Current Status and Barriers of Exercise in Individuals with Spinal Cord Injuries in Korea: A Survey.

This study investigated exercise participation, health status, and barriers to exercise in 109 individuals with spinal cord injury (SCI) using a self-report questionnaire. The responses of the exercise and non-exercise groups were statistically analyzed using t-tests or Fisher's exact test. Significant differences were observed in the cause of injury and the American Spinal Injury Association Impairment Scale between the groups. The non-exercise group had a higher incidence of traumatic and complete injuries. Demographic factors such as gender, age, income level, and marital status did not significantly influence exercise participation. The exercise group reported lower pain scores, less inconvenience from complications, and higher activity and participation scores. However, less than half of the individuals with SCI met the recommended exercise intensity, and community facility usage was low. Barriers to exercise participation included severe disabilities, lack of time, insufficient exercise information, and lack of facility accessibility. To enhance exercise among individuals with SCI, it is essential to develop and extend exercise programs tailored to individual physical factors and a comprehensive understanding of barriers. Prioritizing community-based data management, alongside developing social systems and health policies, is crucial to overcome barriers to exercise participation for individuals with SCI.

Status and Barriers of Physical Activity and Exercise in Community-Dwelling Stroke Patients in South Korea: A Survey-Based Study.

This study aimed to examine the physical activity and exercise status of stroke patients in the community after discharge and the need for community-based exercises. This study included 100 community-dwelling patients with stroke in South Korea. The survey investigated the self-assessment of health status and physical activity, demand for community-based exercise after discharge, quality of life, and social participation. Overall, 96% of the respondents recognized the need to exercise, and two-thirds exercised. The third who did not exercise cited disability (29%), lack of facilities (22%), and health concerns (13%); only 21% of participants had ever used a community exercise facility, and their satisfaction with the facility was low. The main reasons for not using community exercise facilities were concerns about accidents during exercise and accessibility issues. Among real-world community stroke patients, those who exercised regularly had higher EuroQol-5D and reintegration to normal living indices than those who did not exercise (p < 0.05). Although community-dwelling stroke patients were highly aware of the need for physical activity and exercise, few engaged in adequate exercise. This lack of engagement is directly linked to identifiable personal and socio-structural barriers. Addressing these barriers will improve the quality of life and social participation of patients with stroke.

Evaluation of Mobile Applications for Patients with Diabetes Mellitus: A Scoping Review.

There has been increasing interest in mobile healthcare for diabetes management. However, there remains limited evidence regarding the effectiveness of these mobile applications (apps). This scoping review aimed to evaluate the clinical effectiveness of mobile diabetes management apps. We used the following search terms: "mobile app", "mobile application", and "diabetes". We included only articles written in English and published between January 2016 and August 2021. We identified two, six, and four articles focused on type 1 diabetes, type 2 diabetes, and both diabetes types, respectively. Five, four, and three of these studies reported on the apps' functionality, usability, and both, respectively. Our findings indicated that diabetes mobile apps allowed for convenient user experience and improved blood sugar levels in patients with diabetes. Considering these findings, usability must be comprehensively evaluated by using definitions such as the ISO9241-11 usability definition or the mobile application rating scale (MARS) when developing diabetes-related apps. For the feasibility of diabetes mobile apps, we recommend that HbA1C and self-management be included as evaluation variables. Given the increasing importance of continuous management for patients with diabetes, interventions using mobile apps are bound to become effective tools for patient-led self-management.

Outcome of Multiple Myeloma Patients With Hepatitis B Surface Antigen: Korean Multiple Myeloma Working Party 2103 Study.

