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Objectives: To examine the effectiveness of a media literacy‐based smoking prevention program based on Ajzen's theory of planned behavior in female adolescents. Methods: This quasi‐experimental study was conducted with female high school students aged 16–17 years in Seoul, Republic of Korea. The program provided eight sessions over 4 weeks. Quantitative data were collected before and after online surveys in an intervention (n = 21) and control (n = 21) groups, and analyzed using mixed analysis of variance. Qualitative data on participation experiences was collected by requesting the participants to answer open‐ended questions once a week during the intervention and performing co‐occurrence analysis of specific terms in the responses was conducted through text mining. Results: Although the program decreased smoking intention and increased smoking media literacy in the intervention group, there were no significant differences between the groups. Qualitative results obtained from the intervention group showed cognitive and behavioral changes in the perception of the harmfulness of e‐cigarettes in the media and the expression of a willingness to overcome the temptation to smoke. Conclusions: Our findings show that the enhancement of smoking media literacy, specifically by correcting misconceptions regarding e‐cigarettes promoted by the new media, contributes smoking prevention in female adolescents. It supports calls for an expanded role of public health professionals in health education at the school level. [ABSTRACT FROM AUTHOR]

Aim: To identify the factors associated with retention intention among Registered Nurses in South Korean nursing homes. Background: Although nurses are not mandatory personnel, Korean nursing homes employ Registered Nurses. Introduction: Determining the factors related to Registered Nurses' retention intention is important for their job stability and ensure provision of quality care. Methods: This mixed‐methods study employed a sequential explanatory design. A self‐reported questionnaire survey was conducted between May 1 and July 3, 2019, with 155 Registered Nurses providing direct care from 37 nursing homes. In‐depth qualitative interviews were conducted with 10 participants from August 1 to September 30, 2019. Data were analyzed using multilevel analysis for quantitative study and thematic analysis for qualitative study. Results: The participants' average age was 48.48 years. Personal factors related to retention intention were Registered Nurses' role, educational level, and job satisfaction. Institutional factors were ownership, number of beds, and working environment. The qualitative study revealed five themes: "Satisfaction with meaningful relationships," "Potential for professional growth," "Nursing service accompanied by emotional labor," "Poor working environments in nursing homes," and "Unprotected nursing expertise." Discussion: A nursing home's work environment is related to the Registered Nurses' retention intention. Most Registered Nurses in Korea received low wages, lacked access to career management programs, and experienced emotional labor. Conclusion: This study highlighted the personal and institutional factors related to retention intention among Registered Nurses in South Korean nursing homes. Implications for nursing and nursing policy: A law that designates Registered Nurses as an essential nursing home workforce is required. Further, nursing homes should increase the number of Registered Nurses to improve working conditions and thereby job satisfaction. It is also necessary to foster a working environment that facilitates professional development opportunities and job clarity. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the clinical efficacy of tapentadol extended-release (ER) on pain control and the quality of life (QoL) of patients with moderate to severe chronic cancer pain in clinical practice in Korea.Methods: In this prospective, open-label, multicenter trial, patients with sustained cancer pain as well as chronic pain, who were or were not using other analgesics were enrolled. Thirteen centers recorded a total of 752 patients during the 6-month observation period, based on the tapentadol ER dose and tolerability, prior and concomitant analgesic treatment, pain intensity, type of pain, adverse effects, and clinical global impression change (CGI-C). Of those 752 patients, 688 were enrolled, and 650 completed the study for efficacy and adverse drug reactions; among them, 349 were cancer patients.Results: Tapentadol ER significantly reduced the mean pain intensity including neuropathic pain during the observation period by 2.9 points (from a mean 7 ± 0.87 to 4.1 ± 2.02). Furthermore, QoL was observed to be significantly improved based on the CGI-C, an objective measure.Conclusion: This study showed that tapentadol ER was effective for treating patients with moderate to severe cancer pain and neuropathic pain, and therefore it significantly improved the patients' QoL. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the effects of health-related behaviors on metabolically healthy non-obese or obese groups and to analyze gender differences. Methods: This study was a secondary descriptive study. A total of 14,277 adults from the Korea National Health and Nutrition Examination Survey 2013~2015 were classified as: metabolically healthy non-obese; metabolically unhealthy non-obese; metabolically healthy obese; or metabolically unhealthy obese. Five health-related behaviors (amount of alcohol consumption, smoking status, physical activity, daily energy intake, and sleep duration) were included as independent variables. Results: The health-related behaviors associated with metabolic status in non-obese participants were drinking and smoking, whereas those of obese individuals were associated with physical activity. Subgroup analysis showed that more metabolically healthy non-obese men were light drinkers and former smokers than metabolically unhealthy non-obese men. Metabolically healthy non-obese women were more likely to engage in physical activity than metabolically unhealthy non-obese women. Among the obese men, light drinking and physical activity were associated with metabolic status. Conclusion: Evidence-based interventions promoting health-related behaviors are needed to support metabolic health, considering the metabolic status and obesity phenotypes of the participants and their gender. [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]

