Comparative Study of Diabetes Knowledge, Attitudes, Family Support, Self-efficacy, and Self-management Behaviors Between Cancer Survivors With Diabetes and Diabetes Patients Without Cancer.

BACKGROUND: Studies have compared diabetes management quality indicators, focusing on physiological markers such as hemoglobin A1c, between cancer survivors with diabetes and general diabetes patients. However, research comparing differences in diabetes self-management behaviors and the factors influencing them between these groups is lacking. OBJECTIVES: This study aimed to compare self-management behaviors, guided by the information-motivation-behavior model, between cancer survivors with diabetes and general diabetes patients. In addition, we aimed to identify differences in factors such as diabetes knowledge, attitudes, family support, and self-efficacy that may influence diabetes self-management behaviors in both groups. METHODS: A total of 125 cancer survivors with diabetes and 126 general diabetes patients participated in this cross-sectional study. A structured questionnaire assessed demographics, diabetes knowledge, attitudes, self-efficacy, and self-management behaviors. RESULTS: Regarding diabetes education, 47.0% of cancer survivors and 61.6% of general diabetes patients received education. The cancer survivors had lower diabetes knowledge scores (10.30 ± 4.15, P < .001), a lower perceived value of strict blood glucose control (4.10 ± 0.56, P < .001), and less family support (15.50 ± 7.50, P = .019) than the patients without cancer (13.51 ± 3.84, 4.25 ± 0.65, and 17.57 ± 6.40, respectively). CONCLUSION: This study reveals significant differences in diabetes self-management between cancer survivors and general diabetes patients. Cancer survivors showed lower diabetes knowledge, glucose control perception, and family support. These findings highlight the need for tailored self-management programs for cancer survivors. IMPLICATIONS FOR PRACTICE: This study offers insights for developing tailored diabetes self-management programs and educational interventions for cancer survivors.

Capturing key function-focused care problems, nursing diagnoses, and interventions for nursing home patients using a web-based case management system.

PURPOSE: The aim of this study is to identify the key functional care problems, NANDA-I nursing diagnoses, and intervention plans related to function-focused care (FFC) using a web-based case management system for patients who present different cognitive status. METHODS: This study employed a retrospective descriptive research design. Data were obtained from system records on patients after the research team trained the case management system at a nursing home in Dangjin in South Chungcheong Province, South Korea. A total of 119 inpatient records were analyzed. RESULTS: The key physical, cognitive, and social functional problems, nursing diagnoses in six domains (health promotion, elimination and exchange, activity/rest, perception/cognition, coping/stress tolerance, and safety/protection), and intervention plans were identified. CONCLUSION: The identified FFC case management information of interdisciplinary caregivers will provide evidence for the implementation of effective interventions according to a patient's functional status. Additional studies related to the establishment of a large clinical database of advanced case management systems focusing on interdisciplinary caregivers' functional management are needed to support the prioritization of functional care.

How should the healthcare system support cancer survivors? Survivors' and health professionals' expectations and perception on comprehensive cancer survivorship care in Korea: a qualitative study.

BACKGROUND: Qualitative research on cancer survivors' need for comprehensive cancer survivorship care within the health care system is limited. Our study aimed to understand cancer survivors' and health professionals' expectations and perceptions for developing a comprehensive cancer survivorship care system in South Korea. METHODS: An exploratory qualitative study was conducted. A total of 16 subjects (11 cancer survivors and 5 health professionals) were purposively sampled from Regional Cancer Survivorship Centers or Cancer Survivor Clinics in Korea. In-depth semi-structured online or face-to-face interviews were conducted. Six steps of thematic analysis were used to analyze data. RESULTS: The following four primary themes emerged from the interviews: 1) introducing a customized follow-up care system to improve continuity of survivorship care, 2) implementing educational strategies for both survivors and health professionals to manage changed health, and 3) accepting cancer survivors as companions. These three themes included a total of nine subthemes. As a result, the comprehensive survivorship model identified needs in terms of 1) changes in the medical healthcare system and core services that can accommodate the cancer survivors' condition and 2) necessary care services and social support for cancer survivors. CONCLUSIONS: This study identified the existing gaps in Korea's current healthcare system regarding comprehensive cancer survivorship care for cancer survivors. Further research on eHealth-based counseling and educational support, the payment models of cancer survivorship care within universal health coverage, and changing social perceptions to strengthen the biopsychosocial needs of cancer survivors is needed.

