Long term follow-up of cervical intervertebral disc herniation inpatients treated with integrated complementary and alternative medicine: a prospective case series observational study.

BACKGROUND: Symptomatic cervical intervertebral disc herniation (IDH) presenting as neck pain accompanied by arm pain is a common affliction whose prevalence continues to rise, and is a frequent reason for integrative inpatient care using complementary and alternative medicine (CAM) in Korea. However, studies on its long term effects are scarce. METHODS: A total 165 patients with cervical IDH admitted between January 2011 and September 2014 to a hospital that provides conventional and Korean medicine integrative treatment with CAM as the main modality were observed in a prospective observational study. Patients underwent CAM treatment administered by Korean medicine doctors (KMDs) in accordance with a predetermined protocol for the length of hospital stay, and additional conventional treatment by medical doctors (MDs) as referred by KMDs. Short term outcomes were assessed at discharge and long term follow-ups were conducted through phone interviews after discharge. Numeric rating scale (NRS) of neck and radiating arm pain, neck disability index (NDI), 5-point patient global impression of change (PGIC), and factors influencing long term satisfaction rates in PGIC were assessed. RESULTS: Of 165 patients who received inpatient treatment 20.8 ± 11.2 days, 117 completed the long term follow-up up at 625.36 ± 196.7 days post-admission. Difference in NRS between admission and discharge in the long term follow-up group (n = 117) was 2.71 (95% CI, 2.33, 3.09) for neck pain, 2.33 (95% CI, 1.9, 2.77) for arm pain, and that of NDI 14.6 (95% CI, 11.89, 17.32), and corresponding scores in the non-long term follow-up group (n = 48) were 2.83 (95% CI, 2.22, 3.45) for neck pain, 2.48 (95% CI, 1.84, 3.12) for arm pain, and that of NDI was 14.86 (95% CI, 10.41, 19.3). Difference in long term NRS of neck pain and arm pain from baseline was 3.15 (95% CI, 2.67, 3.64), and 2.64 (95% CI, 1.99, 3.29), respectively. PGIC was reported to be "satisfactory" or higher in 79.5% of patients at long term follow-up. CONCLUSIONS: Though the observational nature of this study limits us from drawing a more decisive conclusion, these results suggest that integrative treatment focused on CAM in cervical IDH inpatients may achieve favorable results in pain and functional improvement. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02257723. Registered October 2, 2014.

[Conceptual Analysis of Career Anchors of Nurses].

PURPOSE: This study aimed to provide a theoretical basis for career anchors of nurses by defining and organizing its concept. METHODS: Using the Walker and Avant concept analysis, a total of 29 articles were analyzed through a literature search in this study. RESULTS: The career anchors of nurses are individual career choice motives, a self-concept where in competency and values are harmonized, which act as a desire for growth and development in nursing, and are actions that maintain careers. Additionally, they indicate the direction for achieving individual career goals and act as a core value expected of nurses by nursing organizations, indicating continuous and integrated professional growth and development of the nursing profession. CONCLUSION: The career anchors of nurses identified in the results contribute to securing patient safety, providing quality care through policies, institutionalizing bases for career development, preventing nurse turnover, and retaining skilled nurses.

Effectiveness of a virtual reality application-based education programme on patient safety management for nursing students: A pre-test-post-test study.

AIMS: We aimed to develop a virtual reality-based smartphone application that improves patient safety competency among nursing students in terms of knowledge, attitudes and confidence in patient safety management. We also sought to evaluate the effects and utility of the application in improving patient safety competency. DESIGN: A parallel, randomized controlled pre- and post-test trial was conducted to test the effects of knowledge, attitudes and performance confidence in patient safety management. METHODS: Participants were randomly allocated to the experimental (n = 22), in which nursing students received a two-week mobile web-based training programme covering key topics in patient safety management or the control group (n = 22), in which nursing students received a training booklet. Participants completed a pre-test and two post-test questionnaires to assess the program's impact. The evaluation tools were patient safety management knowledge, attitude and patient safety management performance confidence scale. Data analysis was performed using descriptive statistics, homogeneity test for pre-test, unpaired t-test and repeated measures ANOVA. RESULTS: Patient safety competency in the experimental group improved significantly in terms of knowledge (from 11.68 to 18.55, p < 0.000), attitude (from 3.38 to 4.01; p < 0.005) and performance confidence (from 3.93 to 4.52; p < 0.000) compared with the control group. Our findings suggest that mobile app-based education using virtual reality may be effective in enhancing patient safety management in nursing education.

Effects of Aquatic Exercises for Patients with Osteoarthritis: Systematic Review with Meta-Analysis.

