Effects of 3S business intelligence systems for nursing students: a repeated-measures randomized control trial.

BACKGROUND: The growing need for healthcare services as a result of a consistently rising prevalence of chronic diseases and rapid population aging calls for a new set of activities and practices. Therefore, we developed a program-3S (Simple, Smart, and Speed) Business Intelligence Systems (3S-BIS), which is an ERP software system that helps nursing business to support nursing entrepreneurship -and analyzed its effects on nursing students. METHODS: A repeated-measures randomized controlled trial was performed with two groups: experimental (n = 29) and control (n = 30) groups. The former group underwent the five-day 3S-BIS education program. Each session comprised four components: lectures 1 and 2, simulation case study, and debriefing. Post-tests were performed immediately post-intervention and four and eight weeks later. The effectiveness was measured using the following variables: simulation design assessment, evaluation of educational practices in simulation, education satisfaction, self-efficacy for learning, and entrepreneurship. The differences before and after intervention between the experimental and control groups were analyzed using the Friedman test. The Mann-Whitney U test was used for comparisons between groups at each time point, and the Wilcoxon signed-rank test was used for comparisons within groups at each time point. RESULTS: Post-intervention (8 weeks after intervention), the experimental group demonstrated higher simulation design assessment (z = -3.88, p = < .001), evaluation of educational practices in simulation (z = -3.34, p = .001), education satisfaction (z = -3.11, p = .002), self-efficacy for learning (z = -3.04, p = .002), and entrepreneurship (z = -2.15, p = .031) compared to controls. Furthermore, simulation design assessment score in the experimental group significantly differed between T1 (immediately after intervention) and T0 (baseline), and between T3 (8 weeks after intervention) and T0. Evaluation of educational practices in the simulation, education satisfaction, and self-efficacy also significantly differed between T1 and T0, and between T3 and T0. Entrepreneurship significantly differed between T3 and T2 (4 weeks after intervention), and between T3 and T0. CONCLUSIONS: The 3S-BIS program contributes to enhancing nursing start-up competency. Subsequent studies should evaluate the effects of the program on nurses who work in home healthcare services.

Impact of Virtual Reality Mental Health Nursing Simulation on Nursing Students' Competence.

Purpose: This study investigates the impact of a Virtual Reality (VR)-based Mental Health Nursing Practice Simulation (MHNPS) on nursing students' competency in caring for individuals with mental disorders. Nursing students often face fear, anxiety, and helplessness during mental health (MH) rotations, impeding the attainment of learning objectives in the MH nursing practicum. Therefore, innovative strategies offering practice opportunities are crucial for their competence development. Methods: Using a one-group pretest-posttest repeated measures experimental design, 50 nursing students, having completed at least one MH theory course but not yet engaged in MH clinical practicum, were enrolled. Data collection occurred from October 30, 2022, to January 6, 2023. The VR simulation included six modules covering delusion, hallucination, mania, geriatric depression, adolescent depression with suicidal ideation, and obsessive-compulsive disorder. Pre-simulation questionnaires and post-simulation surveys were administered through provided links. Data were analyzed using descriptive statistics and paired t-tests to assess changes over time. Results: Immediate and sustained improvements were observed in mental disorder-related nursing knowledge, communication self-efficacy, critical thinking ability, and MH nursing clinical confidence. Attitudes toward mental illness improved significantly post-intervention (t=-2.22, p=0.031), while the problem-solving process exhibited significant enhancement six weeks later (t=3.87, p<0.001). Conclusion: The findings affirm the simulation intervention's effectiveness in enhancing nursing students' knowledge, self-efficacy, critical thinking, and confidence in MH nursing practice, with no compromise to patient safety. Integrating simulation into MH nursing practicum narrows the gap between theory and clinical practice, elevates MH care quality, and instills confidence in nursing students as professionals. Despite potential subject selection bias in this single-group pre-post intervention study, the program's comprehensive impact on knowledge, skills, and attitudes suggests opportunities for expanding psychiatric nursing practice capabilities through subsequent studies. Caution is warranted in interpreting results, but the developed program lays the groundwork for advancing nursing students' capabilities in psychiatric nursing practice.

