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This study aimed to investigate the effects of a violence-prevention education program using empathy (VPEP-E) on elementary school students. This quasi-experimental design examined fifth-grade students' (a) empathy level, (b) perception of violence, and (c) permissive and negligent attitudes toward violence, using a pre- and post-test design. A total of 101 students participated: the experimental group (n = 48) received eight sessions of VPEP-E, whereas the control group (n = 53) received violence prevention education through classroom lectures. Significant differences were observed between the groups' empathy level (t = 6.81, p <.001), perception of violence (t = 2.79, p =.006), and permissive and negligent attitudes toward violence (t = -2.21, p =.030; t = -2.02, p =.046). Thus, a school-based VPEP-E may help elementary school students. Long-term studies evaluating behavioral changes from VPEP-E implementation are needed for establishing the effects on violent behavior. [ABSTRACT FROM AUTHOR]

Introduction: There are limited and conflicting data regarding the impact of hepatitis C in pregnancy on adverse birth outcomes. Methods: Using the Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET), a large surveillance cohort, we describe birth outcomes among a cohort of people with HCV in pregnancy in total and by reported substance use. Results: Among 1418 infants, 89% were born to people with reported substance use during pregnancy. The proportion born preterm was 20%, 13% were small-for-gestational age and 34% of term infants required intensive care. Conclusions: Assessments of recent changes to recommendations for HCV screening in pregnancy should evaluate the impact on maternal access to care for both HCV treatment as well as comorbidities such as substance use disorder which may contribute to adverse birth outcomes. Significance: Incidence of hepatitis C in pregnancy is increasing. Prematurity, small-for-gestational age, and intensive care unit admission were common among this surveillance cohort of infants born to people with hepatitis C in pregnancy with high frequency of substance use. Assessments of recent changes to recommendations for HCV screening in pregnancy should evaluate the impact on maternal access to care for both HCV treatment as well as comorbidities such as substance use disorder which may contribute to adverse birth outcomes. [ABSTRACT FROM AUTHOR]

Objective: Language brokering (LB) is an act of interpreting and translating that immigrants often engage in to help their family members who may not be fluent in the English language. The study examined whether adhering to Asian American values (ie, values enculturation) could moderate the association between LB and internalizing symptoms (eg, depression, anxiety) among Asian American college students. Participants & Methods: An online survey was administered to a sample of 159 Asian American college students who had engaged in LB. Results: Results from the moderation analysis indicated that Asian American values enculturation significantly buffered against the adverse effects of high LB frequency on internalizing symptoms after controlling for gender and generation status. Conclusions: The current study offered insights into the toll that LB could take on Asian American college students' mental health as well as the potential protective roles of values enculturation. [ABSTRACT FROM AUTHOR]

Background: Time elapsed since pain onset might affect the likelihood of neuropathic component in low back pain. The aim of this study was to investigate the relationship between neuropathic pain component and pain duration in patients with low back pain and to identify factors associated with neuropathic pain component. Methods: Patients with low back pain who received treatment at our clinic were enrolled. Neuropathic component was assessed using the painDETECT questionnaire at the initial visit. PainDETECT scores and the results for each item were compared according to pain duration category (< 3 months, 3 months to 1 year, 1 year to 3 years, 3 years to 10 years, and ≥ 10 years). A multivariate analysis was used to identify factors associated with neuropathic pain component (painDETECT score ≥ 13) in low back pain. Results: A total of 1957 patients, including 255 patients who reported neuropathic‐like pain symptoms (13.0%), fully satisfied the study criteria for analysis. No significant correlation between painDETECT score and pain duration was observed (ρ = −0.025, p = 0.272), and there were no significant differences between median painDETECT score or trend of change in the proportion of patients with neuropathic component and the pain duration category (p = 0.307, p = 0.427, respectively). The electric shock‐like pain symptom was frequently reported in patients with acute low back pain, and the persistent pain pattern with slight fluctuations was predominant in chronic low back pain. The pattern of attacks with pain between them was much less common in patients with pain for 10 years or longer. Multivariate analysis revealed that a history of lumbar surgery, severe maximum pain, opioid use, lumbosacral radiculopathy, and sleep disturbance were significantly associated with a neuropathic component in low back pain. Conclusion: Time elapsed since current pain onset did not correlate with neuropathic pain component in patients with low back pain. Therefore, diagnostic and therapeutic approaches for this condition should be based on a multidimensional evaluation at assessment and not on pain duration alone. [ABSTRACT FROM AUTHOR]

