Experience of People with Severe Mental Illness in Using Community Mental Health Services: A Systematic Review of Exploratory Research Using Photovoice / 정신간호학회지

Purpose@#The purpose of this study was to understand the experience of using community mental health services from the perspective of people with severe mental illness. @*Methods@#The key research question was, "How was the experience of people with severe mental illnesses using community mental health services in studies using photovoice?" A systematic search was performed using seven core electronic databases (PubMed, EMBASE, CINAHL, Cochrane Library, RISS, KISS, and DBpia). @*Results@#A total of nine studies out of 3,041 were included in the review. Seven central themes were identified through the thematic analysis: "growing hope," "continuing treatment with insight into the illness," "feeling a sense of achievement and improving self-esteem," "feeling joy, stability and connectedness," "pursuing a proactive life," "wanting to live a life that helps others," and "experiencing frustration." @*Conclusion@#The experience of using community mental health services by people with severe mental illness was similar to the experience of recovery. The use of community mental health services and the expansion of the peer support program and supported housing services are needed to promote recovery and improve the quality of life of people with severe mental illness.

Relationships among Knowledge and Skills about Suicide Prevention, Attitudes toward Suicide, and Burnout of Suicide Prevention Work of Nurses at Mental Health Welfare Centers:A Mixed Methods Study

Purpose@#This study aimed to identify relationships among knowledge and skills about suicide prevention, attitudes toward suicide, and burnout of suicide prevention work of nurses at mental health welfare centers. @*Methods@#An explanatory sequential mixed-method research was conducted. For the quantitative study, the subjects (nurses) were 133 nurses executing suicide prevention work. The data were analyzed using the SPSS 25.0 program. For the qualitative research, 13 nurses with high burnout scores were interviewed. The data were analyzed using theme analysis method. @*Results@#Quantitative results showed the average burnout of suicide prevention work was 54.62 ± 12.51. The burnout of suicide prevention work had significant correlations with attitudes toward suicide (r = .30, p < .001) and suicide prevention skills (r = - .18,p = .037). Qualitative results showed six themes related to burnout of suicide prevention work. They were ‘feeling a lack of confidence in one’s suicide counselling skills’, ‘feeling of the limits of one’s ability to cope with a suicide crisis’, ‘feeling regret for not being able to help the clients’, ‘being over-empathetic to the clients’, ‘Not being able to understand the clients because the subjects (nurses) opposes committing suicide’, and ‘thinking that the suicidal thoughts of suicide attempters do not improve’. @*Conclusion@#To reduce burnout of nurses’ suicide prevention work at mental health welfare centers, there is a need to develop an educational program considering nurses' attitudes toward suicide and one to enhance their confidence in suicide prevention skills.

The in vitro and in vivo potency of CT-P59 against Delta and its associated variants of SARS-CoV-2

The Delta variant originally from India is rapidly spreading across the world and causes to resurge infections of SARS-CoV-2. We previously reported that CT-P59 presented its in vivo potency against Beta and Gamma variants, despite its reduced activity in cell experiments. Yet, it remains uncertain to exert the antiviral effect of CT-P59 on the Delta and its associated variants (L452R). To tackle this question, we carried out cell tests and animal study. CT-P59 showed reduced antiviral activity but enabled neutralization against Delta, Epsilon, and Kappa variants in cells. In line with in vitro results, the mouse challenge experiment with the Delta variant substantiated in vivo potency of CT-P59 showing symptom remission and virus abrogation in the respiratory tract. Collectively, cell and animal studies showed that CT-P59 is effective against the Delta variant infection, hinting that CT-P59 has therapeutic potency for patients infected with Delta and its associated variants. HighlightsO_LICT-P59 exerts the antiviral effect on authentic Delta, Epsilon and Kappa variants in cell-based experiments. C_LIO_LICT-P59 showed neutralizing potency against variants including Delta, Epsilon, Kappa, L452R, T478K and P681H pseudovirus variants. C_LIO_LIThe administration of clinically relevant dose of CT-P59 showed in vivo C_LIO_LIprotection against Delta variants in animal challenge experiment. C_LI