Health Behaviors of Cancer Survivors According to the Employment Status and Occupation: A Cross-Sectional Study.

This study aimed to identify differences in health behaviors according to the employment status and occupation of cancer survivors, as well as to identify risk factors. Using data from the Korea National and Health Nutrition Examination Survey (2008-2018), 1023 cancer survivors aged 19-60 years were classified based on their employment status and occupation, and their health behaviors were comparatively assessed. To investigate the impact of occupational status on the health behaviors of cancer survivors, we performed multivariate adjusted logistic regression analysis. Five hundred fifty-six (54.3%) cancer survivors were engaged in economic activities. After adjusting for various factors, white- and blue-collar workers exhibited an increased risk of obesity. The blue-collar group had a 1.45 times higher risk of non-practice with cancer screening, while the white-collar group had a 0.50 times lower risk of non-practice with health screening. The results provide evidence of the need to support cancer survivors in practicing healthy behaviors according to their employment status and occupation. As cancer survivors' economic activities increase, it is necessary to help them manage their health by predicting any possible health-behavior failures.

Recent advances in nanoflowers: compositional and structural diversification for potential applications.

In recent years, nanoscience and nanotechnology have emerged as promising fields in materials science. Spectroscopic techniques like scanning tunneling microscopy and atomic force microscopy have revolutionized the characterization, manipulation, and size control of nanomaterials, enabling the creation of diverse materials such as fullerenes, graphene, nanotubes, nanofibers, nanorods, nanowires, nanoparticles, nanocones, and nanosheets. Among these nanomaterials, there has been considerable interest in flower-shaped hierarchical 3D nanostructures, known as nanoflowers. These structures offer advantages like a higher surface-to-volume ratio compared to spherical nanoparticles, cost-effectiveness, and environmentally friendly preparation methods. Researchers have explored various applications of 3D nanostructures with unique morphologies derived from different nanoflowers. The nanoflowers are classified as organic, inorganic and hybrid, and the hybrids are a combination thereof, and most research studies of the nanoflowers have been focused on biomedical applications. Intriguingly, among them, inorganic nanoflowers have been studied extensively in various areas, such as electro, photo, and chemical catalysis, sensors, supercapacitors, and batteries, owing to their high catalytic efficiency and optical characteristics, which arise from their composition, crystal structure, and local surface plasmon resonance (LSPR). Despite the significant interest in inorganic nanoflowers, comprehensive reviews on this topic have been scarce until now. This is the first review focusing on inorganic nanoflowers for applications in electro, photo, and chemical catalysts, sensors, supercapacitors, and batteries. Since the early 2000s, more than 350 papers have been published on this topic with many ongoing research projects. This review categorizes the reported inorganic nanoflowers into four groups based on their composition and structure: metal, metal oxide, alloy, and other nanoflowers, including silica, metal-metal oxide, core-shell, doped, coated, nitride, sulfide, phosphide, selenide, and telluride nanoflowers. The review thoroughly discusses the preparation methods, conditions for morphology and size control, mechanisms, characteristics, and potential applications of these nanoflowers, aiming to facilitate future research and promote highly effective and synergistic applications in various fields.

Health Literacy and Anxiety Among Hemodialysis Patients During the Coronavirus Disease Pandemic.

Background and Purpose: The COVID-19 pandemic can cause psychological distress, and hemodialysis patients with chronic kidney disease may be particularly vulnerable. The aim of this study is to investigate anxiety levels among patients undergoing hemodialysis during the COVID-19 pandemic and to explore the relationship between health literacy and anxiety. Methods: This study recruited 149 hemodialysis patients from two hospitals between July 16th and July 31st, 2021. Patient data were collected using questionnaires on general characteristics, health literacy, generalized anxiety, and coronavirus disease-related anxiety. We used the Coronavirus Anxiety Scale (CAS) and the Korean version of the Generalized Anxiety Disorder (GAD) scale to evaluate the anxiety symptoms of the patients. Statistical analyses were performed using descriptive statistics, t-test, Mann-Whitney U-test, one-way ANOVA, Kruskal-Walli's test and Spearman's rank correlation. Results: The results showed that health literacy increased with decreasing age and increasing educational level among patients who source health information from the internet and among patients without comorbidities. Patients with comorbidities showed high levels of general anxiety. Patients who search for health information for ≥1 hour had high levels of coronavirus disease-related anxiety. Both CAS and GAD showed a significant negative correlation with the sub-domains of health literacy, except for critical health literacy. Conclusion: The results of this study highlight the need for a follow-up study on whether health literacy programs will reduce the anxiety levels of patients undergoing hemodialysis during infectious disease outbreaks. In addition, provision of social support for patients with comorbidity is essential for reducing their anxiety levels during disease outbreaks.