BACKGROUND: Hepatitis B virus reactivation (HBVr) is a well-known complication of systemic chemotherapy for particularly hematologic malignancies in HBV carriers. We performed a multicenter retrospective study to investigate the incidence and risk factors of HBVr in patients with hepatitis B surface antigen (HBsAg)-positive multiple myeloma (MM). METHODS: We included 123 patients with HBsAg-positive MM who had received systemic therapy. The primary objective of the study was to evaluate the incidence of HBVr in patients with HBsAg-positive MM. RESULTS: The median age was 59 years, and 72 patients were male. With a median follow-up duration of 41.4 months, there were 43 instances of HBVr in 35 patients (28.5%): 29 treatment-related HBVr occurred during 424 treatments. Treatments containing antiviral prophylaxis were associated with a significantly lower incidence of HBVr compared to those without (14.4% vs. 1.9%, P < 0.001). Moreover, treatment with cyclophosphamide (P = 0.002) and doxorubicin (P = 0.053) were risk factors for HBVr; stem cell transplantation was not associated with HBVr. There was no significant difference in overall survival between patients with and without HBVr (P = 0.753) and myeloma progression was the major cause of death. CONCLUSION: Considering the low incidence of HBVr in patients who had received antiviral prophylaxis, HBsAg-positivity should not impede patients from receiving optimal antimyeloma treatment or participating in clinical trials.

Research Topic Trends on Turnover Intention among Korean Registered Nurses: An Analysis Using Topic Modeling.

This study aimed to explore research topic trends on turnover intention among Korean hospital nurses by analyzing the keywords and topics of related articles. Methods: This text-mining study collected, processed, and analyzed text data from 390 nursing articles published between 1 January 2010 and 30 June 2021 that were collected via search engines. The collected unstructured text data were preprocessed, and the NetMiner program was used to perform keyword analysis and topic modeling. Results: The word with the highest degree centrality was "job satisfaction", the word with the highest betweenness centrality was "job satisfaction", and the word with the highest closeness centrality and frequency was "job stress". The top 10 keywords in both the frequency analysis and the 3 centrality analyses included "job stress", "burnout", "organizational commitment", "emotional labor", "job", and "job embeddedness". The 676 preprocessed key words were categorized into five topics: "job", "burnout", "workplace bullying", "job stress", and "emotional labor". Since many individual-level factors have already been thoroughly investigated, future research should concentrate on enabling successful organizational interventions that extend beyond the microsystem.

The Effect of Dignity Therapy on Terminally-Ill Adult Patients: A Systematic Review and Meta-Analysis.

Background: We aimed to evaluate the effect of dignity therapy on the dignity, distress, and quality of life of terminally-ill adult patients. Methods: All randomized controlled trials published prior to Jan 2021 were searched through database, including PubMed, Medline, OVID, Cochrane Library, CINAHL, Web of Science, Scopus, ProQuest Central, KMBASE, KoreaMed, NDSL, and RISS. The RoB 2 was used to assess risk of bias. Effect sizes, Hedge's g and Higgins I 2 -statistics were used for meta-analysis. Results: We finally identified 10 studies for a systematic review, and eight studies out of them were selected for a meta-analysis. Overall, 776 participants were included in the meta-analysis. There were significant differences between with and without dignity therapy groups in dignity and anxiety (SMD = -0.3805, Cl = -0.5606, -0.2004; SMD = -0.1932, Cl = -0.3774, -0.0090, respectively) while there was no significant difference in quality of life and depression (SMD=0.4678, Cl = -0.0989, 1.0345; SMD= -0.0513, Cl= -0.2461, 0.1434, respectively). Conclusion: Dignity therapy may be effective for terminally ill patients on dignity and anxiety. We suggested further empirical studies with dignity therapy and repetitive meta-analysis in the future due to heterogeneity of the studies.

Knowledge, attitudes, and perceptions associated with HPV vaccination among female Korean and Chinese university students.

BACKGROUND: Human papillomavirus (HPV) vaccination is a form of primary prevention for cervical cancer. The HPV vaccination rate of female university students is not high in Korea and China. Therefore, the purpose of this study was to identify and compare the factors associated with intention to receive HPV vaccination between Korean and Chinese female university students. METHODS: The participants were 273 Korean and 317 Chinese female university students who had not been vaccinated for HPV, and data were collected using a self-reported questionnaire about attitudes toward HPV vaccination, HPV knowledge, perceptions of HPV infection, and intention to receive HPV vaccine. RESULTS: There were no significant differences between the Korean and Chinese female university students in HPV knowledge, attitudes, perceptions, and vaccination intention. The factors influencing the intention of HPV vaccination in Korean students were a positive attitude toward the HPV vaccine and a high HPV knowledge score. For Chinese students, sexual experience, awareness of genital warts, a positive attitude toward the HPV vaccine, a high HPV knowledge scores, a perception of the seriousness of HPV infection, and negative emotions regarding HPV infection were significant factors. CONCLUSIONS: It is important to improve attitudes and knowledge about HPV and the HPV vaccine in order to enhance HPV vaccination both in Korea and China. Perceived seriousness and negative emotions regarding HPV infection should be used as a framework to develop subject-tailored interventions in China.