Therapeutic efficacy of CT-P59 against P.1 variant of SARS-CoV-2

P.1. or gamma variant also known as the Brazil variant, is one of the variants of concern (VOC) which appears to have high transmissibility and mortality. To explore the potency of the CT-P59 monoclonal antibody against P.1 variant, we tried to conduct binding affinity, in vitro neutralization, and in vivo animal tests. In in vitro assays revealed that CT-P59 is able to neutralize P.1 variant in spite of reduction in its binding affinity against a RBD (receptor binding domain) mutant protein including K417T/E484K/N501Y and neutralizing activity against P.1 pseudoviruses and live viruses. In contrast, in vivo hACE2 (human angiotensin-converting enzyme 2)-expressing TG (transgenic) mouse challenge experiment demonstrated that a clinically relevant or lower dosages of CT-P59 is capable of lowering viral loads in the respiratory tract and alleviates symptoms such as body weight losses and survival rates. Therefore, a clinical dosage of CT-P59 could compensate for reduced in vitro antiviral activity in P.1-infected mice, implying that CT-P59 has therapeutic potency for COVID-19 patients infected with P.1 variant. HighlightsO_LICT-P59 could bind to and neutralize P.1 variant, but CT-P59 showed reduced susceptibility in in vitro tests. C_LIO_LIThe clinical dosage of CT-P59 demonstrated in vivo therapeutic potency against P.1 variants in hACE2-expressing mice challenge study. C_LIO_LICT-P59 ameliorates their body weight loss and prevents the lethality in P.1 variant-infected mice. C_LI

Patch Test Results in Maritime Foreign Workers / 대한피부과학회지

Background@#Occupational allergic contact dermatitis accounts for about half of all occupational skin diseases. Patch testing is essential for establishing a diagnosis of occupational allergic contact dermatitis. To date, allergic contact dermatitis caused by seawater has rarely been reported. @*Objective@#The aim of this study was to investigate the patch test results of seawater in foreign maritime workers. @*Methods@#We retrospectively reviewed the clinical photos and medical records of patients who underwent the patch test with the Korean standard series and sea-water at Uijeongbu St. Mary’s Hospital and St. Vincent’s Hospital from January 2017 to August 2020. @*Results@#A total of 26 patients were enrolled in the study. All patients were men with a median age of 26.5 years.Twenty-five patients were Sri Lankan, and 25 patients (96.2%) showed a positive reaction to seawater. Patients showed positive reactions with multiple allergens (average: 4), and the positive rates were higher than those reported in previous studies. Atypical reactions, such as pricking patterns or erosive patches, have been observed. A marked erosive reaction was observed even at the site without allergen attachment in a patient who showed a negative reaction to seawater. @*Conclusion@#These results suggest the possibility of artificially inducing positive reactions to seawater in maritime workers. Therefore, it is necessary to identify atypical reactions and confirm the relationship between positive reactions and medical history when judging contact dermatitis with unknown substances such as seawater. This study emphasizes education on the standardization of the reading of results.

Patch Test Results in Maritime Foreign Workers / 대한피부과학회지

Background@#Occupational allergic contact dermatitis accounts for about half of all occupational skin diseases. Patch testing is essential for establishing a diagnosis of occupational allergic contact dermatitis. To date, allergic contact dermatitis caused by seawater has rarely been reported. @*Objective@#The aim of this study was to investigate the patch test results of seawater in foreign maritime workers. @*Methods@#We retrospectively reviewed the clinical photos and medical records of patients who underwent the patch test with the Korean standard series and sea-water at Uijeongbu St. Mary’s Hospital and St. Vincent’s Hospital from January 2017 to August 2020. @*Results@#A total of 26 patients were enrolled in the study. All patients were men with a median age of 26.5 years.Twenty-five patients were Sri Lankan, and 25 patients (96.2%) showed a positive reaction to seawater. Patients showed positive reactions with multiple allergens (average: 4), and the positive rates were higher than those reported in previous studies. Atypical reactions, such as pricking patterns or erosive patches, have been observed. A marked erosive reaction was observed even at the site without allergen attachment in a patient who showed a negative reaction to seawater. @*Conclusion@#These results suggest the possibility of artificially inducing positive reactions to seawater in maritime workers. Therefore, it is necessary to identify atypical reactions and confirm the relationship between positive reactions and medical history when judging contact dermatitis with unknown substances such as seawater. This study emphasizes education on the standardization of the reading of results.