Effectiveness of a personalized digital exercise and nutrition-based rehab program for patients with gastric cancer after surgery: Study protocol for a randomized controlled trial.

Background: Patients with gastric cancer often encounter impaired quality of life and reduced tolerability to adjuvant treatments after surgery. Weight preservation is crucial for the overall prognosis of these patients, and exercise and supplemental nutrition play the main role. This study is the first randomized clinical trial to apply personalized, treatment stage-adjusted digital intervention with wearable devices in gastric cancer rehabilitation intervention for 12 months, commencing immediately after surgery. Methods: This is a prospective, multicenter, two-armed, randomized controlled trial and aims to recruit 324 patients from two hospitals. Patients will be randomly allocated to two groups for 1 year of rehabilitation, starting immediately after the operation: a personalized digital therapeutic (intervention) group and a conventional education-based rehabilitation (control) group. The primary objective is to clarify the effect of mobile applications and wearable smart bands in reducing weight loss in patients with gastric cancer. The secondary outcomes are quality of life measured by the EORTC-QLQ-C30 and STO22; nutritional status by mini nutrition assessment; physical fitness level measured by grip strength test, 30-s chair stand test and 2-min walk test; physical activity measured by IPAQ-SF; pain intensity; skeletal muscle mass; and fat mass. These measurements will be performed on enrollment and at 1, 3, 6, and 12 months thereafter. Conclusions: Digital therapeutic programs include exercise and nutritional interventions modified by age, body mass index, surgery type and postoperative days. Thus, expert intervention is pivotal for precise and safe calibration of this program. Trial registration: Clinicaltrials.gov identifier: NCT04907591 (registration date: June 11, 2020; https://clinicaltrials.gov/ct2/show/NCT04907591).

Impact of Adjuvant Hormone Therapy on Sleep, Physical Activity, and Quality of Life in Premenopausal Breast Cancer: 12-Month Observational Study.

PURPOSE: This study aimed to investigate the differences in sleep disturbance changes between patients receiving two hormone therapies ("tamoxifen plus ovarian function suppression group [T+OFS group]" versus "tamoxifen group [T group]") and the chronological changes in sleep disturbances in each group. METHODS: Premenopausal women with unilateral breast cancer who underwent surgery and were scheduled to receive hormone therapy (HT) with tamoxifen alone or with tamoxifen plus gonadotropin-releasing hormone (GnRH) agonist for ovarian function suppression were included. The enrolled patients wore an actigraphy watch for two weeks and completed questionnaires (insomnia, sleep quality, physical activity [PA], and quality of life [QOL]) at five time points: immediately before HT and 2, 5, 8, and 11 months after HT. RESULTS: Among the 39 enrolled patients (21 and 18 patients in the T+OFS group and T group, respectively), 25 (17 and 8 patients in the T+OFS group and T group, respectively) were finally analyzed. There were no differences between the two groups in time-dependent changes in insomnia, sleep quality, total sleep time, rapid eye movement sleep rate, QOL, and PA; however, the severity of hot flashes was significantly higher in the T+OFS group than in the T group. Although the interaction between group and time was not significant, insomnia and sleep quality significantly worsened at 2-5 months of HT when changes over time were analyzed within the T+OFS group. In both the groups, PA and QOL were maintained without significant changes. CONCLUSION: Unlike tamoxifen alone, tamoxifen plus GnRH agonist initially worsened insomnia and sleep quality, but gradually improved with long-term follow-up. Patients who initially experience insomnia during tamoxifen plus GnRH agonist administration can be reassured based on the results of this study, and active supportive care may be used during this period. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04116827.

The effect of curcumin on blood pressure and cognitive impairment in spontaneously hypertensive rats.