Association between COVID-19-related stress and self-directed learning ability among Korean nursing students.

PURPOSE: Traditional face-to-face classes for nursing students due to the COVID (Coronavirus Disease)-19 pandemic around the world made it inevitable to operate education delivery method using remote/hybrid fashion. This study was aimed to validate the Korean version of the Student Stress Inventory-Stress Manifestations (SSI-SM) and assess the association between COVID-19 pandemic related stress level and self-directed learning ability competence in nursing students. DESIGN: This research was a cross-sectional study design. METHODS: The study was conducted from December 2020 to January 2021, with a convenience sample of 172 nursing students in the 3rd and 4th grades in South Korea. The Korean version of SSI-SM(K-SSI-SM) was translated and adapted according to standard guideline, and tested construct validity and reliability. In addition, a multiple linear regression analysis was used to examine the associations between the COVID-19 related stress level and the self-directed learning ability. RESULTS: An exploratory analysis showed that K-SSI-SM composed of 13-item in three factors (uncertainty, non-sociability, and somatization) accounted for 68.73% of the total variance after it was modified. The internal consistency was good with 0.91. Multiple linear regression analysis revealed that higher self-directed learning ability was associated with lower stress levels (ß = -0.19, p = 0.008), positive toward online learning (ß = 0.41, p = 0.003) and scored higher in theory (ß = 0.30, p < 0.001) in nursing students. CONCLUSION: The K-SSI-SM is an acceptable instrument for assessing stress levels in Korean nursing students. And nursing faculties need to pay attention to related factors of self-directed learning ability, in order to achieve the course's self-directed learning goal in students attending online classes.

Analysis of the Incidence of Type 2 Diabetes, Requirement of Insulin Treatment, and Diabetes-Related Complications among Patients with Cancer.

This retrospective nationwide population-based cohort study used a dataset collected from the Korean National Health Insurance Service. We evaluated incident type 2 diabetes, insulin requirements, and diabetes-associated complications during a 10-year follow-up period using the log-rank test and Cox proportional hazards regression models. In total, 8114 and 16,228 individuals with and without cancer, respectively, were enrolled. We found a higher incidence rate and an increased adjusted hazard ratio (HR) for new cases of type 2 diabetes in patients with cancer, compared with those without cancer. Additionally, patients with cancer had a higher risk of insulin requirement than patients without cancer (adjusted HR 1.43, 95% confidence interval [CI], 1.14-1.78). Although there was no significant association between diabetes-associated complications and overall cancer diagnosis, specific cancer types (pancreas, bladder, and prostate) showed an increased risk of subsequent diabetic nephropathy. Therefore, clinicians should closely monitor patients with cancer for the early detection of type 2 diabetes and related morbidities.

Relationship of Depression, Anxiety, and Bipolar Disease with Burning Mouth Syndrome: A Nationwide Cohort Study.

Burning mouth syndrome (BMS) is a chronic, painful condition of the oral mucosa. Although the pathogenesis remains unclear, psychological and neuroendocrine factors are considered the major contributors. Few longitudinal studies have investigated the effects of psychological factors on the occurrence of BMS. Therefore, we evaluated the risk of BMS in patients with affective disorders using a nationwide population-based cohort dataset. We identified patients with depression, anxiety, and bipolar disorder and then selected comparison participants using the 1:4 propensity score-matching method. We investigated the incidence of BMS events during the follow-up period using survival analysis, the log-rank test, and Cox proportional hazards regression models. After adjusting for other contributing conditions, the adjusted hazard ratio (HR) for developing BMS was 3.37 (95% confidence interval [CI]: 1.67-6.80) for depression and 5.09 (95% CI: 2.19-11.80) for anxiety; however, bipolar disorder showed no significant risk. Specifically, female patients with depression and anxiety had an increased risk of BMS. Moreover, patients with anxiety showed an increased adjusted HR of BMS events during the first 4 years after diagnosis, whereas patients with depression did not. In conclusion, depression and anxiety disorders are significantly associated with the risk of BMS. Additionally, female patients showed a significantly higher risk of BMS than male patients, and anxiety showed increased BMS events earlier than depression. Therefore, clinicians should consider the risk of BMS when treating patients with depression or anxiety.