This systematic review examined papers published in Korean, English and newer publications that were not included in previous studies to assess the effect size of aquatic exercise-based interventions on pain, quality of life and joint dysfunction among patients with osteoarthritis. Six national and international databases were used to review literature (published up to 7 March 2019) on randomized controlled trials of aquatic exercise-based interventions in patients with osteoarthritis. For the 20 studies included, a meta-analysis showed that aquatic exercise produces 0.61-point reduction (n = 756; mean difference (MD) = -0.61; 95% confidence interval (CI): -0.90--0.32) in pain compared with a control group, and aquatic exercise was effective in reducing pain (n = 315; MD = -0.28; 95% CI: -0.50--0.05) compared with a land-based exercise group. Another meta-analysis showed that aquatic exercise produces 0.77-point improvement in quality of life (n = 279; MD = -0.77; 95% CI: -1.38--0.15) compared with a control group. Finally, a meta-analysis showed that aquatic exercise produces 0.34-point reduction in joint dysfunction (n = 279; MD = -0.77; 95% CI: -1.38--0.15) compared with a control group. For patients with osteoarthritis, aquatic-exercise-based interventions are effective for reducing pain and joint dysfunction and improving quality of life.

PRSS14/Epithin is induced in macrophages by the IFN-γ/JAK/STAT pathway and mediates transendothelial migration.

PRSS14/Epithin (also known as matriptase and ST14), a member of the type II transmembrane serine proteases, is primarily found in a subpopulation of normal epithelial cells and in epithelial cancers. Its known functions include maintaining the epithelial barrier, thymic development, and cancer progression. In this study, we show that several macrophage cell lines and activated bone marrow-derived macrophages also express PRSS14/Epithin. Surface expression, as well as cytoplasmic expression, was detectable upon activation by IFN-γ, but not TNF-α or TGF-ß. Induction of the protein appeared to be restricted to macrophages. IFN-γ showed a biphasic regulation in RAW264.7 cells, and upregulated expression was sustained for several days. This induction by IFN-γ was partially through the increase of PRSS14/Epithin mRNA production, which is downstream of the JAK pathway, shown by the inhibition by tyrphostin AG490. Using chromatin immunoprecipitation, we verified that two sites among six putative STAT1 binding sites in the PRSS14/Epithin promoter were occupied by STAT1 upon activation. Treatment with IFN-γ enhanced the serum-triggered transendothelial migration of RAW264.7 cells, but not that of PRSS14/Epithin knock-down RAW264.7 cells, although they express multiple markers such as ICAM1, CD80, and CD40 at normal levels. These data strongly suggest that PRSS14/Epithin plays an important role in the transendothelial migration of activated macrophages in the inflammatory microenvironment, and the mode of action is similar to the events in cancer metastasis.

Analysis of Factors Related to Social Network Service Addiction Among Korean High School Students.

We employed a descriptive survey to determine the effects of excessive social network service (SNS) usage. Measures of SNS addiction, SNS fatigue, anxiety, and school life adjustment were employed with 209 high school students (85.2% female, 14.8% male). SNS addiction increased as students became more dissatisfied with school life, used SNS for a longer period, and had increased access to SNS as compared with their counterparts. SNS addiction was positively correlated with SNS fatigue (r = .24, p < .001) and anxiety (r = .20, p = .003). SNS fatigue and anxiety were positively correlated (r = .30, p < .001), and school adjustment and anxiety were negatively correlated (r = -.25, p < .001). SNS daily use (in both frequency and number of minutes) and anxiety were associated with SNS addiction (adjusted R = 38.4%). It is necessary to develop intervention programs for vulnerable groups and promote early screening for SNS addiction.

Effect of learning contracts in clinical pediatric nursing education on students' outcomes: A research article.

BACKGROUND: According to previous research, learning contracts positively influence learners' self-directed learning ability, learning satisfaction, and academic performance. However, there are insufficient researches on the application of learning contracts to clinical training in pediatric nursing. This study sought basic data for developing an effective teaching and learning strategy for clinical education in pediatric nursing. OBJECTIVE: This study aimed to validate the effect of learning contracts on students' problem-solving skills, self-directed learning capability, and communication self-efficacy. DESIGN: Nonequivalent control group posttest design. PARTICIPANTS AND SETTINGS: The participants comprised a total of 50 junior nursing students, 25 in each group at a college in Daejeon City, South Korea. METHOD: This study compared the above-mentioned outcomes between control (before clinical pediatric nursing education) and experimental groups (after received such education and applied learning contracts). RESULTS: The experimental group demonstrated higher problem-solving skills, self-directed learning capability, and communication self-efficacy scores than did the control group. CONCLUSION: Learning contracts should be applied in practical courses as a teaching and learning method to improve relevant nursing skills, such as problem-solving skills, self-directed learning capabilities, and communication self-efficacy.