Background: There are growing concerns about the impact of the COVID-19 pandemic on the mental health of older adults. We examined the effect of the pandemic on the risk of depression in older adults. Methods: We analyzed data from the prospective cohort study of Korean older adults, which has been followed every 2 years. Among the 2308 participants who completed both the third and the fourth follow-up assessments, 58.4% completed their fourth follow-up before the outbreak of COVID-19 and the rest completed it during the pandemic. We conducted face-to-face diagnostic interviews using Mini International Neuropsychiatric Interview and used Geriatric Depression Scale. We performed generalized estimating equations and logistic regression analyses. Results: The COVID-19 pandemic was associated with increased depressive symptoms in older adults [ b (standard error) = 0.42 (0.20), p = 0.040] and a doubling of the risk for incident depressive disorder even in euthymic older adults without a history of depression (odds ratio = 2.44, 95% confidence interval 1.18–5.02, p = 0.016). Less social activities, which was associated with the risk of depressive disorder before the pandemic, was not associated with the risk of depressive disorder during the pandemic. However, less family gatherings, which was not associated with the risk of depressive disorder before the pandemic, was associated with the doubled risk of depressive disorder during the pandemic. Conclusions: The COVID-19 pandemic significantly influences the risk of late-life depression in the community. Older adults with a lack of family gatherings may be particularly vulnerable. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify students' awareness of the use of a chatbot (A-uC), a type of artificial intelligence technology, for violence prevention among elementary school students. Methods: The participants comprised 215 students in the fourth to sixth grades in Chuncheon, South Korea, and data were collected via a self-reported questionnaire. Results: The mean A-uC score was 3.43±0.83 out of 5 points. The mean scores for the 4 sub-dimensions of the A-uC tool were 3.48±0.80 for perceived value, 3.44±0.98 for perceived usefulness, 3.63±0.92 for perceived ease of use, and 3.15±1.07 for intention to use. Significant differences were observed in A-uC scores (F=59.26, p<.001) according to the need for the use of chatbots in violence prevention education. The relationships between intention to use and the other A-uC sub-dimensions showed significant correlations with perceived value (r=.85, p<.001), perceived usefulness (r=.76, p<.001), and perceived ease of use (r=.64, p<.001). Conclusion: The results of this study suggest that chatbots can be used in violence prevention education for elementary school students. [ABSTRACT FROM AUTHOR]

Rapid diagnostic tests (RDTs) facilitate fast and accurate identification of infectious disease microorganisms and are a valuable component of multimodal antimicrobial stewardship (AMS) programs but are currently underutilized in the Asia-Pacific region. An experienced group of infectious diseases clinicians, clinical microbiologists, and a clinical pharmacist used a modified Delphi consensus approach to construct 10 statements, aiming to optimize the utility and applicability of infection-related RDTs for AMS in the Asia-Pacific region. They provide guidance on definition, types, optimal deployment, measuring effectiveness, and overcoming key challenges. The Grading of Recommendations Assessment, Development, and Evaluation system was applied to indicate the strength of the recommendation and the quality of the underlying evidence. Given the diversity of the Asia-Pacific region, the trajectory of RDT development will vary widely; the collection of local data should be prioritized to allow realization and optimization of the full benefits of RDTs in AMS. [ABSTRACT FROM AUTHOR]

Sudden sensorineural hearing loss (SSNHL) has several aetiologies and may be a presenting symptom of vestibular schwannoma (VS). The aim of this study was to investigate the recovery rate after steroid treatment and the prognostic factors of SSNHL with VS. This was a retrospective observational study wherein 32 patients with VS who presented with SSNHL were analysed at a tertiary referral centre. Hearing gain and prognostic factors were the main outcome measures for steroid treatment intervention. Among the 1698 patients presenting with SSNHL, VS was found in 43 (2.5%) patients. Eleven cases (34.3%) showed good recovery, with significant improvements in the pure-tone audiometry values. Even though age was a significant factor, there were no associations between steroid response and initial hearing level, presence of vertigo, tumour size, and tumour extension. Our study showed that hearing recovery of SSNHL does not exclude a VS diagnosis. We suggest that steroid treatment be considered in patients with VS presenting SSNHL. [ABSTRACT FROM AUTHOR]

Objective We explored latent profiles based on mindfulness and difficulties in emotion regulation scores, and investigated each profiles' relations to work–family–school conflict (WFSC). Participants: A total of 194 first year college students (64.4% women) participated in this study. Methods: Latent profile analysis was utilized. Results: Three profiles emerged, characterized as the "healthy" profile (57.5%), the "observant yet judgmental" profile (33.3%) and the "unhealthy without strategies" profile (9.2%). The "healthy" profile showed (a) significantly lower scores on all conflict domains compared to the "observant yet judgmental" profile, and (b) significantly lower scores on all behavior-based conflicts regardless of the domains, compared to the "unhealthy without strategies" profile. The difference between the "observant yet judgmental" profile and "unhealthy without strategies" profile appeared in family-school time. Results indicate that mindfulness and healthy emotion regulation capacity function as protective factors to WFSC. Conclusions: Our findings hold strength in explicating profiles that would otherwise have not been detected when exploring mindfulness and difficulties in emotion regulation independently. [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]

This study aimed to compare perceptions of spiritual care among patients with life-threatening cancer, their primary family caregivers, and hospice/palliative care nurses. Data were collected using both structured and unstructured approaches. Structured questionnaire data were examined using statistical analysis methods, and unstructured data were examined using content analysis to compare the 3 participant groups. The questionnaire revealed that among all 3 groups, spiritual care was commonly perceived to relate to "having the opportunity for internal reflection," "finding meaning," "encouraging hope," and "listening to and being with patients." Content analysis of the unstructured data revealed 5 themes: "Caring with sincerity," "Strengthening spiritual resources," "Alleviating physical pain and discomfort" (among patients and primary family caregivers only), "Improving spiritual care service," and "Multifaceted cooperation" (among hospice/palliative care nurses only). Our findings suggest that for patients with life-threatening illnesses such as terminal cancer, spiritual care should not be limited to religious practice but should also satisfy inner existential needs, for example, by encouraging hope, providing empathy, and helping patients find meaning in their circumstances. [ABSTRACT FROM AUTHOR]