Transcultural adaptation and validity of the nurse professional competence scale Korean version for graduating nursing students: An explanatory factor analysis.

AIM: The study aimed to assess the validity and reliability of the short-form Nurse Professional Competence Scale-Korean version (NPC-K) among Korean nursing students at the point of graduation. DESIGN: This was a cross-sectional survey. METHODS: The Nurse Professional Competence scale was translated into Korean using the World Health Organization (WHO) translation method. A total of 195 graduating nursing students participated. Exploratory factor analysis for validity and Cronbach's alpha coefficients for reliability were examined. RESULTS: Factor analysis showed that five NPC-K factors accounted for 68.38% of the total variance. Cronbach's alpha for the total scale was 0.97. The NPC-K has high internal reliability and acceptable construct validity. The content of the scale reflected nursing students' confidence in formal competence requirements based on Korean cultural and educational backgrounds. An accurate assessment of nurse professional competence using the NPC-K may help nursing academics enhance the quality of education and training.

Total Knee Replacement After Arthroscopic Meniscectomy in Knee Osteoarthritis: A Nationwide Population-Based Cohort Study.

BACKGROUND: Recent studies raise concerns that arthroscopic meniscectomy (AM) for degenerative tear may be detrimental to the maintenance of the joint structure. This study was performed to examine the rate of total knee replacement (TKR) among patients with knee osteoarthritis (OA) who underwent AM for meniscal tears and compare this rate with those who did not. METHODS: A retrospective cohort study was conducted using the National Health Insurance Database of South Korea. Among knee OA patients aged 50-79, those who were treated with AM due to meniscal damage from 2007 to 2009 were selected as the AM group while those not treated with AM despite the presence of meniscal damage were selected as control group. Both were matched based on a propensity score and followed-up until the earliest occurrence of: TKR, death, or 10 years. Cox proportional hazards models were used to compare the outcome. RESULTS: A total of 36,974 patients were included in AM groups and non-AM group after 1:1 matching. TKR occurred in 9.62% and 7.64% in AM and non-AM groups with the average duration after meniscectomy of 5.88 ± 2.77 and 5.50 ± 2.94 years, respectively. After adjustment for baseline confounders, the TKR rate in the AM group was calculated to be 25% higher than that in the non-AM group (subdistribution hazard ratio, 1.25; 95% confidence interval, 1.16-1.34). The mortality rate was 5.20%, which did not significantly differ between groups. CONCLUSION: OA patients who underwent AM for the meniscal injury had higher incidence of TKR up to 10 years of follow-up than the non-operated group. The greater TKR utilization observed in patients undergoing AM merits caution when treating OA patients with meniscal injury.

Anti-Inflammatory Effects of the LK5 Herbal Complex on LPS- and IL-4/IL-13-Stimulated HaCaT Cells and a DNCB-Induced Animal Model of Atopic Dermatitis in BALB/c Mice.

Atopic dermatitis (AD) is a chronic inflammatory skin disease influenced by a complex interplay of genetic and environmental factors. The activation of the JAK-STAT pathway increases the expression of inflammatory cytokines such as IL-4 and IL-13, further deteriorating AD. Therefore, for the treatment of AD, the JAK-STAT pathway is emerging as a significant target, alongside inflammatory cytokines. This study investigates the potential therapeutic effects of a novel herbal complex, LK5, composed of Scutellaria baicalensis, Liriope platyphylla, Sophora flavescens, Dictammus dasycarpus, and Phellodendron schneider, known for their anti-inflammatory and immune-modulating properties. We examined the anti-inflammatory and anti-AD effects of the LK5 herbal complex in HaCaT cells stimulated by LPS and IL-4/IL-13, as well as in a mouse model of AD induced by DNCB. In HaCaT cells stimulated with LPS or IL-4/IL-13, the LK5 herbal complex demonstrated anti-inflammatory effects by inhibiting the expression of inflammatory cytokines including TNF-α, IL-6, and IL-1ß, and downregulating the phosphorylation of STAT proteins. In a murine AD-like model induced by DNCB, administration of the LK5 herbal complex significantly ameliorated clinical symptoms, including dermatitis, ear thickness, and TEWL. Histological analysis revealed a reduction in epidermal thickness and mast cell infiltration. The LK5 herbal complex also inhibited pruritus induced by compound 48/80. Furthermore, the LK5 herbal complex treatment significantly decreased the levels of inflammatory cytokines such as TSLP, IL-6, and IgE in plasma and ear tissue of AD-induced mice. These findings suggest that the LK5 herbal complex may modulate the immune response and alleviate AD symptoms by inhibiting STAT pathways.