Systematic Review of Quality Improvement Projects Related to Intershift Nursing Handover.

BACKGROUND: Nursing handover is a real-time process in which patient-specific information is passed between nurses to ensure the continuity and safety of patient care. PURPOSE: The purpose of this study was to determine the effects of quality improvement (QI) projects in improving the intershift nursing handover process. METHODS: A computerized search was performed of electronic databases for articles published during 2009-2019 in English or Korean for which the full texts were available. The included studies involved QI projects, handover between nurses, and intershift handover. The QI-MQCS (Quality Improvement Minimum Quality Criteria Set) was used to appraise the quality of QI strategies. RESULTS: The handover methods used in the 22 QI projects could be broadly divided into 2 types: (1) using a standardized communication tool; and (2) involving patient-participation bedside handover. CONCLUSIONS: The published research on intershift handover-related QI projects employed standardized communication tools and the patient-participation bedside handover method to reduce adverse events and handover times and increase the satisfaction of patients and nurses. Future studies should measure the changes in patient safety-related outcomes.

Gender Differences in Sexual Information Needs and Relating Factors in Cancer Patients: A Cross-Sectional Survey.

This study aimed to identify the sexual information requirements and related factors according to gender to improve sexual health in cancer patients. In this cross-sectional study, a total of 687 cancer patients from a single cancer center in Korea completed a self-reported questionnaire. Multiple logistic regression analysis was used to compare the sexual information requirements and related factors among cancer patients. The results showed that male cancer patients had higher demands for sexual information than female cancer patients (t = 27.11, p < 0.001). Men appeared to have a greater need than women in the need for sexual information (t = 30.41, p < 0.001) and professional sexual intervention (t = 21.97, p < 0.001). Regarding sexual information needs, income (OR: 0.43, 95% CI: 0.25 to 0.73) was a significant factor in men. In women, age (OR: 0.51, 95% CI: 0.31 to 0.86), alcohol consumption (OR: 1.88, 95% CI: 1.12-3.16), and chemotherapy (OR: 1.87, 95% CI: 1.12-3.12) were significant factors. Significant differences in the overall sexual information needs and related factors were observed between male and female cancer patients. Therefore, a strategy needs to be established to improve the sexual health of cancer patients considering gender differences.

Patient safety culture and handoff evaluation of nurses in small and medium-sized hospitals.

OBJECTIVES: This study was conducted to investigate the current status of handoffs, perception of patient safety culture, and degrees of handoff evaluation in small and medium-sized hospitals and identified factors that make a difference in handoff evaluation. METHODS: This is a descriptive study. 425 nurses who work at small and medium-sized hospitals in South Korea were included in our study. They completed a set of self-reporting questionnaires that evaluated demographic data, handoff-related characteristics, perception of patient safety culture, and handoff evaluation. RESULTS: Results showed that the overall score of awareness of a patient safety culture was 3.65 ± 0.45, the level was moderate. The score of handoff evaluation was 5.24 ± 0.85. Most nurses experienced errors in handoff and most nurses had no guidelines and checklist in the ward. Handoff evaluation differed significantly according to the level of education, work patterns, duration of hospital employment, handoff method, degree of satisfaction with the current handoff method, errors occurring at the time of handoff, handoff guidelines, and appropriateness of handoff education time (P < 0.05). CONCLUSION: For handoff improvement, guidelines and standards should be established. It is necessary to develop a structured handoff education system. And formal handoff education should be implemented to spread knowledge uniformly.

The Attitudes of Physicians and the General Public toward Prognostic Disclosure of Different Serious Illnesses: a Korean Nationwide Study.