BACKGROUND/OBJECTIVES: It is known that the renin-angiotensin system (RAS) in the brain could regulate cognitive functions as well as blood pressure. Inhibition of RAS for the improvement of cognitive function may be a new strategy, but studies so far have mostly reported on the effects of RAS inhibition by drugs, and there is no research on cognitive improvement through RAS inhibition of food ingredients. Therefore, this study investigated the effect of curcumin on blood pressure and cognitive function and its related mechanism in spontaneously hypertensive rat/Izm (SHR/Izm). MATERIALS/METHODS: Six-week-old SHR/Izm rats were divided into 5 groups: control group (CON), scopolamine group (SCO, drug for inducing cognitive deficits), positive control (SCO and tacrine [TAC]), curcumin 100 group (CUR100, SCO + Cur 100 mg/kg), and curcumin 200 group (CUR200, SCO + Cur 200 mg/kg). Changes in blood pressure, RAS, cholinergic system, and cognitive function were compared before and after cognitive impairment. RESULTS: The SCO group showed increased blood pressure and significantly reduced cognitive function based on the y-maze and passive avoidance test. Curcumin treatments significantly improved blood pressure and cognitive function compared with the SCO group. In both the CUR100 and CUR200 groups, the mRNA expressions of angiotensin-converting enzyme (ACE) and angiotensin II receptor type1 (AT1), as well as the concentrations of angiotensin II (Ang II) in brain tissue were significantly decreased. The mRNA expression of the muscarinic acetylcholine receptors (mAChRs) and acetylcholine (ACh) content was significantly increased, compared with the SCO group. CONCLUSIONS: The administration of curcumin improved blood pressure and cognitive function in SCO-induced hypertensive mice, indicating that the cholinergic system was improved by suppressing RAS and AT1 receptor expression and increasing the mAChR expression.

Effectiveness of personalized treatment stage-adjusted digital therapeutics in colorectal cancer: a randomized controlled trial.

BACKGROUND: Colorectal cancer survivors often experience decline in physical performance and poor quality of life after surgery and during adjuvant therapies. In these patients, preserving skeletal muscle mass and high-quality nourishment are essential to reduce postoperative complications and improve quality of life and cancer-specific survival. Digital therapeutics have emerged as an encouraging tool for cancer survivors. However, to the best of our knowledge, randomized clinical trials applying personalized mobile application and smart bands as a supportive tool to several colorectal patients remain to be conducted, intervening immediately after the surgical treatment. METHODS: This study is a prospective, multi-center, single-blinded, two-armed, randomized controlled trial. The study aims to recruit 324 patients from three hospitals. Patients will be randomly allocated to two groups for one year of rehabilitation, starting immediately after the operation: a digital healthcare system rehabilitation (intervention) group and a conventional education-based rehabilitation (control) group. The primary objective of this protocol is to clarify the effect of digital healthcare system rehabilitation on skeletal muscle mass increment in patients with colorectal cancer. The secondary outcomes would be the improvement in quality of life measured by EORTC QLQ C30 and CR29, enhanced physical fitness level measured by grip strength test, 30-sec chair stand test and 2-min walk test, increased physical activity measured by IPAQ-SF, alleviated pain intensity, decreased severity of the LARS, weight, and fat mass. These measurements will be held on enrollment and at 1, 3, 6 and 12 months thereafter. DISCUSSION: This study will compare the effect of personalized treatment stage-adjusted digital health interventions on immediate postoperative rehabilitation with that of conventional education-based rehabilitation in patients with colorectal cancer. This will be the first randomized clinical trial performing immediate postoperative rehabilitation in a large number of patients with colorectal cancer with a tailored digital health intervention, modified according to the treatment phase and patient condition. The study will add foundations for the application of comprehensive digital healthcare programs focusing on individuality in postoperative rehabilitation of patients with cancer. TRIAL REGISTRATION: NCT05046756. Registered on 11 May 2021.

A systematic review and meta-analysis of studies on extended reality-based pediatric nursing simulation program development.

PURPOSE: This systematic literature review and meta-analysis explored extended reality (XR)-based pediatric nursing simulation programs and analyzed their effectiveness. METHODS: A literature search was conducted between May 1 and 30, 2022 in the following electronic databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. The search period was from 2000 to 2022. In total, 6,095 articles were reviewed according to the inclusion and exclusion criteria, and 14 articles were selected for the final content analysis and 10 for the meta-analysis. Data analysis was performed using descriptive statistics and the Comprehensive Meta- Analysis program. RESULTS: XR-based pediatric nursing simulation programs have increased since 2019. Studies using virtual reality with manikins or high-fidelity simulators were the most common, with six studies. The total effect size was statistically significant at 0.84 (95% confidence interval=0.50-1.19, z=4.82, p<.001). CONCLUSION: Based on the findings, we suggest developing standardized guidelines for the operation of virtual pediatric nursing simulation education and practice. Simultaneously, the application of more sophisticated research designs for effect measurement and the combined applications of various virtual simulation methods are needed to validate the most effective simulation methodology.