Background: The optimal technique for plate fixation to treat type B and C periprosthetic femoral fractures (PFFs) is unclear. The purpose of this study is to evaluate the radiographic results of inner-side-out limited contact dynamic compression plate (LC-DCP) to treat PFFs during or after total hip arthroplasty (THA). Methods: This retrospective study comprised of four men and six women with an average age of 64.7 years who underwent open reduction and internal fixation with an inner-side-out LC-DCP technique to treat PFFs; the reduction was maintained preliminary with the use of contoured plate and cables, and the grooves on the undersurface of LC-DCP for limited contact was used to hold and prevent the cables from slippage during tightening the cables. There were five intraoperative and five postoperative PFFs after THA. According to the Vancouver classification, the intraoperative PFFs included type B2 in two, B3 in one and C3 in two patients while postoperative PFFs were categorized into type B1 in one, type B2 in two and type C in two patients. The mean follow-up duration was 5.9 years (range 1–10.4). We evaluated radiographic union and complications after index operation. Results: All patients demonstrated radiographic bone union at an average follow-up duration of 4.4 months (range 3–8). Two patients showed stem subsidence after revision THA and one patient demonstrated a subsequent peri-implant fracture around the distal end of plate after union of the initial PPF; one patient underwent re-revision THA for stem loosening while another patient went through refixation for the peri-implant fracture. There was no nonunion, infection, nerve injury, or dislocation. Conclusion: The inner-side-out LC-DCP technique showed satisfactory radiographic outcome. In certain situations where locking plates are not available, this technique might be a useful alternative for treating type B and C PFFs. [ABSTRACT FROM AUTHOR]

The cross-cultural validity of a modified version of psychology of working theory (PWT; Duffy, Blustein, Diemer, & Autin, 2016) was tested in samples of United States (n = 346) and Korean (n = 319) undergraduates. Participants completed measures of economic resources, work volition, career adaptability, occupational engagement, and future decent work perceptions. The results illustrated measurement invariance between the two samples. Thus, the hypothesized models were tested separately in the two samples and the results were compared regarding parameter significance, direction, and magnitude. Overall, the modified model generally fit well with both samples. However, there were notable cross-cultural differences: economic resources significantly predicted work volition, occupational engagement, and future decent work perceptions only in the United States sample and the future decent work perceptions and occupational engagement were negatively associated in the Korean sample. Explanations about the cross-cultural differences and invariances were provided and practical and research implications were discussed. Public Significance Statement: This study examined predictors of occupational engagement and future perceptions of decent work among undergraduate samples from the United States and Korea. Although psychological factors such as the perceived ability to freely make career choice and the resources to cope with various career tasks were important for both sample, notable differences existed concerning the links between economic resources to career-related behaviors and perceptions of future work. [ABSTRACT FROM AUTHOR]

Background: Breast self‐examination is a convenient and effective way to detect breast abnormalities. Based on Dale's Cone of Experience theory, we hypothesized that the combination of a smartphone application with hands‐on practice would have a greater impact than using a smartphone application alone. The purpose of this study was to compare the effects of different educational methods on (a) knowledge, (b) attitudes, (c) skills, and (d) students' satisfaction with the learning methods. Methods: We conducted a pre‐ and post‐test quasi‐experimental design and developed a smartphone application using a video clip. One experimental group received smartphone‐based education, another group received smartphone‐based education combined with hands‐on practice, and the control group received a one‐time classroom lecture. We administered a pre‐test, provided intervention, and conducted a post‐test. Results: Among the three groups, the knowledge and attitude of the experimental groups were significantly higher than that of the control group. In addition, the group using the combination of the smartphone application and hands‐on practice showed the highest score changes in skills and satisfaction with the learning methods. Conclusions: Smartphone application use combined with hands‐on practice could be an effective education method for breast self‐examination. [ABSTRACT FROM AUTHOR]

Objective: The deviated nose presents a tremendous challenge for rhinoplasty surgeons, especially the correction of the cartilaginous dorsum deviation. In this study, we introduce the surgical techniques of correcting a deviated cartilaginous vault by creating a new center of the lower third using a caudal septal extension graft combined with unilaterally extended spreader grafts. Methods: This retrospective observational study was conducted in a university-based tertiary medical center from December 2014 to January 2018. Thirty-two patients who underwent primary open rhinoplasty for correction of a deviated nose using this method participated in the study. Patient characteristics and surgical records were collected. Anthropometric measurements and analyses were performed based on preoperative and postoperative photographs. The aesthetic outcome consensus of three rhinoplasty surgeons was evaluated specifically for nasal dorsum deviation correction. Postoperative complications were reviewed from the medical records. Results: Among the 32 patients, there were 18 males and 14 females. The mean (SD) age of the patients was 26.7 (8.76) years. Anthropometric measurements showed significant improvements in dorsal deviation angle (a 3.7° change towards midline, P <.001), nasal tip projection (increase of 6.96% measured by Goode's method, P <.001), and nostril shape (nostril axis inclination decrease of 11.7°, P <.001) after surgery. The nasolabial angle showed no significant change. Aesthetic outcomes were excellent in seven patients (21.9%), good in fourteen patients (43.7%), fair in eight patients (25.0%), and no change in three patients (9.4%). Minor postoperative complications (four patients) were observed during follow-up. Conclusion: Centering the cartilaginous vault using a caudal septal extension graft combined with unilaterally extended spreader grafts is a useful technical option in the correction of a deviated nose, and provides improvement in nasal tip projection and nostril shape. [ABSTRACT FROM AUTHOR]