Double Primary Mucinous Eccrine Adenocarcinomas Each Occurring Separately on the Left Eyelid and Right Eyelid with a Time Lag / 대한피부과학회지

A 57-year-old man presented with a tender, solitary, 0.3 cm-sized, subdermal nodule on the left periocular area for several months. He had surgery three times for recurrent primary mucinous eccrine adenocarcinoma on the right periocular area. Skin biopsy showed a tumor separated by strands of fibrous tissue and small compartments of tumor cells were surrounded by pale-staining mucin. The cluster of tumor cells contained atypical epithelial cells. The mucin stained with periodic acid-Schiff (PAS) and alcian blue at pH 2.5. Cytokeratin-7 (CK7) was positive for tumor cells, but cytokeratin-20 (CK20) and S-100 were negative. For evaluation of local metastasis, computed tomography was performed and there was no evidence of regional lymph node metastasis. The lesion was removed by local excision and the patient was under close follow up without any sign of recurrence. To our knowledge, double primary mucinous eccrine adenocarcinomas in the opposite body site has never been reported.

Development of an Ethical Sensitivity Scale for Clinical Nurses / 기본간호학회지

Purpose@#The purpose of this study was to develop and test the validity and reliability of the Ethical Sensitivity Scale for Clinical Nurses (ESSCN). @*Methods@#40 items for the preliminary instrument of ESSCN were developed through a literature review and deep interviews with 8 clinical nurses. The scale validation was conducted with a convenience sample of 344 nurses recruited from four general hospitals in Busan and the Gyeongnam area. Content validity, construct validity, criterion validity, convergent validity and discriminative validity were used to evaluate the validity. Cronbach’s ⍺ and test-retest were used to evaluate the reliability of ESSCN. @*Results@#The 36-item ESSCN was found to have eight subscales- patient respect, professional ethics, nursing practice responsibilities, willingness to do good, ethical contemplation, ethical burden, perception of ethical situation and empathy- explaining 61.4% of the total variance. The correlation coefficient between ESSCN and the Korean Moral Sensitivity Questionnaire was .52 (p<.001). Criterion-related validity was supported by known-group comparison. The Cronbach's ⍺ reliability coefficient was .92 and test-retest reliability coefficient was .89 (p<.001). @*Conclusion@#The results of this study suggest that the ethical sensitivity scale is a reliable and valid instrument for measuring ethical sensitivity by clinical nurses.

Effects of Diabetic Foot Care Education for the Aged with Low Health Literacy

PURPOSE: The purpose of this study was to examine the effects of diabetic foot care education for the older adults with low health literacy.METHODS: A quasi-experimental design with a non-equivalent control group pretest-posttest was used. The participants who were diagnosed with diabetes, were adults over 65 years old at the welfare center of Y and B city. They were divided into the experimental group (n=32) and the control group (n=31). Inclusion criteria were a score of 5 or under on the Short form of Korean Functional Health Literacy Test and 24 or more on the Korean version of Mini-Mental State Examination. Foot care education was conducted in a small group for 40 minutes, once a week, for three weeks. The education materials are composed of an easy term, picture and photographs to understand easily.RESULTS: The scores of diabetic foot care knowledge (t=4.57, p < .001), foot care self-efficacy (t=6.07, p < .001), and foot self-care behavior (t=4.18, p < .001) were significantly increased in the experimental group compared to the control group. Foot health status was not significantly improved.CONCLUSION: The findings indicate that this education program can be used as a nursing intervention improving foot care knowledge, foot care self-efficacy, and foot self-care behavior in order to prevent the diabetic foot problems of elderly diabetic persons with low health literacy.