Feasibility and usability of a personalized mHealth app for self-management in the first year following breast cancer surgery.

This study investigated the feasibility and usability of a personalized mobile health (mHealth) app for self-management during the year following breast cancer surgery. Twenty-nine participants were instructed to use an app and smart band immediately after discharge. Only 18 completed the study. Their perceived necessity and satisfaction for main domains and app were assessed at 1, 2, 4, 6, 9, and 12 months. A self-reporting questionnaire assessed usability at 12 months. Consequently, retention rate as measures of feasibility showed a mean of 75.8%. Exercise and diet management were the most accessed app domains. Perceived necessity was higher than satisfaction. The mean usability score was 80.2. Most participants found the app useful and effective as a delivery for healthcare. Further, 94% of them were willing to pay for and recommend it. Thus, mHealth app can help breast cancer patients improve their healthy behaviors and healthcare further. This study provides insights for designing long-term randomized controlled trials using mHealth interventions.

Single-cell analysis of multiple myelomas refines the molecular features of bortezomib treatment responsiveness.

Both the tumor and tumor microenvironment (TME) are crucial for pathogenesis and chemotherapy resistance in multiple myeloma (MM). Bortezomib, commonly used for MM treatment, works on both MM and TME cells, but innate and acquired resistance easily develop. By single-cell RNA sequencing (scRNA-seq), we investigated bone marrow aspirates of 18 treatment-naïve MM patients who later received bortezomib-based treatments. Twelve plasma and TME cell types and their subsets were identified. Suboptimal responders (SORs) to bortezomib exhibited higher copy number alteration burdens than optimal responders (ORs). Forty-four differentially expressed genes for SORs based on scRNA-seq data were further analyzed in an independent cohort of 90 treatment-naïve MMs, where 24 genes were validated. A combined model of three clinical variables (older age, low absolute lymphocyte count, and no autologous stem cell transplantation) and 24 genes was associated with bortezomib responsiveness and poor prognosis. In T cells, cytotoxic memory, proliferating, and dysfunctional subsets were significantly enriched in SORs. Moreover, we identified three monocyte subsets associated with bortezomib responsiveness and an MM-specific NK cell trajectory that ended with an MM-specific subset. scRNA-seq predicted the interaction of the GAS6-MERTK, ALCAM-CD6, and BAG6-NCR gene networks. Of note, tumor cells from ORs and SORs were the most prominent sources of ALCAM on effector T cells and BAG6 on NK cells, respectively. Our results indicate that the complicated compositional and molecular changes of both tumor and immune cells in the bone marrow (BM) milieu are important in the development and acquisition of resistance to bortezomib-based treatment of MM.

Factors Associated with Job Stress among Hospital Nurses: A Meta-Correlation Analysis.

This study aims to investigate research trends concerning job stress among hospital nurses. Articles about job stress among hospital nurses published in English from 2008 to 2018 were searched. In the first search, 2673 articles were extracted from the MEDLINE, EMBASE, KoreaMed, KERIS, KISS, KISTI, and KMbase databases. Altogether, 154 articles were used in the systematic review and meta-analysis. Thirty-nine variables were explored regarding job stress. Among the major variables, insufficient job control, personal conflict, and burnout had a positive correlation. In contrast, intention to stay, job satisfaction, and personal accomplishment had a negative correlation. In the meta-analysis conducted in relation to a specific conceptual framework, the negative-outcome factors showed significant positive correlations with job stress, whereas the positive-outcome factors showed significant negative correlations with job stress. This study identified factors associated with job stress in nurses through a meta-correlation analysis, and the overall correlation coefficient was relatively high at 0.51. Job factors and moderators had significant meta-correlation coefficients. These results can be utilized in clinical practice and research to help develop intervention programs to relieve job stress among nurses.

Predictive Models for Nurses' Entrepreneurial Intentions Using Comparison of Competing Models.