Reducing functional decline is an essential treatment goal in older adults after hip fracture surgery. The current study examined different effects of functional decline–related factors according to activities of daily living (ADL) and instrumental ADL (IADL) in older adults after hip fracture surgery. A total of 120 participants were included. In quantile regression, preoperative walking and fear of falling were significantly associated with ADLs in the 25th percentile ADL group. Fear of falling was the only significant factor in the poorest IADL group (25th percentile). Efforts should be made to reduce fear of falling after hip fracture surgery. Preoperative walking status was significant in patients with poor ADL after hip fracture surgery; therefore, walking status should be taken into consideration when planning rehabilitation care in this group, so that the best possible ADL outcomes can be attained. (6),312–320.][Research in Gerontological Nursing, 12(6),312–320.] [ABSTRACT FROM AUTHOR]

This study aimed to examine the reliability and validity of a scale to assess the competence of Korean nurses who provide spiritual care for patients with terminal illnesses. The reliability and validity were examined using Cronbach [alpha] , item analysis, and exploratory factor analysis. The participants were 248 hospice nurses working at 40 hospices and palliative hospitals in South Korea. The results showed that the reliability was high, as indicated by a Cronbach [alpha] of.942. The exploratory factor analysis revealed 6 dimensions (assessment and implementation of spiritual care, professionalization and improvement of the quality of spiritual care, personal support and patient counseling, referral to professionals, attitude toward the patient's spirituality, and communication) with 27 items. The 6 factors explained 68.20% of the variance in the Korean version of the Spiritual Care Competence Scale. From the results, the Korean version of the Spiritual Care Competence Scale may serve as an appropriate measure for provision of spiritual care for patients with terminal illness. In addition, it may be useful in assessing hospice and palliative nurses' ability for spiritual care. [ABSTRACT FROM AUTHOR]

Aims Individuals without traditional cardiovascular risk factors (CVRFs) still experience adverse events in clinical practice. This study evaluated the predictors of subclinical coronary atherosclerosis in individuals without traditional CVRFs. Methods and results A total of 1250 (52.8 ± 6.5 years, 46.9% male) asymptomatic individuals without CVRFs who underwent coronary computed tomographic angiography for a general health examination were analysed. The following were considered as traditional CVRFs: systolic/diastolic blood pressure ≥140/90 mmHg; fasting glucose ≥126 mg/dL; total cholesterol ≥240 mg/dL; low-density lipoprotein cholesterol (LDL-C) ≥160 mg/dL; high-density lipoprotein cholesterol <40 mg/dL; body mass index ≥25.0 kg/m2; current smoking status; and previous medical history of hypertension, diabetes, and dyslipidaemia. Subclinical atherosclerosis, defined as the presence of any coronary plaque, was present in 20.6% cases; the incidences of non-calcified, calcified, and mixed plaque were 9.6%, 12.6%, and 2.6%, respectively. Multivariate regression analysis showed that LDL-C level [odds ratio (OR): 1.008; 95% confidence interval (CI): 1.001–1.015], together with age (OR: 1.101; 95% CI: 1.075–1.128) and male sex (OR: 5.574; 95% CI: 3.310–9.388), was associated with the presence of subclinical atherosclerosis (All P  < 0.05). LDL-C level was significantly associated with an increased risk of calcified plaques rather than non-calcified or mixed plaques. Conclusion LDL-C, even at levels currently considered within normal range, is independently associated with the presence of subclinical coronary atherosclerosis in individuals without traditional CVRFs. Our results suggest that a stricter control of LDL-C levels may be necessary for primary prevention in individuals who are conventionally considered healthy. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to test the mediating effect of job embeddedness in the relationship between nursing practice environment on nursing job performance and organizational commitment. Methods: For this study a descriptive design with survey method was utilized. Participants were 192 clinical nurses recruited from 2 hospitals in A, B city and J province in Korea. From June, 6 to 24, 2018, a questionnaire scale was used to collect the data. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation analysis, and liner regression analysis. Results: There were significant positive relationships for nursing job performance and organizational commitment with nursing practice environment. In addition, job embeddedness had a full mediating role in the relationship between nursing practice environment and nursing job performance, and a partial mediation effect in nursing practice environment and organizational commitment. Conclusion: The purpose of this study was to identify the mediating effects of job embeddedness and to find ways to improve organizational commitment, which is a useful variable to predict performance outcomes, nurse job performance and job behavior of organizational members. Also, the study results can be used as basic data for nursing manpower management strategies. [ABSTRACT FROM AUTHOR]

This study examined the effect of an intervention on coping knowledge among fifth- and sixth-grade elementary schoolchildren who received smartphone-delivered emergency preparedness education. This was a quasi-experimental study using a pre-/posttest design. Eighty-six children were recruited to participate. The children in the experimental group (n = 44) received smartphone-delivered emergency preparedness education while those in the control group (n = 42) received traditional lecture-centered education. Data were analyzed using a repeated-measured analysis of variance. Subsequently, the experimental group scored significantly higher than the control group on coping knowledge (F = 7.96, f = .31, p = .010). The use of technology such as smartphone-delivered emergency preparedness education may be effective to improve their coping knowledge of fifth- and sixth-grade elementary schoolchildren. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to identify factors influencing beliefs about intimate partner violence among Korean adults. Design and Sample This is a cross-sectional descriptive study that analyzed data from 466 adults. Measures Beliefs about intimate partner violence were measured using a self-report questionnaire with a total of 28 items consisting of four subscales: perpetrator's justification for beating women, blaming women for violence against them, perpetrator's responsibility for violence, and giving help to victims. Results Men and women had significantly different beliefs about intimate partner violence ( t = −7.19, p < .001). Some characteristics were identified that led to unhealthy beliefs about intimate partner violence. Four variables-gender, age, educational level, and witnessing parental violence-had an explanatory power of 20% with regard to beliefs about IPV ( F = 10.50, p = .000). Conclusions In South Korea, men, older individuals, and those with less formal education or who have witnessed parental violence need education to foster healthier beliefs about intimate partner violence. Nurses can play a vital role in efforts to decrease intimate partner violence. [ABSTRACT FROM AUTHOR]