Analysis of the Association between Metabolic Syndrome and Renal Function in Middle-Aged Patients with Diabetes.

This study investigated the effects of metabolic syndrome on the estimated glomerular filtration rate in middle-aged participants with diabetes to provide basic data to enable the development of education programs for middle-aged people to prevent diabetic kidney disease. This cross-sectional descriptive study analyzed data obtained in the 2nd year of the 8th Korea National Health and Nutrition Examination Survey in 2020 and enrolled 279 participants aged 40-65 years who were diagnosed with diabetes. Multilevel stratified cluster sampling was used to improve the representativeness of the samples and the accuracy of parameter estimation. The risk factors of metabolic syndrome and the risk of elevated eGFR were analyzed using regression analysis and the correlation between the variables was determined using Pearson's correlation analysis. Middle-aged participants with diabetes whose eGFR was <90 showed a significant difference in their risk for metabolic syndrome based on sex, age, disease duration, and total cholesterol concentrations. Systolic blood pressure and waist circumference in men, and waist circumference and HDL cholesterol level in women were identified as risk factors that contribute to the increasing prevalence of metabolic syndrome.

Inorganic Nanoflowers-Synthetic Strategies and Physicochemical Properties for Biomedical Applications: A Review.

Nanoflowers, which are flower-shaped nanomaterials, have attracted significant attention from scientists due to their unique morphologies, facile synthetic methods, and physicochemical properties such as a high surface-to-volume ratio, enhanced charge transfer and carrier immobility, and an increased surface reaction efficiency. Nanoflowers can be synthesized using inorganic or organic materials, or a combination of both (called a hybrid), and are mainly used for biomedical applications. Thus far, researchers have focused on hybrid nanoflowers and only a few studies on inorganic nanoflowers have been reported. For the first time in the literature, we have consolidated all the reports on the biomedical applications of inorganic nanoflowers in this review. Herein, we review some important inorganic nanoflowers, which have applications in antibacterial treatment, wound healing, combinatorial cancer therapy, drug delivery, and biosensors to detect diseased conditions such as diabetes, amyloidosis, and hydrogen peroxide poisoning. In addition, we discuss the recent advances in their biomedical applications and preparation methods. Finally, we provide a perspective on the current trends and potential future directions in nanoflower research. The development of inorganic nanoflowers for biomedical applications has been limited to date. Therefore, a diverse range of nanoflowers comprising inorganic elements and materials with composite structures must be synthesized using ecofriendly synthetic strategies.

Therapeutic Potency of NO Loaded into Anticancer Copper Metal-Organic Framework through Nonclassical Hydrogen Bonding.

Metal-organic frameworks (MOFs) are potential exogenous scaffolds for therapeutic nitric oxide (NO) delivery because they can store drug or bioactive gas molecules within pores or on active metal sites. Herein, we employed a Cu-MOF coordinated with glutarate (glu) and 1,2-bis(4-pyridyl)ethane (bpa) to obtain NO-loaded Cu-MOF (NO⊂Cu-MOF). NO loading transformed the space group of Cu-MOF from monoclinic C2/c to triclinic P-1 through nonclassical hydrogen bonding with glu and bpa. Cu-MOF showed good stability in deionized water and phosphate-buffered saline. NO⊂Cu-MOF released up to 1.10 µmol mg-1 NO over 14.6 h at 37 °C, which is suitable for therapeutic applications. NO⊂Cu-MOF showed moderate biocompatibility with L-929 cells and significant anticancer activity against HeLa cells, suggesting an apoptosis-mediated cell death mechanism. These insights into NO bonding modes with Cu-MOF that enable controlled NO release can inspire the design of functional MOFs as hybrid NO donors for drug delivery.