Fungal Genomics in Dermatology / 대한의진균학회지

To date, hundreds of fungal genomes have been sequenced, and many more are underway. Recently developed cutting-edge techniques generate very large amounts of data, and the field of fungal genomics in dermatology has consequently evolved substantially. Methodological improvements have broadened the scope of large-scale ecological studies in dermatology, including biodiversity assessments and genomic identification of fungi. Here, we aimed to provide a brief introduction to bioinformatic approaches to fungal genomics in the field of dermatology. We described the history and basic concepts of fungal genomics and presented sequencing-based techniques for fungal identification, including a list of the revised taxa of dermatophytes, as determined by current phylogenetic analysis. Finally, we discussed the emerging trends in fungal genomics in dermatology, such as next-generation sequencing.

Factors Influencing the Decrease in Depression among Married Women with Depression: Using the Fifth and Sixth Wave Data of Korean Longitudinal Survey of Women and Families / 정신간호학회지

PURPOSE: The purpose of this study was to identify factors influencing decreasing depressive mood of married women with depression. METHODS: Data that integrate the Korean longitudinal survey of women and families in 2014 and 2016 were used. Subjects for this study were 974 people who participated in the fifth survey in 2014 and the sixth survey in 2016, and married women were included in the depression group in the fifth survey. The data was analyzed with χ2 test, t-test, and logistic multiple regression analysis using the SPSS 23.0 program. RESULTS: The decreased-depression group's depression decreased from 11.78 points in the fifth survey to 6.31 points in the sixth survey. This study showed that main factors such as age (OR=0.96, p=.002), educational level (OR=0.54, p=.007), economical status (OR=0.62, p=.037), satisfaction with marriage life (OR=1.15, p < .001), use of medical services (OR=1.65, p=.002), and physical activity (OR=1.08, p=.019) help decrease married women's depression. CONCLUSION: This study findings indicate a need to develop the strategies to increase satisfaction for marriage life and physical activity and to enhance health promotion to decrease depression among depressed married women.

Effects of a Maternal Role Adjustment Program on First-time Mothers

PURPOSE: To investigate the effect of a maternal role adjustment program on first-time mothers. METHODS: The research was quasi-experimental with a non-equivalent control group non-synchronized design. Participants were first-time mothers admitted to two postpartum clinics at women's hospitals. The experimental group had 38 mothers and the control group had 35 mothers. A maternal role adjustment program was applied individually to the experimental group between the 1st and 2nd weeks after childbirth. Assessing Adaptation to Motherhood, Semantic Differential Scale-Myself as Mother, and Edinburgh Postnatal Depression Scale were used to measure effects of the program. A pre-test was conducted in the 1st week after childbirth while post-tests were conducted in the 4th and 6th weeks. Data were analyzed with χ2 test, Fisher's exact test, t-test, and repeated measures ANOVA using SPSS 24.0. RESULTS: Maternal role adjustment (F=6.17, p=.015) and maternal identity (F=6.63, p=.012) were significantly increased in the experimental group compared to those in the control group. However, the difference in postpartum depression (F=1.11, p=.335) was not statistically significant between the two groups. CONCLUSION: The maternal role adjustment program can be utilized as an effective nursing intervention program to enhance maternal role adjustment and maternal identity for first-time mothers.

Parents' Knowledge and Attitudes Regarding a Screening Test for and Subsequent Management of Students' Emotional and Behavioral Problems

PURPOSE: The purpose of this study was to investigate parents' perceptions and attitudes regarding a screening test for and subsequent management of students' emotional and behavioral problems. METHODS: A descriptive research design was used, and included disproportional stratified and cluster random sampling. The sample comprised 223 parents of elementary, middle, and high school students. Data were analyzed using descriptive statistics, Chi-squared test, and ANOVA with SPSS/WIN 21.0. RESULTS: Overall, parents responded that they knew of the goals, types, and tools of screening tests for students' emotional and behavioral problems. In total, 64.6% of parents reported having information for the screening test in advance. Only 13.5%(n=30) of students had emotional and behavioral problems in the last year. Among these students, 56.7%(n=17) were referred to mental health facilities but only 29.4%(n=5) of them received ongoing management from these facilities. CONCLUSION: These findings suggest that parents should receive information about the screening test for and subsequent management of students' emotional and behavioral problems. Health professionals need to build strategies to provide ongoing management for students who have emotional and behavioral problems.

