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This article aims to examine the effects of an instructional model that leverages innovative technologies in the classroom to cultivate collaboration that improves students' comprehension, fosters their creativity, and enables them to better express and communicate their ideas through drawing. This discussion focuses on classroom interaction systems and technologies that can foster creativity, including tablets, electronic blackboards, interaction management solutions, and high-speed wireless internet. To address the study aims, we conceptualized an instructional model entitled "Visual Thinking through Tablet-based Classroom Interaction" (VTTCI) and applied it for one semester in English classes in a high-tech middle school in Korea. This model aimed to enable students to better express and communicate their ideas through drawing; to understand the lesson material's text and topic; to conceive of core ideas related to the topic; to visually express concepts through drawings, presentations, and discussions; and to ultimately gain a better understanding of the material based on the drawings. After applying the instructional model for one semester, we assessed the creativity of the students in the six treatment classes using the Torrance Tests of Creative Thinking-Figural form, (TTCT), and we compared their scores with those of the students in the six control group classes, who did not receive the treatment. The results revealed that the students in the treatment group scored significantly higher on the Originality, Abstractness of Titles, and Elaboration subscales and on overall creativity. Thus, the VTTCI model can be seen to affect creativity. The results show that the students' creative proficiency improved with the adoption of the instructional model for tablet-based interactive classrooms.

Background: The concept of developmentally supportive care in preterm infants is of considerable significance in the neonatal intensive care unit (NICU) setting with regard to preventing complications from preterm birth and promoting optimal growth and development. To provide high-quality developmentally supportive care, NICU nurses must possess high levels of knowledge, importance, perception, and competence. Purpose: The purpose of this study was to investigate South Korean NICU nursing staff's level of knowledge concerning developmentally supportive care, as well as the perceived importance, perception, and perceived competence regarding this concept. Methods: This study employed a cross-sectional descriptive design. Between June 1 and 19, 2020, 160 nurses completed a self-report questionnaire pertaining to developmentally supportive care, which covered the aspects of knowledge, perceived importance, perception (including attitudes, perceived behavioral control, subjective norms, and intentions), and perceived competence. Results: The levels of knowledge, attitude, and intention as a subfactor of perception, and perceived competence pertaining to developmentally supportive care were not high. There was no significant difference in the knowledge and perceived competence of skilled nurses compared with novice nurses. However, skilled nurses recognized that they could provide better developmentally supportive care than novice nurses. Perceived competence was positively correlated with perceived importance and perception. Implications for Practice and Research: Systematic educational programs that can enhance developmentally supportive care competence should be provided to NICU staff nurses. These must clarify the importance of developmentally supportive care and improve NICU nurses' knowledge, attitudes, self-efficacy, and intentions. [ABSTRACT FROM AUTHOR]

Introduction : Despite increases in obesity prevalence, awareness of obesity as a disease requiring active treatment remains lacking in Korea. We investigated differences in medical problems and expenditures and mortality across obesity categories using 12-year data from the National Health Insurance Service. Materials and Methods: Individuals aged 40–79 years who underwent medical examinations during 2003–2004 (n = 415,201) were divided based on Asian body mass index (kg/m2) criteria: normal weight (18.5 to < 23.0, 36.4%), overweight (23.0 to < 25.0, 28.3%), obesity (25.0 to < 30.0, 32.5%), and severe obesity (≥ 30.0, 2.8%). Medical problems and expenditures were fitted to linear mixed models. Mortality was analyzed via Cox proportional-hazards model. Results: More severe obesity was associated with a higher rate of medical problems, relative to normal weight: coefficient = 0.31 (95% confidence interval [CI], 0.30–0.32) for overweight, 0.61 (0.60–0.61) for obesity, and 1.07 (1.04–1.09) for severe obesity. A similar association was observed for medical expenditure: coefficient = 8.85 (95%CI, 6.80–10.89) for overweight, 20.04 (18.07–22.01) for obesity, and 48.76 (43.66–53.86) for severe obesity. Relative to overweight participants, those with normal weight and severe obesity exhibited a higher mortality risk (hazard ratio [HR] 1.21 [95%CI, 1.18–1.25] for normal; 1.27 [1.19–1.36] for severe obesity). In age-specific analyses, mortality risk was the highest for participants with severe obesity, aged < 60 years (HR, 1.58 [95%CI, 1.41–1.77]). Conclusion: Disease burden including medical problems and expenditure, and mortality in middle-aged adults, increased proportionally to the degrees of obesity. Health policies and medical systems aimed at reducing the burden of obesity may help reduce the burden of disease on society. [ABSTRACT FROM AUTHOR]