There is a need to introduce predictive models of nurses' entrepreneurial intentions that can identify which variables will promote entrepreneurship among nurses. This study aimed to explore the factors influencing nurses' entrepreneurial intentions. We performed a systematic review and developed prediction models using factors identified and validated in a meta-analysis. Moreover, we individually tested and compared three models based on: (1) the Theory of Planned Behavior, (2) a meta-analysis, and (3) a combination of the two. Data from 386 nurses were analyzed using SPSS 23.0 for Windows and AMOS 21.0. The squared multiple correlation statistics of Models 1, 2, and 3 were 54.3%, 35.8%, and 60.0%, respectively. Model 3 provided a better explanation of nurses' entrepreneurial intentions. Attitude, subjective norm, perceived behavioral control, entrepreneurial orientation, and need for entrepreneurship education are the most important variables to strengthen the entrepreneurial intention of nurses. The results of this study can be used as a theoretical model to explain nurse entrepreneurship intentions. In addition, these findings offer a useful resource for constructing a start-up curriculum within nursing colleges that fosters prospective nursing entrepreneurs.

Lariciresinol Displays Anti-Diabetic Activity through Inhibition of α-Glucosidase and Activation and Enhancement of Insulin Signaling.

SCOPE: The aim of this study is to investigate the antidiabetic effect of lariciresinol (LSR) in C2C12 myotubes and streptozotocin (STZ)-induced diabetic mice. METHODS AND RESULTS: To investigate antidiabetic potential of LSR, α-glucosidase inhibitory assay, molecular docking, glucose uptake assay, western blot assay on antidiabetic biomarkers are performed. STZ-induced diabetic model is used for in vivo study by calculating oral glucose tolerance test, histochemical examination, and glycogen assay. LSR inhibits α-glucosidase activity with an IC50 value of 6.97 ± 0.37 µM and acts as a competitive inhibitor with an inhibitory constant (Ki) value of 0.046 µM. In C2C12 cells, LSR activates insulin signaling leading to glucose transporter 4 (GLUT4) translocation and augmented glucose uptake. Furthermore, in Streptozotocin (STZ)-treated diabetic mice, 3 weeks of oral LSR administration (10 mg kg-1 ) considerably decrease blood glucose levels, while increasing insulin levels in an oral glucose tolerance test, improve pancreatic islet size, increase GLUT4 expression, and significantly enhance insulin signaling in skeletal muscle. LSR treatment also activates glycogen synthase kinase 3ß (GSK-3ß) resulting in improved glycogen content. CONCLUSION: The findings indicate a potential usefulness for oral LSR in the management and prevention of diabetes by enhancing glucose homeostasis.

Home-Based Intermittent Pneumatic Compression Therapy: The Impact in Chronic Leg Lymphedema in Patients Treated for Gynecologic Cancer.

We conducted a prospective study of cancer patients to investigate the efficacy, quality of life, satisfaction, and safety of a home-based intermittent pneumatic compression (IPC) device during the maintenance phase of lower extremity lymphedema. This device has a unique mode designed to mimic the manual lymphatic drainage (MLD) technique and thereby gently facilitate lymphatic draining of proximal extremities. Thirty patients with stage 3 chronic secondary unilateral leg lymphedema in the maintenance phase underwent IPC and conventional compression therapy for 4 weeks at home. The participants were guided to use 1 h course (30 min of MLD-mimicking mode and 30 min of conventional mode) of IPC device twice a day for 4 weeks. We assessed the patients' limb-volume measurement, quality of life (QOL), and satisfaction four times. There were no significant time-dependent interactions in the inter-limb volume difference ratio (Vratio). In a subgroup analysis, participants who used the home-based IPC device and maintained their routine self-maintenance program of short-stretch bandages (group B, n = 21) showed a more significant decline in Vratio than those who did not maintained their routine care (group A, n = 9). All scores of QOL decreased significantly after the intervention without subgroup difference. All participants were satisfied with the 4-week intervention. This study demonstrated that a home-based IPC device with an MLD-mimicking program is a useful option for maintaining the volume of limbs and improving the QOL of patients with stage 3 chronic leg lymphedema during the maintenance phase.

Development and Evaluation of the "High-Up" Program for Enhancing the Nursing-Management Competency of Mid-Career Hospital Nurses: A Quasi-Experimental Study.

