Factors affecting the quality of life of gastric cancer survivors.

BACKGROUND: The number of gastric cancer survivors has been increasing, and such survivors experience various changes in their lives post-recovery. Adapting to these changes requires appropriate interventions that can improve their quality of life (QoL). This study was conducted to investigate the factors affecting the QoL of gastric cancer survivors and provide basic data for effective intervention. METHODS: Data were collected between September 8 and September 29, 2017, from the Gastric Cancer Center at a tertiary hospital. Questionnaire surveys were conducted using the EORTC QLQ-C30/STO22, Self-Efficacy-Scale, Multidimensional Scale of Perceived Social Support, and Quality of Life-Cancer Survivors Questionnaire on gastric cancer survivors who were followed up for 3 years after gastrectomy. Data were analyzed using descriptive statistics, t test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis. RESULTS: A total of 136 gastric cancer survivors completed the questionnaire survey. There were significant positive correlations of QoL with self-efficacy, functional status, and social support (r = .35, p < .001; r = .53, p < .001; r = .26, p < .001, respectively). There were significant negative correlations of QoL with general symptoms (r = - .39, p < .001) and gastric cancer-specific symptoms (r = - .51, p < .001). The regression model explained 48.3% of the QoL, and the affecting factors were gastric cancer-specific symptoms (ß = - .397, p < .001), religious belief (ß = .299, p < .001), functional status (ß = .251, p = .003), and self-efficacy (ß = .191, p = .004). CONCLUSION: This study confirmed that gastric cancer-specific symptoms, spiritual well-being, self-efficacy, and functional status affect the QoL of gastric cancer survivors. Hence, these factors should be considered in the interventions to improve the QoL of gastric cancer survivors.

How Do We Start Palliative Care for Patients With End-Stage Liver Disease?

Patients with end-stage liver disease undergo repetitive patterns of recovery and deterioration and are burdened with uncertainty. Although quality of life is low in patients with end-stage liver disease and their family members, few studies have been conducted to identify what palliative care should be provided for them. This integrative review aimed to explore palliative care for patients with end-stage liver disease, focusing on the components and outcome measurements for further research. After searching for studies on palliative care for end-stage liver disease published between 1995 and 2017, 12 studies that met the inclusion criteria were analyzed. The common components of palliative care for patients with liver disease were: (a) an interdisciplinary approach, (b) early palliative care, (c) discussion goals of care with patient and family members, (d) symptom management, and (e) psychosocial support. It was reported that patients who were provided palliative care had improved itching, well-being, appetite, anxiety, fatigue, and depression, increased the number of do-not-resuscitate orders, palliative care consultations, and decreased length of stay. These findings could guide the development of palliative care for end-stage liver disease patients.

Effects of the teach-back method among cancer patients: a systematic review of the literature.

PURPOSE: This study aimed to systematically review published research on the use of the teach-back method among cancer patients and provide basic data for developing effective nursing interventions. METHODS: Using a PICOS (Population, Intervention, Comparisons, Outcomes, Study Designs) framework, we reviewed 246 studies from selected electronic databases-CINAHL, EMBASE, PubMed, PsycInfo, RISS, KISS, DBpia, NDSL, and KCI-and selected five studies for further analysis. We evaluated the reference quality using Cochrane's risk of bias and risk of bias assessment tool for non-randomized studies, following which we performed reviews and analyses. RESULTS: Five studies were selected for the final analysis, including four quasi-experimental studies and one randomized controlled experimental study. The intervention programs were provided mostly by outpatient clinics. The cancer types of the subjects were breast cancer and gastrointestinal cancer in four and one study, respectively. The number and duration of the interventions varied depending on the content. The number of outcome variables ranged from 1 to 5, depending on the study; among these, self-efficacy, symptom experience, and distress were used. Teach-back intervention programs significantly affected happiness, health literacy, anxiety about death, symptom experience, distress, and self-efficacy. CONCLUSION: This study found that teach-back interventions have positive health outcomes including happiness, uncertainty, self-efficacy, self-management behavior, symptom experience, distress, anxiety, and health literacy among cancer patients. However, it found no effects with regard to drug administration, functional measurements, or satisfaction. Future research should continuously examine the teach-back approach and assess its positive health outcomes for cancer patients.