BACKGROUND: Although international guidelines recommend palliative care approaches for many serious illnesses, the palliative needs of patients with serious illnesses other than cancer are often unmet, mainly due to insufficient prognosis-related discussion. We investigated physicians' and the general public's respective attitudes toward prognostic disclosure for several serious illnesses. METHODS: We conducted a cross-sectional survey of 928 physicians, sourced from 12 hospitals and the Korean Medical Association, and 1,005 members of the general public, sourced from all 17 administrative divisions in Korea. RESULTS: For most illnesses, most physicians (adjusted proportions - end-organ failure, 99.0%; incurable genetic or neurologic disease, 98.5%; acquired immune deficiency syndrome [AIDS], 98.4%; stroke or Parkinson's disease, 96.0%; and dementia, 89.6%) and members of the general public (end-organ failure, 92.0%; incurable genetic or neurologic disease, 92.5%; AIDS, 91.5%; stroke or Parkinson's disease, 92.1%; and dementia, 86.9%) wanted to be informed if they had a terminal prognosis. For physicians and the general public, the primary factor to consider when disclosing terminal status was "the patient's right to know his/her condition" (31.0%). Yet, the general public was less likely to prefer prognostic disclosure than physicians. Particularly, when their family members were patients, more than 10% of the general public did not want patients to be informed of their terminal prognosis. For the general public, the main reason for not disclosing prognosis was "psychological burden such as anxiety and depression" (35.8%), while for the physicians it was "disclosure would have no beneficial effect" (42.4%). CONCLUSION: Most Physicians and the general public agreed that disclosure of a terminal prognosis respects patient autonomy for several serious illnesses. The low response rate of physicians might limit the generalizability of the results.

Knowledge and Health Beliefs of Gestational Diabetes Mellitus Associated with Breastfeeding Intention Among Pregnant Women in Bangladesh.

PURPOSE: This study aimed to investigate the knowledge of gestational diabetes mellitus (GDM) and the health beliefs about GDM management, as well as to investigate the effects of these factors on breastfeeding intention in Bangladesh. METHODS: This study involved a cross-sectional survey of 358 healthy pregnant women who visited antenatal clinics in Bangladesh. RESULTS: Perceived susceptibility, perceived benefit, and self-efficacy were identified as significant factors for breastfeeding intention (p < .05). Participants had a poor understanding and a lack of knowledge of GDM, which can lead to inadequate health behavior. Health beliefs were significantly associated with participants' breastfeeding intention related to GDM. CONCLUSION: Antenatal education for breastfeeding in GDM mothers should focus on providing accurate information on GDM and strengthening their health beliefs such as self-efficacy within the context of the mothers' culture.

The Impacts of Prognostic Awareness on Mood and Quality of Life Among Patients With Advanced Cancer.

BACKGROUND: Accurate awareness of the prognosis is an important factor in the treatment decision of patients with advanced cancer; however, prognostic disclosure is still subject to debate because it can reduce patient's satisfaction and increase depression. AIM: The purpose of this study is to assess whether patients' prognostic awareness is associated with decreased quality of life (QoL) or increased depressive mood in patients with advanced cancer. DESIGN AND PARTICIPANTS: In this cohort study, 386 patients with advanced cancer were recruited across 3 periods from December 2016 to August 2018. The outcome of this study was a change in QoL and depression according to the patients' prognostic awareness at baseline, 3 months, and 6 months. RESULTS: This study found significant differences in changes of QoL based on patients' prognostic awareness. From baseline to 3 months, emotional functioning (P = .039), pain (P = .042), existential well-being (P = .025), and social support (P = .038) subscale scores improved significantly more in those with lack of prognostic awareness. Over 6 months, the group without prognostic awareness improved significantly in terms of physical functioning (P = .037), emotional functioning (P = .002), nausea/vomiting (P = .048), and constipation (P = .039) subscale scores and existential well-being scores (P = .025). No significant difference between the groups was found in terms of depression. CONCLUSION: Accurate prognostic awareness may pose harm and may provide no additional benefits in terms of QoL and mood among patients with advanced cancer for a short period of time.

Comparison of three risk stratification models for non-clear cell renal cell carcinoma patients treated with temsirolimus as first-line therapy.