Development of a Breastfeeding Effectiveness Scale (BES)

PURPOSE: The purpose of this study was to develop and evaluate breastfeeding effectiveness scale to measure effectiveness of breastfeeding for mothers in the early postpartum period. METHODS: A conceptual framework was constructed from properties of effective breastfeeding (Yang and Seo, 2011), and item construction was derived from literature review and analysis of the data along with interviews with breastfeeding mothers. Content validity was tested by experts. Each item was scored on a five-point Likert scale. The preliminary questionnaire was administered to 248 breastfeeding mothers. Data were analyzed using item analysis, factor analysis, Pearson correlation coefficients, and Cronbach's α. RESULTS: From the factor analysis, 20 items in seven factors were derived. The factors were identified as mother's satisfaction, suckling, assurance of milk quantity, infant's satisfaction, latching on, infant's feeding desire, and breastfeeding positioning. The seven factors explained 65.1% of total variance, Cronbach's α of the total items was .83 and the factors ranged from .44 to .75. CONCLUSION: Results of this study suggest that breastfeeding effectiveness scale is a reliable and valid instrument to measure breastfeeding effectiveness of mothers in the early postpartum period.

A Content Analysis of Psychiatric-Mental Health Nurses' Experience of Using Humor / 정신간호학회지

PURPOSE: The study was conducted to explore experience of using humor among psychiatric-mental health nurses. METHODS: Semi-structured in-depth interviews were used to collect data from 30 nurses working in community mental health centers or psychiatric wards. Data were categorized and coded using content analysis. RESULTS: The findings confirm that 11 categories, 43 sub-categories, and 104 statements were drawn from 4 domains. The four domains included effectiveness of humor, effective use of humor, ineffective use of humor, and barriers and promotive strategies to the use of humor. Nurses experienced positive and negative effects of humor. Popular fad words, jokes, imitation, and compliments were identified as effective types of humor. Discounting humor and belittling humor were identified as ineffective types of humor. Effective humor was humor that was used after establishing a trust relationship and when the patient's mental status was stable. Barriers to using humor were heavy workload, nurses' careful character, and nurses' concern about patients' responses. CONCLUSION: Nurses should assess the nurse-patient relationship and patients' mental status when they plan to use humor. In addition, hiring more nurses and providing education about humor are suggested to improve sense of humor and recognize the effectiveness of humor.

Concept Analysis of Motivation for Vocational Rehabilitation in Persons with Mental Disabilities / 정신간호학회지

PURPOSE: This study was conducted to analyze and clarify the concept of 'motivation for vocational rehabilitation in persons with mental disabilities'. METHODS: A hybrid model was used to analyze the concept of motivation for vocational rehabilitation in persons with mental disabilities. The model included a comprehensive literature review and field study. Field study was conducted through in-depth interviews with 5 persons with mental disabilities who had employment experience and participant observation in rehabilitation facilities. RESULTS: The concept of motivation for vocational rehabilitation in persons with mental disabilities was found to be a complex phenomenon having meaning in two dimensions: Goal-oriented and cognitive dimensions. Five attributes and fourteen indicators were defined. Motivation for vocational rehabilitation in these persons was defined as a recognition of the need to get a job, and the willingness and confidence to get and keep a job in order to achieve normal life, happiness, economic stability, and their value. CONCLUSION: The findings from this study will contribute to the development of assessment tools and nursing interventions to reinforce the motivation for vocational rehabilitation in persons with mental disabilities.

A Structural Model for Primiparas' Breastfeeding Behavior

PURPOSE: The study was done to construct and test a structural model to explain primipara breastfeeding behavior. METHODS: The participants were 213 primiparas on postpartum wards. Data were analyzed using the PASW 18.0 and AMOS 19.0 programs. RESULTS: Fitness statistics for the hypothetical model were appropriate (chi2 =38.50, p=.070, GFI=.96, RMSEA=.05, AGFI=.93, NFI=.95, TLI=.97, CFI=.98, PNFI=.57, chi2/df=1.43). Breastfeeding behaviors were directly influenced by intention to breastfeed, perceived effectiveness of breastfeeding, and the amount of supplementary feeding. The amount of supplementary feeding had the largest direct impact on breastfeeding behavior. The largest total effect on breastfeeding behavior was intention to breastfeed. The environment of the maternity hospital indirectly influenced breastfeeding behavior. These factors explained 18.9% of variance in the primipara breastfeeding behavior. CONCLUSION: The results of the study indicate that in order to promote primipara breastfeeding the amount of supplementary feeding immediately after the birth should be limited and an environment that encourages exclusive breastfeeding in the hospital should be provided. The results also suggest it is necessary to provide nursing interventions that increase the intention to breastfeed and the perceived effectiveness of breastfeeding.