Conclusion: Middle fossa approach (MFA) shows a hearing preservation rate of 86% and facial nerve function was preserved with HB grade I or II in 93%. MFA is a good treatment option for intra-canalicular vestibular schwannomas when surgical excision is needed. Background: Surgical outcomes of vestibular schwannoma have progressively improved with the advancement of microsurgical instruments. MFA is known to have better chances to preserve hearing, while it has limited access to the posterior fossa, limitation of tumor size, and higher risk of post-operative facial nerve weakness. Objectives: To investigate surgical outcomes and clinical efficiency of MFA in vestibular schwannoma. Methods: A retrospective study was done in 14 patients who underwent MFA for vestibular schwannoma in Asan Medical Center. Results: The median age at diagnosis was 46.3 years. At initial presentation, 57% of the patients had vertigo, 43% hearing disturbance, and 64% tinnitus. The mean tumor size was 9.7 mm. The tumors were completely resected in 86% of the patients. Hearing was post-operatively preserved in 12 patients and two patients lost their hearing following surgery. Facial nerve function post-operatively remained unchanged in 12 patients (86%). [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify the differences in suicide risk, meaning in life, and need for life respect among three age groups (young adults, the middle aged, and the elderly) of 540 public hospital outpatients in South Korea. This was a cross-sectional study. Among these 3 age groups, we observed significant differences in suicide risk, meaning in life, and need for life respect according to education level, marital status, living arrangements, type of disease, gender, and monthly income. These findings might contribute to the prevention of suicide in the future and the implementation of better community-based nursing care. [ABSTRACT FROM PUBLISHER]

Purpose The aim of this study was to identify the physiological, psychological, and situational factors affecting fatigue among mothers of hospitalized children. Design and Methods This study used a cross-sectional descriptive design with a self-report questionnaire. Participants were 211 mothers with children younger than 6 years old who were admitted to general hospitals. Based on the theory of unpleasant symptoms, the physiological, psychological, and situational factors were tested using structural equation modeling. Results Mothers' fatigue was influenced by physiological ( β = .24), situational, and psychological factors ( β = .17), and situational ( β = .37) factors such as the mother's sleeping hours, the child's adaptation to hospitalization, anxiety and having support with their housework. These three factors explained 31.34% of the variance in fatigue. In particular, it was found that the psychological factors exacerbate the negative influence of the situational factors on fatigue. Moreover, the situational factors were most strongly related to mothers' fatigue, and they had an indirect effect via the psychological factors as a mediator. Practice Implications It is necessary to implement a nursing intervention that targets the controllable factors such as anxiety and children's adaptation to hospitalization that were identified in this study. Pediatric nursing care should not be limited to treating children's illnesses, but should be extended to providing family-centered care. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test the effects of healthy life practice (HLP) education on reported health behaviors, including health promotion, disease prevention, and safety among fourth-grade elementary school students. A quasi-experimental, pretest/posttest design was used. The 101 recruited participants from two schools were assigned to the intervention group (n = 51) that received 10 health education sessions and the control group (n = 50) that did not receive the intervention. Significant differences in health behaviors were observed between the two groups (t = 2.563, p = .012), specifically for disease prevention (t = 2.178, p = .032) and safety (t = 2.711, p = .008). However, no significant between-group differences were observed in health promotion (t = .270, p = .788). Educational interventions aimed at changing HLP-related health behaviors may be effective for elementary schoolchildren. [ABSTRACT FROM AUTHOR]

Conclusion:Seven-day administration of systemic steroids was more effective in preserving hearing for 12 weeks after cochlear implantation (CI) than a 3-day delivery. Objectives:To determine the effectiveness of extended delivery of systemic steroids to preserve hearing in guinea pigs after CI. Methods:Dexamethasone (4 mg/ml) was delivered parenterally via a mini-osmotic pump for either 3 or 7 days. A dummy CI electrode was inserted via cochleostomy approach in 8-week-old guinea pigs. Auditory thresholds were assessed from tone burst auditory brainstem responses (2, 8, 16, 24, and 32 kHz) at 1 day prior to CI, and 1, 4, and 12 weeks after implantation. Histologic evaluation of the cochleae was carried out. Results:No differences were observed in hearing thresholds among groups before CI. Significant hearing preservation was achieved at 8, 16, 24, and 32 kHz only in the 7-day infusion group compared with the control group at 1 week after CI. The same trend was maintained at 4 weeks (16, 24 kHz) and 12 weeks (16, 24, and 32 kHz). Histologic review of the 7-day infusion group revealed less fibrosis and ossification in the scala tympani and the preservation of more spiral ganglion cells, compared with the control group. [ABSTRACT FROM PUBLISHER]

