection of the allergen, and the optimal duration of therapy. Moreover, no clear indications exist for surgical treatment. Pregnant or lactating women frequently complain of symptoms of rhinitis. However, due to the fear of potential complications to their babies, they avoid medical treatment despite significant discomfort. Therefore, we present 14 answers to core questions about immunotherapy, surgical treatment, and considerations for special circumstances, such as pregnancy and lactation. [ABSTRACT FROM AUTHOR]