The aim of this study was to develop an educational program to strengthen the nursing management competency of experienced nurses who are prospective nurse managers and then determine the effectiveness of the program. This quasi-experimental study was conducted from January to April 2021. A total of 22 nurses were assigned to the experiment group (mean age: 26.55 ± 1.30 years; 2 males, 20 females), and 20 were assigned to the control group (mean age: 27.55 ± 2.04 years; 20 females). The program, known as the "High-Up" program, comprised problem-based learning (PBL) and video lectures. In the experiment group, nurses discussed PBL cases through video conferences and applied problem-solving methods. The collected data were analyzed using the Friedman test and Wilcoxon rank-sum test (administered through SPSS). At four weeks after the intervention, the experiment group showed higher critical thinking tendency scores than the control group (pre-intervention score: 3.48 ± 0.36; post-intervention score: 3.71 ± 0.49; Z = -1.99, p = 0.046). The findings indicate that the "High-Up" program can enhance the nurse management competency of experienced nurses who need to prepare for nurse manager roles, and that it can also positively influence the performance of nursing organizations. However, it can be difficult to comprehensively enhance nursing management competency in a short period of time, meaning continuous education is required.

Prognostic role of the ratio of natural killer cells to regulatory T cells in patients with multiple myeloma treated with lenalidomide and dexamethasone.

Despite advances in treating newly diagnosed multiple myeloma (NDMM), a biomarker-driven personalized approach remains an unmet need. A combination of lenalidomide and dexamethasone (RD) is a widely available chemotherapeutic option for NDMM. We aimed to find a circulating immune cell-based biomarker to predict prognosis following RD in patients with NDMM. Clinical data and peripheral blood samples of 71 consecutive NDMM patients treated with RD were retrospectively analyzed. Peripheral blood samples were taken at the time of diagnosis. Immune cell populations, including natural killer (NK) cells, T cells, and their subpopulations, were identified by flow cytometry. In univariable analysis, four variables, including low expression (third or lower quartile) of NK cells, high expression (first or greater quartile) of regulatory T (Treg) cells, female sex, and lambda light chain type, could be plausible factors in predicting poor progression-free survival (PFS). With use of the ratio of NK cells to Treg cells (NK/Treg) as a biomarker, the median PFS of patients with low NK/Treg (less than first quartile, n = 18) was significantly inferior to that of patients with high NK/Treg (first or greater quartile, n = 53): 19.8 months versus 57.3 months, p = 0.047. In multivariable analysis, low NK/Treg was significantly associated with poor PFS (hazard ratio: 2.877, 95% confidence interval: 0.001-1.009, p = 0.048), even after adjusting for other confounding factors. NK/Treg at the time of diagnosis might be a useful immune cell biomarker for clinical decision-making for the use of RD in NDMM. Further investigations are needed to improve outcomes of NDMM patients based on the understanding of the role of NK/Treg.

Nursing Students' Subjective Happiness: A Social Network Analysis.

Improving nursing students' subjective happiness is germane for efficiency in the nursing profession. This study examined the subjective happiness of nursing students by applying social network analysis (SNA) and developing a strategy to improve the subjective happiness of nursing. The study adopted a cross sectional survey to measure subjective happiness and social network of 222 nursing students. The results revealed that the centralization index, which is a measure of intragroup interactions from the perspective of an entire network, was higher in the senior year compared with the junior year. Additionally, the indegree, outdegree, and centrality of the social network of students with a high level of subjective happiness were all found to be high. This result suggests that subjective happiness is not just an individual's psychological perception, but can also be expressed more deeply depending on the subject's social relationships. Based on the study's results, to strengthen self-efficacy and resilience, it is necessary to utilize strategies that activate group dynamics, such as team activities, to improve subjective happiness. The findings can serve as basic data for future research focused on improving nursing students' subjective happiness by consolidating team-learning social networks through a standardized program approach within a curriculum or extracurricular programs.

The effects of the Start-Up NurseS program on nursing students using management strategy simulation.