This study identified the effects of a community-based cardiovascular disease prevention program (CVD-PP) on health behavior and modifiable cardiovascular risk factors in low-income Korean elderly with hypertension. Eighty-eight individuals completed the 3-month self-efficacy-enhancing interventions in which the control group received standard care. In the intervention group, there were statistically significant improvements in self-efficacy (t = 2.519,p = 0.016) and health behavior (t = 3.453,p = 0.001), and significant differences in diastolic blood pressure (t = –2.518,p = 0.018) between the two groups. This CVD-PP administered by visiting nurses may be effective in improving self-efficacy and health behavior and in reducing modifiable cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Osteonecrosis of the femoral head (ONFH) is a complex and multifactorial disease that is influenced by a number of genetic factors in addition to environmental factors. Some autoimmune disorders, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and inflammatory bowel disease (IBD), are associated with the development of ONFH. Complement receptor type 2 (CR2) is membrane glycoprotein which binds C3 degradation products generated during complement activation. CR2 has many important functions in normal immunity and is assumed to play a role in the development of autoimmune disease. We investigated whether CR2 gene polymorphisms are associated with risk of ONFH in SLE patients. Eight polymorphisms in the CR2 gene were genotyped using TaqMan™ assays in 150 SLE patients and 50 ONFH in SLE patients (SLE_ONFH). The association analysis of genotyped SNPs and haplotypes was performed with ONFH. It was found that three SNPs, rs3813946 in 5′-UTR (untranslated region), rs311306 in intron 1, and rs17615 in exon 10 (nonsynonymous SNP; G/A, Ser639Asn) of the CR2 gene, were associated with an increased risk of ONFH under recessive model (P values; 0.004~0.016). Haplotypes were also associated with an increased risk (OR; 3.73~) of ONFH in SLE patients. These findings may provide evidences that CR2 contributes to human ONFH susceptibility in Korean SLE patients. [ABSTRACT FROM AUTHOR]

This study determines the effect of simulation with team-based learning ( TBL) on newborn nursing care. This randomized controlled trial included 74 nursing students from one university located in Seoul, South Korea. Participants were categorized into two groups according to educational modality: one group involved both simulation and TBL, and the other involved simulation alone. Learning attitudes , academic achievement, and simulation performance were examined to assess effectiveness. The mean difference in learning attitudes between the two groups was non-significant. Low academic achievement differed significantly between the two groups (t = 3.445, P = 0.002). There was no significant difference in mean scores for simulation performance between the two groups. In this study, simulation with TBL was effective in improving learning outcomes. In current nursing education, various learning methods are employed within complex nursing situations and require flexibility and problem-solving approaches. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the association of a urinary tubular marker, liver-type fatty acid binding protein (L-FABP) and an inflammatory marker, serum/urinary YKL-40, with albuminuria in patients with childhood-onset type 1 diabetes (T1D). Methods: Twenty-nine patients with childhood-onset T1D and 32 controls were enrolled. Serum and urinary concentrations of YKL-40 and urinary concentrations of L-FABP were measured. Results: The serum levels of YKL-40 were not significantly different between the control group and the patient groups. However, the levels of urinary YKL-40/creatinine (Cr) were higher in the patients, even those with normoalbuminuria than in the controls ( p < 0.001). The levels of urinary L-FABP/Cr were not different between the control group and the patient groups. However, the level of urinary L-FABP/Cr in the microalbuminuria group was higher than that in the normoalbuminuria group ( p = 0.03). There were no associations between the levels of urinary albumin-to-creatinine ratio and urinary L-FABP/Cr or YKL-40/Cr. However, the urinary L-FABP/Cr level was significantly correlated with the hemoglobin A1C level ( p = 0.005) and the urinary YKL-40/Cr level ( p = 0.043). Conclusions: Urinary L-FABP/Cr and YKL-40/Cr may reflect renal injury in early stages of nephropathy in patients with childhood-onset T1D, even in the normoalbuminuric state. [ABSTRACT FROM AUTHOR]

Objectives: Women with gestational diabetes mellitus (GDM) may be able to reduce their risk of recurrent GDM and progression to type 2 diabetes mellitus through lifestyle change; however, there is limited population-based information on GDM recurrence rates. Methods: We used data from a population of women delivering two sequential live singleton infants in Massachusetts (1998-2007) to estimate the prevalence of chronic diabetes mellitus (CDM) and GDM in parity one pregnancies and recurrence of GDM and progression from GDM to CDM in parity two pregnancies. We examined four diabetes classification approaches; birth certificate (BC) data alone, hospital discharge (HD) data alone, both sources hierarchically combined with a diagnosis of CDM from either source taking priority over a diagnosis of GDM, and both sources combined including only pregnancies with full agreement in diagnosis. Descriptive statistics were used to describe population characteristics, prevalence of CDM and GDM, and recurrence of diabetes in successive pregnancies. Diabetes classification agreement was assessed using the Kappa statistic. Associated maternal characteristics were examined through adjusted model-based t tests and Chi square tests. Results: A total of 134,670 women with two sequential deliveries of parities one and two were identified. While there was only slight agreement on GDM classification across HD and BC records, estimates of GDM recurrence were fairly consistent; nearly half of women with GDM in their parity one pregnancy developed GDM in their subsequent pregnancy. While estimates of progression from GDM to CDM across sequential pregnancies were more variable, all approaches yielded estimates of ≤5 %. The development of either GDM or CDM following a parity one pregnancy with no diagnosis of diabetes was <3 % across approaches. Women with recurrent GDM were disproportionately older and foreign born. Conclusion: Recurrent GDM is a serious life course public health issue; the inter-pregnancy interval provides an important window for diabetes prevention. [ABSTRACT FROM AUTHOR]