Surgical resection with lymphadenectomy and perioperative chemotherapy is the universal mainstay for curative treatment of gastric cancer (GC) patients with locoregional disease. However, GC survival remains asymmetric in West‐ and East‐world regions. We hypothesize that this asymmetry derives from differential clinical management. Therefore, we collected chemo‐naïve GC patients from Portugal and South Korea to explore specific immunophenotypic profiles related to disease aggressiveness and clinicopathological factors potentially explaining associated overall survival (OS) differences. Clinicopathological and survival data were collected from chemo‐naïve surgical cohorts from Portugal (West‐Europe cohort [WE‐C]; n = 170) and South Korea (East‐Asia cohort [EA‐C]; n = 367) and correlated with immunohistochemical expression profiles of E‐cadherin and CD44v6 obtained from consecutive tissue microarrays sections. Survival analysis revealed a subset of 12.4% of WE‐C patients, whose tumors concomitantly express E‐cadherin_abnormal and CD44v6_very high, displaying extremely poor OS, even at TNM stages I and II. These WE‐C stage‐I and ‐II patients tumors were particularly aggressive compared to all others, invading deeper into the gastric wall (P =.032) and more often permeating the vasculature (P =.018) and nerves (P =.009). A similar immunophenotypic profile was found in 11.9% of EA‐C patients, but unrelated to survival. Tumours, from stage‐I and ‐II EA‐C patients, that display both biomarkers, also permeated more lymphatic vessels (P =.003), promoting lymph node (LN) metastasis (P =.019), being diagnosed on average 8 years earlier and submitted to more extensive LN dissection than WE‐C. Concomitant E‐cadherin_abnormal/CD44v6_very‐high expression predicts aggressiveness and poor survival of stage‐I and ‐II GC submitted to conservative lymphadenectomy. [ABSTRACT FROM AUTHOR]

In gastric cancer (GC), biomarkers that define prognosis and predict treatment response remain scarce. We hypothesized that the extent of CD44v6 membranous tumor expression could predict prognosis and therapy response in GC patients. Two GC surgical cohorts, from Portugal and South Korea (n = 964), were characterized for the extension of CD44v6 membranous immuno-expression, clinicopathological features, patient survival, and therapy response. The value of CD44v6 expression in predicting response to treatment and its impact on prognosis was determined. High CD44v6 expression was associated with invasive features (perineural invasion and depth of invasion) in both cohorts and with worse survival in the Portuguese GC cohort (HR 1.461; 95% confidence interval 1.002–2.131). Patients with high CD44v6 tumor expression benefited from conventional chemotherapy in addition to surgery (p < 0.05), particularly those with heterogeneous CD44v6-positive and -negative populations (CD44v6_3+) (p < 0.007 and p < 0.009). Our study is the first to identify CD44v6 high membranous expression as a potential predictive marker of response to conventional treatment, but it does not clarify CD44v6 prognostic value in GC. Importantly, our data support selection of GC patients with high CD44v6-expressing tumors for conventional chemotherapy in addition to surgery. These findings will allow better stratification of GC patients for treatment, potentially improving their overall survival. [ABSTRACT FROM AUTHOR]