Functional effects of a pathogenic mutation in Cereblon (CRBN) on the regulation of protein synthesis via the AMPK-mTOR cascade.

Initially identified as a protein implicated in human mental deficit, cereblon (CRBN) was recently recognized as a negative regulator of adenosine monophosphate-activated protein kinase (AMPK) in vivo and in vitro. Here, we present results showing that CRBN can effectively regulate new protein synthesis through the mammalian target of rapamycin (mTOR) signaling pathway, a downstream target of AMPK. Whereas deficiency of Crbn repressed protein translation via activation of the AMPK-mTOR cascade in Crbn-knock-out mice, ectopic expression of the wild-type CRBN increased protein synthesis by inhibiting endogenous AMPK. Unlike the wild-type CRBN, a mutant CRBN found in human patients, which lacks the last 24 amino acids, failed to rescue mTOR-dependent repression of protein synthesis in Crbn-deficient mouse fibroblasts. These results provide the first evidence that Crbn can activate the protein synthesis machinery through the mTOR signaling pathway by inhibiting AMPK. In light of the fact that protein synthesis regulated by mTOR is essential for various forms of synaptic plasticity that underlie the cognitive functions of the brain, the results of this study suggest a plausible mechanism for CRBN involvement in higher brain function in humans, and they may help explain how a specific mutation in CRBN can affect the cognitive ability of patients.

Palliative Care for Patients With Heart Failure: An Integrative Review.

Palliative care should be integrated into routine disease management for all patients with serious illness, regardless of settings or prognosis. The purposes of this integrative review were to identify the features of randomized controlled trials for adult patients with heart failure and to provide basic references for the development of future trials. Using Whittemore and Knafl's integrative literature review method, comprehensive searches of the PubMed, Cochrane Library, CINAHL, EMBASE, and Korean databases were conducted, integrating keywords about heart failure and palliative care interventions. Quality appraisal was assessed using Cochrane risk-of-bias tools. In total, there were 6 trials providing palliative care interventions integrating team-based approaches between palliative care specialists and nonpalliative clinicians, such as a cardiologist, cardiac nurse, and advanced practice nurse across inpatient and outpatient settings. The different types of interventions included home visits, symptom management via phone calls or referral to a specialist team, and the establishment of treatment planning. Patient-reported outcome measures included positive effects of palliative interventions on symptom burden and quality of life. Given that most of the selected studies were conducted in Western countries, palliative care should be culturally tailored to assist heart failure patients worldwide.

A novel statistical-dynamical method for a seasonal forecast of particular matter in South Korea.

Societal concerns about air quality in East Asia are still growing despite country-level efforts to reduce air pollution emissions. In coping with this growing concern, the government and the public demand a longer­lead forecast of air quality to ensure sufficient response time until society prepares for countermeasures such as a temporary reduction of specific emission sources. Here we propose a novel method that produces skillful seasonal forecasting of wintertime (December to February) PM10 concentration over South Korea. The method is based on the idea that climate condition and air quality have co-variability in the seasonal time scales and that the state-of-art seasonal prediction model will benefit air quality forecasting. More specifically, a linear regression model is constructed to link observed winter PM10 concentration and climate variables where the predicted climate variables were furnished from NCEP CFSv2 forecast initialized during autumn. In this case, climate variables were selected as predictors of the model because they are not only physically related to air quality but also 'predictable' in CFS hindcast. Through analysis of retrospective forecasts of 20 winters for the period 2001-2020, we found this model shows statistically significant skill for the seasonal forecast of wintertime PM10 concentration.