Patients infected with human immunodeficiency virus (HIV) may develop mental health problems such as anxiety and depression, which negatively impact of disease progression. We investigated factors associated with the prevalence of anxiety and depression symptoms among HIV-infected patients in Korea. A total of 840 HIV-infected patients who participated in the Korea HIV/AIDS Cohort Study from 2006 to 2012 were evaluated. Socio-demographic, epidemiologic, and clinical variables were obtained through standardized questionnaires. The State-Trait Anxiety Inventory and Beck Depression Inventory were used to assess the symptoms of anxiety and depression. Multiple logistic regression analyses were performed to identify factors associated with symptoms of anxiety and depression. The prevalence of anxiety and depressive symptoms among HIV-infected patients was 32% and 36%, respectively. Ex-smoker and persistent symptoms for more than one week within the past six months and diagnosis of HIV infection within one year were associated with increased anxiety symptoms (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.09–2.69; OR 1.52, 95% CI 1.09–2.11; OR 1.49, 95% CI 1.02–2.20) and current smoking and persistent symptoms were also associated with increased depressive symptoms (OR 2.10, 95% CI 1.31–3.30; OR 1.87, 95% CI 1.25–2.79). Marital status, current smoking, current drinking, and persistent symptoms were associated with both increased anxiety and depressive symptoms (OR 1.75, 95% CI 1.07–2.88; OR 1.66, 95% CI 1.06–2.61; OR 1.88, 95% CI 1.18–2.99). The prevalence of anxiety and depressive symptoms among HIV-infected patients is higher than those estimated for the general population. This study shows the necessity to evaluate symptoms of anxiety and depression and suggest psychological support for HIV-infected patients who smoke or have persistent symptoms or have sexual partner or drink. [ABSTRACT FROM AUTHOR]

Background Central sensitization plays an important role in the chronic pain experienced by osteoarthritis ( OA) patients. In this prospective observational study, we investigated the influence of the level of preoperative centrally mediated symptoms measured by the Central Sensitization Inventory ( CSI) on pain intensity after total knee arthroplasty ( TKA) for OA. Methods Ninety-eight female OA patients undergoing TKA were enrolled in this study. We assessed CSI scores, pain-related data, and other clinical data preoperatively. All patients received spinal anesthesia and postoperative epidural analgesia. Pain intensity (at rest and on movement) and rescue meperidine requirements were assessed during postoperative days 1 and 2. Also, pain intensity and patient satisfaction were assessed 1 month and 3 months after surgery. After the completion of all postoperative assessments, we separated the study population into a preoperative CSI score ≥40 and <40 group. We assessed pain-related data between the 2 groups at each assessment time. Results Ninety-one patients completed the postoperative assessments (a preoperative CSI ≥40 group; n = 44, CSI <40 group; n = 47). Patients with preoperative CSI ≥40 complained of a greater pain intensity ( P = 0.001) during postoperative days 1 and 2 and required a higher dose of meperidine rescue ( P = 0.003) than those with a preoperative CSI <40. The high CSI score group also showed a less favorable outcome in terms of pain relief on follow-up at 1 month ( P = 0.006) and 3 months ( P = 0.002) after surgery. In multivariate analysis, a preoperative CSI score ≥40 was the strongest determinant with 5.091 of the highest odds ratio (95% CI 1.324 to 19.523, P = 0.016) for predicting a persistent pain 3 months after surgery among demographic and pain-related variables. Conclusions OA patients with high levels of comorbid centrally mediated symptoms showed severe pain and increased analgesic requirements after TKA in the early postoperative period. Moreover, these patients seemed to be at higher risk of persistent pain, and a high CSI score was predictive of low patient satisfaction in terms of pain relief after surgery. [ABSTRACT FROM AUTHOR]

Background Because of its anatomical location and function, the obturator externus ( OE) muscle can be a source of pain; however, this muscle is understudied as a possible target for therapeutic intervention in pain practice. In this retrospective observational study, we evaluated the clinical effectiveness of the OE muscle injection with a local anesthetic in chronic pelvic pain patients with suspected OE muscle problems. Methods Twenty-three patients with localized tenderness on the inferolateral side of the pubic tubercle accompanied by pain in the groin, anteromedial thigh, or hip were studied. After identifying the OE with contrast dye under fluoroscopic guidance, 5 to 8 mL of 0.3% lidocaine was injected. Pain scores were assessed before and after injection; patient satisfaction was also assessed. Results Mean pain score decreased by 44.7% (6.6 ± 1.8 to 3.5 ± 0.9, P < 0.001) 2 weeks after OE muscle injection as compared with pain score before injection. In addition, 82% of patients (19 of 23 patients) reported excellent or good satisfaction during 2 weeks after injection. No patients reported complications from OE muscle injection. Conclusions Fluoroscopy-guided injection of the OE muscle with local anesthetic reduced pain scores and led to a high level of satisfaction at short-term follow-up in patients with suspected OE muscle problem. The results of this study suggest that OE muscle injection may be a valuable therapeutic option for a select group of chronic pelvic pain patients who present with localized tenderness in the OE muscle that is accompanied by groin, anteromedial thigh, or hip pain. [ABSTRACT FROM AUTHOR]

This study analyzed the prevalence of metabolic syndrome (MetS) and evaluated the factors associated with MetS. Subjects numbered 2,213 adults who participated in the health screening survey. Results show that the prevalence of MetS, Risk-MetS, and Non-MetS was 28.2%, 44.9%, and 26.9% respectively. Factors influencing variables were age, gender, history of hypertension and diabetes mellitus, abdominal obesity, high-density lipoprotein cholesterol, triglyceride, blood pressure, fasting blood glucose, alcohol consumption, and level of physical activity. Community health nurses should plan to develop MetS management programs that target Mets or Risk-MetS groups to promote health. [ABSTRACT FROM AUTHOR]