BACKGROUND/AIMS: For metastatic renal cell carcinoma (RCC), various prognostic scoring systems have been developed. However, owing to the low prevalence of nonclear cell RCC, the three most commonly used tools were mainly developed based on patients with clear cell histology. Accordingly, this study applied three prognostic models to Korean non-clear cell RCC patients treated with first-line temsirolimus. METHODS: This study analyzed data for 74 patients with non-clear cell RCC who were treated with temsirolimus as the first-line therapy at eight medical centers between 2011 and 2016. The receiver-operating characteristic (ROC) curves for the different prognostic models were analyzed. RESULTS: Twenty-seven (36.5%), 24 (32.4%), and 44 patients (59.5%) were assigned to the poor prognosis groups of the Memorial Sloan-Kettering Cancer Center (MSKCC), International Metastatic RCC Database Consortium (IMDC), and Advanced Renal Cell Carcinoma (ARCC) risk stratification models, respectively. All three prognostic models reliably discriminated the risk groups to predict progression-free survival and overall survival (p < 0.001). The area under the ROC curve (AUC) for progression and survival was highest for the ARCC model (0.777; 0.734), followed by the IMDC (0.756; 0.724) and the MSKCC (0.742; 0.712) models. Furthermore, the sensitivity and specificity for predicting progression were highest with the ARCC model (sensitivity 63.6%, specificity 85.7%), followed by the MSKCC (sensitivity 58.2%, specificity 86.5%) and the IMDC models (sensitivity 56.4%, specificity 85.7%). CONCLUSION: All three prognostic models accurately predicted the survival of the non-clear cell RCC patients treated with temsirolimus as the first-line therapy. Furthermore, the ARCC risk model performed better than the other risk models in predicting survival.

Clinical Characteristics of Clear Cell Ovarian Cancer: A Retrospective Multicenter Experience of 308 Patients in South Korea.

PURPOSE: The purpose of this study was to evaluate clinical characteristics and treatment pattern of ovarian clear cell carcinoma (OCCC) in Korea and the role of adjuvant chemotherapy in early stage. MATERIALS AND METHODS: Medical records of 308 cases of from 21 institutions were reviewed and data including age, performance status, endometriosis, thromboembolism, stage, cancer antigen 125, treatment, recurrence, and death were collected. RESULTS: Regarding stage of OCCC, it was stage I in 194 (63.6%), stage II in 34 (11.1%), stage III in 66 (21.6%), and stage IV in 11 (3.6%) patients. All patients underwent surgery. Optimal surgery (residual disease ≤ 1 cm) was achieved in 89.3%. Majority of patients (80.5%) received postoperative chemotherapy. The most common regimen was taxane-platinum combination (96%). Median relapse-free survival (RFS) was 138.5 months for stage I, 33.4 for stage II, 19.3 for stage III, and 9.7 for stage IV. Median overall survival (OS) were not reached, 112.4, 48.7, and 18.3 months for stage I, II, III, and IV, respectively. Early-stage (stage I), endometriosis, and optimal debulking were identified as favorable prognostic factors for RFS. Early-stage and optimal debulking were also favorable prognostic factors for OS. Majority of patients with early-stage received adjuvant chemotherapy. However, additional survival benefit was not found in terms of recurrence. CONCLUSION: Majority of patients had early-stage and received postoperative chemotherapy regardless of stage. Early-stage and optimal debulking were identified as favorable prognostic factors. In stage IA or IB, adding adjuvant chemotherapy did not show difference in survival. Further study focusing on OCCC is required.

Correction to: Priorities of a "good death" according to cancer patients, their family caregivers, physicians, and the general population: a nationwide survey.

While recently extending that research, however, we discovered that 236 members of the general population were mistakenly duplicated by the investigating agency (Word Research) and 1241 were reported rather than 1005. Here, we present corrections and discuss the relevant data.

Comparison and correlation among in vitro and in vivo assays to assess cord blood quality according to delivery temperature and time after collection.