Objectives: To investigate the optimal input matrix size for deep learning-based computer-aided detection (CAD) of nodules and masses on chest radiographs.Methods: We retrospectively collected 2088 abnormal (nodule/mass) and 352 normal chest radiographs from two institutions. Three thoracic radiologists drew 2758 abnormalities regions. A total of 1736 abnormal chest radiographs were used for training and tuning convolutional neural networks (CNNs). The remaining 352 abnormal and 352 normal chest radiographs were used as a test set. Two CNNs (Mask R-CNN and RetinaNet) were selected to validate the effects of the squared different matrix size of chest radiograph (256, 448, 896, 1344, and 1792). For comparison, figure of merit (FOM) of jackknife free-response receiver operating curve and sensitivity were obtained.Results: In Mask R-CNN, matrix size 896 and 1344 achieved significantly higher FOM (0.869 and 0.856, respectively) for detecting abnormalities than 256, 448, and 1792 (0.667-0.820) (p < 0.05). In RetinaNet, matrix size 896 was significantly higher FOM (0.906) than others (0.329-0.832) (p < 0.05). For sensitivity of abnormalities, there was a tendency to increase sensitivity when lesion size increases. For small nodules (< 10 mm), the sensitivities were 0.418 and 0.409, whereas the sensitivities were 0.937 and 0.956 for masses. Matrix size 896 and 1344 in Mask R-CNN and matrix size 896 in RetinaNet showed significantly higher sensitivity than others (p < 0.05).Conclusions: Matrix size 896 had the highest performance for various sizes of abnormalities using different CNNs. The optimal matrix size of chest radiograph could improve CAD performance without additional training data.Key Points: • Input matrix size significantly affected the performance of a deep learning-based CAD for detection of nodules or masses on chest radiographs. • The matrix size 896 showed the best performance in two different CNN detection models. • The optimal matrix size of chest radiographs could enhance CAD performance without additional training data. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to examine the relationship between staffing and job satisfaction of registered nurses ( RNs) and nursing assistants ( NAs). Background Although a number of previous studies have demonstrated the link between the numbers of patients cared for on the last shift and/or perceptions of staffing adequacy, we could find only one study that utilized a measure of actual staffing (opposed to perceptions of staffing adequacy) and correlated it with job satisfaction of registered nurses. Methods This cross-sectional study included 3523 RNs and 1012 NAs in 131 patient care units. Staff were surveyed to determine job satisfaction and demographic variables. In addition, actual staffing data were collected from each of the study units. Results Hours per patient day was a significant positive predictor for registered nurse job satisfaction after controlling for covariates. For NAs, a lower skill mix was marginally significant with higher job satisfaction. In addition, the more work experience the NAs reported, the lower their job satisfaction. Conclusion Adequate staffing levels are essential for RN job satisfaction whereas NA job satisfaction depends on the number of assistive personnel in the mix of nursing staff. Implications for Nursing Management Two implications are (1) providing adequate staffing is critical to maintain RN job satisfaction and (2) the NA job needs to be re-engineered to make it a more attractive and satisfying career. [ABSTRACT FROM AUTHOR]

To determine if nurse staffing predicts teamwork. A cross-sectional, descriptive design with a sample of nursing staff ( N= 2,545) on 52 patient care units in four hospitals was utilized. The Nursing Teamwork Survey was utilized to collect data on the level of perceived nursing teamwork on each of the study units. In addition, nursing staffing data were collected for each study unit. Higher levels of nurse staffing were related to better teamwork. Specifically, the greater the hours per patient day, the higher the level of overall teamwork on the unit (β= 0.417, p= .033). Also the greater the skill mix, the higher the level of overall teamwork on the unit (β= 0.436, p= .009). Adequate levels of staffing are needed to ensure nursing teamwork. The ability to provide quality and safe care is associated with teamwork, which in turn requires adequate staffing. [ABSTRACT FROM AUTHOR]