Aim: This study examined the effects of a conscious sedation dressing on pain and anxiety in pediatric patients with burns. Methods: This was a quasi‐experimental study, using a nonequivalent control group. Using convenience sampling, the participants were assigned to two groups, an experimental group (n = 10), which comprised children who received a conscious sedation dressing, and a control group (n = 13), which comprised children who received general dressing care. To minimize the risk of contamination between the two groups, the sampling was sequentially performed. Results: The children in the experimental group showed significantly lower levels of pain (U = 3.29, d = 1.00, P =.003) and physiological responses, as evidenced by lower systolic blood pressures, diastolic blood pressures, pulse rates, and respiratory rates than the control group (systolic blood pressures: t = 5. 05, d = 1.22, P <.001; diastolic blood pressures: t = 2.12, d = 0.93, P =.046; pulse rates: t = 2.28, d = 1.00, P =.033; and respiratory rates: t = 2.47, d = 1.09, P =.022). Conclusion: The application of a conscious sedation dressing may alleviate pain and anxiety for pediatric burn patients. [ABSTRACT FROM AUTHOR]

In this study, we identified the factors influencing behavioral intention to undergo Papanicolaou testing among Japanese and Korean women in early adulthood. Their behavioral intentions were compared in this cross-sectional descriptive study. In total, 887 women (Japanese = 498, Korean = 389) aged 20-39 years participated in this study. Using a self-report questionnaire, knowledge, attitudes, subjective norm, perceived behavioral control, and behavioral intention were surveyed. There were significant differences between Japanese and Korean women's scores on all main variables. For Japanese women, all the variables moderately correlated with behavioral intention. In comparison, for Korean women, all independent variables, except for knowledge, moderately correlated with behavioral intention. Through a multiple regression analysis, age, undergoing Papanicolaou testing, attitudes, subjective norm, and perceived behavioral control were identified as significant predictors of behavioral intention among Japanese women. Among Korean women, job status, undergoing a Papanicolaou test, attitudes, subjective norm, and perceived behavioral control were demonstrated as significant predictors of behavioral intention. Health professionals should consider these factors to encourage Papanicolaou testing in women in early adulthood. [ABSTRACT FROM AUTHOR]

Inflammation and vascular dysregulation may contribute to the development of depression and impose a burden on erythropoiesis. This study aimed to identify the association of erythrocyte indices with the severity of depressive symptoms and risk of developing depressive disorders in the older people. A prospective cohort study on a randomly sampled Korean older population; the baseline assessment from 2010 to 2012, the first follow-up assessment from 2012 to 2014, and the second follow-up assessment from 2014 to 2016 (mean follow-up duration = 3.4 years). A nationwide and community-based cohort. A total of 4451 Koreans aged 60 years or older. We examined the associations of the values and changes in mean corpuscular volume, mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) with the risk of prevalent and incident depression using logistic regression analyses. High MCH and MCHC in female participants and high MCHC in male participants were associated with high geriatric depression scale scores and risk of prevalent depression. In female participants, high- and middle-MCH tertile groups showed a 2.68- and 2.34-fold higher risk of incident depression than did the low tertile group. In male participants, the high-MCH tertile group showed a 1.79-fold higher risk of incident depression than did the low tertile group. In both sexes, the participants whose MCV changed to the high or middle tertile or remained in the high or middle tertile during the follow-up period, and whose MCH increased to the high tertile or remained in the high tertile, were at a higher risk of incident depression. Changes in erythrocyte may be associated with the risk of depression in older adults. This prospective study proposes a new perspective of the old hematologic parameters for understanding the pathophysiology of late-life depression. [ABSTRACT FROM AUTHOR]

Understanding disability-adjusted life-years (DALYs) based on dementia subtypes and mild cognitive impairment (MCI) is essential for optimal resource allocation. This study aimed to investigate disease burdens of various dementias and MCI in a representative South Korean population. Retrospective cohort study. 6481 Korean older adults. We estimated the disease-specific DALYs. DALYs due to MCI and all-cause dementia are estimated to increase from 1295 per 100,000 in 2016 to 9501 per 100,000 in 2065. In 2016, DALYs attributed to Alzheimer's dementia, vascular dementia, and MCI accounted for 33% (423 per 100,000), 20% (316 per 100,000), and 24% (123 per 100,000), respectively, of the total DALYs due to MCI and all-cause dementia. In 2065, DALYs due to Alzheimer's dementia, vascular dementia, and MCI will account for 38% (3654 per 100,000), 17% (1654 per 100,000), and 27% (2585 per 100,000) of total DALYs due to MCI and all-cause dementia, respectively. The years of life lived with disability (YLDs) due to MCI and all-cause dementia are estimated to rise from 479 per 100,000 in 2016 to 2807 per 100,000 in 2065. In 2016, YLDs due to Alzheimer's dementia, vascular dementia, and MCI composed 37% (177 per 100,000), 18% (85 per 100,000), and 15% (70 per 100,000), respectively, of the total YLDs due to MCI and all-cause dementia. In 2065, YLDs due to Alzheimer's dementia, vascular dementia, and MCI will account for 48% (1358 per 100,000), 15% (410 per 100,000), and 10% (290 per 100,000), respectively, of total YLDs due to MCI and all-cause dementia. Considering the rapidly growing disease burden, resources should be allocated to continuously monitor and manage the MCI and dementia burden. Particular attention to Alzheimer's dementia is required considering its significant contribution to current and future disease burden, especially to YLD. [ABSTRACT FROM AUTHOR]