Cord blood (CB) has been used as an alternative source for unrelated allogeneic hematopoietic stem cell transplantation. To determine which assay was useful for predicting the successful outcome of CB transplantation, CBs were grouped according to the temperature (4 °C, 24 °C, and 37 °C) and time (24, 48, and 72 h) after collection. The viability, early apoptosis, and colony forming units (CFUs) were ascertained for the total nucleated cells (TNCs) and CD34+ cells; in addition, the engraftment of infused CD34+ cells in NSG mice was determined. The viability of the TNCs and CD34+ cells and total CFUs were significantly decreased whereas the early apoptosis was significantly increased in the 72 h group at 37 °C compared to that of the 24 h group at 24 °C. The viability and early apoptosis of the TNCs correlated with those of CD34+ cells. In addition, the viability and early apoptosis correlated with the number of granulocyte/monocyte progenitor CFUs. In transplanted NSG mice, the frequency of human CD45+ cells decreased in the 72 h group at 24 °C compared to that of the 24 h group at 24 °C and was negatively correlated with early apoptosis of TNCs and CD34+ cells. This study demonstrated that the early apoptosis of TNCs and CD34+ cells constitutes a useful marker for predicting the engraftment of HSCs and may provide helpful data for standard assessment regarding CB quality by analyzing the correlation between in vitro and in vivo assays using NSG mice.

Correction to: The impact of caregiver's role preference on decisional conflicts and psychiatric distresses in decision making to help caregiver's disclosure of terminal disease status.

In the original publication of the article, the incorrect grant number HC13C1391 was published in the acknowledgement section. The correct grant number is HC15C1391.

Quality of Life in Patients With Non-Small Cell Lung Cancer: Structural Equation Modeling.

BACKGROUND: Quality of life (QOL) is important for cancer patients, even for survival. However, factors affecting QOL of non-small cell lung cancer (NSCLC) patients have not been studied sufficiently. OBJECTIVE: The aims of this study were to understand the relationships among social support, resilience, distress, and symptom and to identify predictors of QOL for NSCLC patients. METHODS: Participants were 212 adult patients who visited an outpatient department at a tertiary hospital located in Seoul, Korea. Data were collected using self-reported questionnaires and clinical records. RESULTS: Social support, resilience, distress, symptom burden, and QOL explained 99.9% of the variance in QOL. Social support was not a significant predictor of distress and QOL, but a significant predictor of resilience. Resilience was a significant predictor of both distress and QOL. Distress was not a significant predictor of QOL, but a significant predictor of symptom burden. Symptom burden was a significant predictor of QOL and had the largest direct effect on QOL. Resilience also had an important impact on QOL because resilience influenced QOL in various paths. CONCLUSION: This study suggests that social support, resilience, distress, and symptom burden are predictors of QOL in an NSCLC population. These predictors had direct and indirect effects on each other and on QOL. IMPLICATIONS FOR PRACTICE: Developing an interventional program to increase resilience and social support as well as to decrease symptom burden and distress may be necessary to improve QOL of NSCLC patients.

Purification and characterization of the thermostable protease produced by Serratia grimesii isolated from channel catfish.

BACKGROUND: Microbial spoilage of fishery products accounts for significant financial losses, yearly on a global scale. Psychrotrophic spoilage bacteria often secrete extracellular enzymes to break down surrounding fish tissue, rendering the product unsuitable for human consumption. For a better understanding of bacterial spoilage due to enzymatic digestion of fish products, proteases in Serratia grimesii isolated from North American catfish fillets (Ictalurus punctatus) were investigated. RESULTS: Mass spectrometric evidence demonstrated that S. grimesii secretes two distinct extracellular proteases and one lipase. Protease secretion displayed broad thermostability in the 30-90 °C range. The major protease-secretion (O-1) was most active under alkaline conditions and utilized manganese as a co-factor. Organic solvents significantly disrupted the efficacy of S. grimesii extracellular enzymes and, in a series of bactericidal detergents, protease activity was highest when treated with Triton X-100. Ethylenediaminetetraacetic acid (EDTA) and phenylmethylsulfonyl fluoride (PMSF) significantly inhibited the enzyme activity, while protease was moderately stable under freeze-thaw and refrigerated storage. CONCLUSION: The influence of fish spoilage-related enzymes, depending on various factors, is discussed in this paper. This study will provide new insight into enzymatic spoilage and its control, which can be exploited to enhance food safety and the shelf-life of fishery products worldwide. © 2018 Society of Chemical Industry.