Development of a Coping Scale for Families of Patients with Schizophrenia

PURPOSE: The purpose of this study was to develop and evaluate a coping scale for families of patients with schizophrenia(CSFPS). METHODS: Item construction was derived from literature reviews and interviews with family members and psychiatric nurses. Content validity was tested by experts. Each item was scored on a four-point Likert scale. The preliminary questionnaire was administered to 188 family members of patients with schizophrenia. The data were analyzed using item analysis, factor analysis, Pearson correlation coefficients, and Cronbach's alpha. RESULTS: From the factor analysis, 32 items in five factors were derived. The factors were named active coping strategies, avoidance coping strategies, hospital treatment-oriented coping strategies, emotional coping strategies, and suppressive coping strategies for problematic behaviors. The five factors explained 49.7% of the total variance, Cronbach's alpha of the total items was .83 and the factors ranged from .66 to .86. CONCLUSION: The results of this study suggest that CSFPS is a reliable and valid instrument to measure coping in families of patients with schizophrenia.

Content Analysis on Caring Experiences of Mothers of Children with Burns

PURPOSE: This study was conducted to identify the caring experience of the mothers of childhood burn patients. METHODS: Data were collected from 28 mothers of childhood burn patients, through semi-structured in-depth interviews. Data were categorized and coded by using content analysis. RESULTS: 27 categories and 102 statements were drawn from 4 domains. The analyzed domains were psychological sufferings, confronted harsh reality, coping method, and future concerns. Psychological sufferings were categorized heartache, sense of guilt, confusion, regret, depression, sorriness, getting hurt, frustration and upset feeling. Confronted harsh nature were categorized economic difficulty, physical burn-out, lack of caring other children and family troubles. Coping method were categorized positive thinking, having hope, ventilating feelings, accepting the situations, demanding help from family members, changing patterns of the burned child rearing, collecting information for burn treatment, refusing accept the condition of burned child, avoiding personal and social relationship, and reliance on religion. Concerns were categorized concerns of growth and adaptation of the burned child, anxiety for scar, concerns of adapting school life and vague future concerns. CONCLUSION: The nursing interventions for early assessing psychological problems and providing social supports for caring both burn patients and other siblings should be provided to the mothers of childhood burn patients.

Up-regulation of BLT2 is critical for the survival of bladder cancer cells

The incidence rates of urinary bladder cancer continue to rise yearly, and thus new therapeutic approaches and early diagnostic markers for bladder cancer are urgently needed. Thus, identifying the key mediators and molecular mechanisms responsible for the survival of bladder cancer has valuable implications for the development of therapy. In this study, the role of BLT2, a receptor for leukotriene B4 (LTB4) and 12(S)-hydroxyeicosatetraenoic acid (HETE), in the survival of bladder cancer 253J-BV cells was investigated. We found that the expression of BLT2 is highly elevated in bladder cancer cells. Also, we observed that blockade of BLT2 with an antagonist or BLT2 siRNA resulted in cell cycle arrest and apoptotic cell death, suggesting a role of BLT2 in the survival of human bladder cancer 253J-BV cells. Further experiments aimed at elucidating the mechanism by which BLT2 mediates survival revealed that enhanced level of reactive oxygen species (ROS) are generated via a BLT2-dependent up-regulation of NADPH oxidase members NOX1 and NOX4. Additionally, we observed that inhibition of ROS generation by either NOX1/4 siRNAs or treatment with an ROS-scavenging agent results in apoptotic cell death in 253J-BV bladder cancer cells. These results demonstrated that a 'BLT2-NOX1/4-ROS' cascade plays a role in the survival of this aggressive bladder cancer cells, thus pointing to BLT2 as a potential target for anti-bladder cancer therapy.