Controllable Nitric Oxide Storage and Release in Cu-BTC: Crystallographic Insights and Bioactivity.

Crystalline metal-organic frameworks (MOFs) are extensively used in areas such as gas storage and small-molecule drug delivery. Although Cu-BTC (1, MOF-199, BTC: benzene-1,3,5-tricarboxylate) has versatile applications, its NO storage and release characteristics are not amenable to therapeutic usage. In this work, micro-sized Cu-BTC was prepared solvothermally and then processed by ball-milling to prepare nano-sized Cu-BTC (2). The NO storage and release properties of the micro- and nano-sized Cu-BTC MOFs were morphology dependent. Control of the hydration degree and morphology of the NO delivery vehicle improved the NO release characteristics significantly. In particular, the nano-sized NO-loaded Cu-BTC (NO⊂nano-Cu-BTC, 4) released NO at 1.81 µmol·mg-1 in 1.2 h in PBS, which meets the requirements for clinical usage. The solid-state structural formula of NO⊂Cu-BTC was successfully determined to be [CuC6H2O5]·(NO)0.167 through single-crystal X-ray diffraction, suggesting no structural changes in Cu-BTC upon the intercalation of 0.167 equivalents of NO within the pores of Cu-BTC after NO loading. The structure of Cu-BTC was also stably maintained after NO release. NO⊂Cu-BTC exhibited significant antibacterial activity against six bacterial strains, including Gram-negative and positive bacteria. NO⊂Cu-BTC could be utilized as a hybrid NO donor to explore the synergistic effects of the known antibacterial properties of Cu-BTC.

Evaluating the Effectiveness of Community-Based Dementia Caregiver Intervention on Caregiving Burden, Depression, and Attitude Toward Dementia: A Quasi-experimental Study.

Objective: Accumulating evidence of the effects of dementia caregiving on individuals, society, and health has generated intervention studies to reduce the stress among family caregivers of people with dementia. This study aims to evaluate the effectiveness of a family support program, community-based dementia caregiver intervention (CDCI), among family caregivers of people with dementia compared with a control group (no intervention). Patients and Methods: This study is a quasi-experimental, non-randomized controlled trial conducted in six dementia relief centers of a community healthcare center in Korea. Family caregivers of 83 patients with dementia were recruited; of these 78 were included in the final study, with 40 in the intervention group and 38 in the control group. Analysis of covariance (ANCOVA) was used to compare the mean difference in the scores of the total short-form Zarit Burden Interview (SZBI), personal strain, role strain, depression, and attitude between the groups. Results: Compared with controls, in the intervention group, the adjusted mean score of personal strain (F = 4.353, t = 0.041) and attitude toward dementia (F = 10.284, t = 0.002) differed significantly after the intervention, with a small to moderate effect. There was no significant difference in the total SZBI, role strain, or depression mean score. Conclusion: The findings suggest that CDCI may be an effective intervention strategy to reduce personal strain and enhance the attitudes of family caregivers of people with dementia.

Association of Blood Heavy Metal Levels and Renal Function in Korean Adults.

This study aimed to investigate the association between the levels of lead, mercury, cadmium, and nickel in the blood and renal function and to provide basic data for the development of health programs for the prevention of renal failure. This study included 1984 participants aged 19 and older who participated in the Korean National Health and Nutrition Examination Survey from 2019. Differences in values according to general characteristics and the estimated glomerular filtration rate (eGFR) stage were analyzed using a chi-square test, t-test, ANOVA, and the influencing factors were analyzed through multiple regression analysis. The concentrations of lead, mercury, cadmium, and nickel, and the risk of elevated eGFR were analyzed using linear regression. The correlation between the variables was determined using Pearson's correlation analysis. Analysis of the correlation between blood lead, mercury, cadmium, and nickel levels and blood eGFR levels revealed that blood eGFR levels were significantly negatively correlated with blood lead, cadmium, and nickel levels (p ≤ 0.001). This study is significant in that it found a significant association between decreased eGFR and heavy metal levels and provided meaningful basic data on the association between heavy metals and renal function.