BACKGROUND: Korea's rising youth unemployment, resulting from a long-term economic downturn, has fostered a conducive environment for entrepreneurship. The global healthcare market is expanding rapidly, and entrepreneurship in the nursing sector is also predicted to grow. OBJECTIVES: The objective of this study was to analyze the effects of the Start-Up NurseS program, developed using a management strategy simulation technique, on entrepreneurial attitude, entrepreneurial intention, entrepreneurial self-efficacy, entrepreneurship, and entrepreneurship education demand among nursing students. DESIGN: A randomized control trial with repeated measures. SETTINGS: Four nursing departments in two metropolitan cities. PARTICIPANTS: We assigned 34 nursing students to the experimental group and 33 to the comparison group. METHODS: Nursing students in the experimental group participated in the Start-Up NurseS program for four weeks. Post-intervention data were collected three times: immediately after the program, at four weeks, and at eight weeks. RESULTS: Entrepreneurial attitude, entrepreneurial intention, entrepreneurial self-efficacy, and entrepreneurship were more positive in the experimental group than in the control group. In the former, entrepreneurial attitude, entrepreneurial intention, entrepreneurial self-efficacy, and entrepreneurship showed significant differences immediately after the program, four weeks later, and eight weeks later. CONCLUSIONS: The program had a significant effect on improving nursing start-up competency and can be expanded to various nursing fields.

A Systematic Review and Meta-Analysis of Fall Prevention Programs for Pediatric Inpatients.

Falls account for a high proportion of the safety accidents experienced by hospitalized children. This study aims to analyze the contents and effects of fall prevention programs for pediatric inpatients to develop more adaptable fall prevention programs. A literature search was performed using PubMed (including Medline), Science Direct, CINAHL, Embase, and Cochrane. We included articles published from the inception of each of the databases up to 31 March 2019. A total of 1725 results were reviewed according to the inclusion and exclusion criteria, and nine studies were selected. Data were analyzed using descriptive statistics and the Comprehensive Meta-Analysis program. Four of the nine studies divided their participants into a high-risk fall group and a low-or medium-risk fall group, and all studies used a high-risk sign/sticker as a common protocol guideline for its high-risk fall group. The odds ratio of 0.95 (95% Cl 0.550-1.640) for the fall prevention program in seven studies was not statistically significant. To develop a standardized fall prevention program in the future, randomized control trial studies that can objectively measure the fall rate reduction effect of the integrated fall prevention program need to be expanded.

Effectiveness of interactive augmented reality-based telerehabilitation in patients with adhesive capsulitis: protocol for a multi-center randomized controlled trial.

BACKGROUND: As the primary treatment for adhesive capsulitis, intensive and accurate home exercise is as important as physical therapy in hospitals. Augmented reality (AR)-based telerehabilitation has been implemented recently in various musculoskeletal conditions to increase patient compliance and enable patients to exercise with the correct posture. The objective of this study is to present a protocol for investigating the additive effect of interactive AR-based telerehabilitation in comparison with the usual care for patients with adhesive capsulitis. METHODS: This study presents the protocol of a prospective, multi-center, single-blinded, two-armed randomized controlled trial (RCT). One hundred patients with stage I or II adhesive capsulitis will be recruited at the physical medicine and rehabilitation clinic. Patients will be randomly divided into two groups with 1:1 allocation. The intervention group will receive 3 months of hospital-based physical therapy in conjunction with home-based telerehabilitation. The control group will receive 3 months of hospital-based physical therapy in conjunction with a home-based exercise described in a brochure provided by the hospital. The primary outcome will be the change in passive range of motion (ROM) of the affected shoulder joint from baseline to 12 weeks after baseline assessment. The secondary outcomes will be active ROM, pain measured with the numeric rating scale, shoulder pain and disability index, 36-Item Short Form Survey, EuroQoL-5D-5L, and Canadian Occupational Performance Measure. DISCUSSION: This will be the first RCT study protocol to investigate the effect of telerehabilitation in patients with adhesive capsulitis. The result of this RCT will determine whether AR-based telerehabilitation is more effective than a brochure-based home exercise program and will provide evidence of the usefulness of "telerehabilitation" using hardware (IoT) and software (monitoring platform) technologies to develop "digital therapeutics" for the future. TRIAL REGISTRATION: This trial was retrospectively registered at the Clinicaltrials.gov website on 20 March 2020, with the identifier NCT04316130 .