The proteasome inhibitor bortezomib has demonstrated clinical activity in patients with multiple myeloma (MM). Adverse events, including thrombocytopenia and peripheral neuropathy, have affected 30% to 60% of patients overall, and interrupted therapy in 10% to 20%. No prior toxicity data are available for Asian patients who have used bortezomib for MM. We used National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0, to review the clinical records of patients with an MM diagnosis from 25 centers in Korea. The included patients were treated with bortezomib alone or in combination with other agents, including thalidomide. Ninety-five MM patients were treated. The patients had a median age of 60 years (range, 42-77 years). The median number of previous treatments was 3 (range, 0-10), and 39% of the patients had been treated with 4 or more major classes of agents, including thalidomide (67%), and autologous stem cell transplantation (51%). Regimens included bortezomib only in 38 patients (40%), bortezomib plus dexamethasone in 34 patients (36%), and bortezomib plus a thalidomide-containing regimen in 23 patients (24%). The analysis of patient response to therapy revealed a complete response (CR) or a near-CR in 31 patients (33%) and a partial response in 30 patients (32%), for an objective response rate of 65% in 93 patients. The most common adverse events reported were thrombocytopenia (47%), sensory neuropathy (42%), anemia (31%), and leukopenia (31%). Thirteen patients (14%) stopped therapy because of adverse events (neuropathy, 8; infection, 4; diarrhea, 1). Neuropathy greater than grade 2 was more frequent in patients who received 4 or more prior therapy regimens (17/37) than in those who received 3 or fewer (14/58). In addition, therapy including thalidomide was significantly correlated with neuropathy of grades 1 to 3 (P = .001). We identified 6 therapy-related deaths (6%) within 20 days after the last dose of bortezomib. The causes of death were infection in 3 patients, disease progression in 2 patients, and suicide in 1 patient. The incidences of thrombocytopenia and neurotoxicity were similar; however, gastrointestinal toxicities were relatively low in Korean patients compared with those reported in Western studies. Significant neuropathy was associated with the number of prior regimens and combination with thalidomide. These findings provide useful information for clinicians and patients using bortezomib. [ABSTRACT FROM AUTHOR]

Background: Adjuvant chemotherapy after surgery improves survival of patients with stage II-III, resectable gastric cancer. However, the overall survival benefit observed after adjuvant chemotherapy is moderate, suggesting that not all patients with resectable gastric cancer treated with adjuvant chemotherapy benefit from it. We aimed to develop and validate a predictive test for adjuvant chemotherapy response in patients with resectable, stage II-III gastric cancer.Methods: In this multi-cohort, retrospective study, we developed through a multi-step strategy a predictive test consisting of two rule-based classifier algorithms with predictive value for adjuvant chemotherapy response and prognosis. Exploratory bioinformatics analyses identified biologically relevant candidate genes in gastric cancer transcriptome datasets. In the discovery analysis, a four-gene, real-time RT-PCR assay was developed and analytically validated in formalin-fixed, paraffin-embedded (FFPE) tumour tissues from an internal cohort of 307 patients with stage II-III gastric cancer treated at the Yonsei Cancer Center with D2 gastrectomy plus adjuvant fluorouracil-based chemotherapy (n=193) or surgery alone (n=114). The same internal cohort was used to evaluate the prognostic and chemotherapy response predictive value of the single patient classifier genes using associations with 5-year overall survival. The results were validated with a subset (n=625) of FFPE tumour samples from an independent cohort of patients treated in the CLASSIC trial (NCT00411229), who received D2 gastrectomy plus capecitabine and oxaliplatin chemotherapy (n=323) or surgery alone (n=302). The primary endpoint was 5-year overall survival.Findings: We identified four classifier genes related to relevant gastric cancer features (GZMB, WARS, SFRP4, and CDX1) that formed the single patient classifier assay. In the validation cohort, the prognostic single patient classifier (based on the expression of GZMB, WARS, and SFRP4) identified 79 (13%) of 625 patients as low risk, 296 (47%) as intermediate risk, and 250 (40%) as high risk, and 5-year overall survival for these groups was 83·2% (95% CI 75·2-92·0), 74·8% (69·9-80·1), and 66·0% (60·1-72·4), respectively (p=0·012). The predictive single patient classifier (based on the expression of GZMB, WARS, and CDX1) assigned 281 (45%) of 625 patients in the validation cohort to the chemotherapy-benefit group and 344 (55%) to the no-benefit group. In the predicted chemotherapy-benefit group, 5-year overall survival was significantly improved in those patients who had received adjuvant chemotherapy after surgery compared with those who received surgery only (80% [95% CI 73·5-87·1] vs 64·5% [56·8-73·3]; univariate hazard ratio 0·47 [95% CI 0·30-0·75], p=0·0015), whereas no such improvement in 5-year overall survival was observed in the no-benefit group (72·9% [66·5-79·9] in patients who received chemotherapy plus surgery vs 72·5% [65·8-79·9] in patients who only had surgery; 0·93 [0·62-1·38], p=0·71). The predictive single patient classifier groups (chemotherapy benefit vs no-benefit) could predict adjuvant chemotherapy benefit in terms of 5-year overall survival in the validation cohort (pinteraction=0·036 in univariate analysis). Similar results were obtained in the internal evaluation cohort.Interpretation: The single patient classifiers validated in this study provide clinically important prognostic information independent of standard risk-stratification methods and predicted chemotherapy response after surgery in two independent cohorts of patients with resectable, stage II-III gastric cancer. The single patient classifiers could complement TNM staging to optimise decision making in patients with resectable gastric cancer who are eligible for adjuvant chemotherapy after surgery. Further validation of these results in prospective studies is warranted.Funding: Ministry of ICT and Future Planning; Ministry of Trade, Industry, and Energy; and Ministry of Health and Welfare. [ABSTRACT FROM AUTHOR]