Contributing Factors of a Good Death for Children With Cancer From Bereaved Parents' Perspectives in South Korea.

Achieving a good-quality death for children with cancer is as paramount as saving their life, given its implications for both the children's end-of-life quality and the grief journey of their parents. This study explored factors contributing to a good death for children with cancer, as perceived by bereaved parents in South Korea. A retrospective survey was conducted, involving 58 bereaved parents of a child who died of cancer. t-tests and regressions were performed to identify factors related to deceased children associated with parents' reports of a good death for children with cancer. The results revealed significant correlations between parents' age, income, religious affiliation, time elapsed since death, child's age at death, and cancer recurrence with several aspects of a good death. These findings underscore the importance of assessing characteristics of both parents and their children to enhance the quality of death experienced by children with cancer in South Korea.

Dynamic visualization of ultraviolet dose on skin with sunscreen applied using minimum erythema dose.

BACKGROUND: Visualizing the ultraviolet (UV) dose on skin serve as an intuitive approach to ensure appropriate sunscreen usage and reduce the risk of erythema. UV dose is determined by a number of external factors, such as properties of sunscreens, weather, and type of outdoor activity. We propose a framework for visualizing UV doses that considers various external factors. MATERIALS AND METHODS: First, the skin of a three-dimensional human model was represented using triangular meshes, and various static postures and dynamic motions were simulated to express outdoor activities. Then, we evaluated the persistency and insufficiency properties of sunscreen, which are time dependent and directly affect the effectiveness of the sunscreen skin protection factor (SPF) during UV exposure. Finally, to calculate the UV dose in real time, we tracked the trajectory of the sun and motion of the skin while considering the time-dependent properties of sunscreen. RESULTS: An S/W system was implemented based on the proposed framework to visualize the distribution of UV doses through dynamic color changes in exposed skin areas. The color types include true colors, which represent the minimum erythema dose (MED), and pseudo colors representing states before 1 MED is reached. We devised various examples to discuss the usability of the proposed framework. CONCLUSION: The system conveniently displays the MED according to an individual's skin phototype. When the properties of a wide range of commercial sunscreens are added to the system database, it is expected that the rate of appropriate sunscreen usage by customers will increase.

Patients with advanced lateral osteoarthritis can return to sports and work after distraction arthroplasty plus lateral meniscal allograft transplantation combined with cartilage repair.

PURPOSE: This study aimed to report return to sports (RTS) and return to work (RTW) outcomes after distraction arthroplasty (DA) plus lateral meniscal allograft transplantation (MAT) combined with cartilage repair in active patients with advanced osteoarthritis. It was hypothesised that DA combined with lateral MAT would improve clinical and radiological outcomes and enable RTS and RTW for most patients. METHODS: In total, 21 patients with advanced osteoarthritis (moderate to severe joint space narrowing at lateral edge on Rosenberg view and large cartilage defect of lateral femoral condyle) who underwent concomitant DA and MAT were retrospectively reviewed. Clinical outcomes were assessed using subjective knee scores [Lysholm score, International Knee Documentation Committee (IKDC) subjective knee score, and Tegner activity scale (TAS)] and functional tests (isokinetic extensor muscle strength test, single-leg vertical jump test, and single-leg hop for distance test). The rates of RTS, RTW, and satisfaction were evaluated. Radiological outcomes were assessed using magnetic resonance imaging (MRI) and X-ray (Rosenberg view). RESULTS: The mean age at surgery and mean follow-up duration were 37.2 ± 5.9 years and 37.1 ± 5.4 months, respectively. All improvements in subjective scores were statistically significant (p < 0.001). The Lysholm score improved from 58.3 ± 8.1 to 84.3 ± 8.2, the IKDC subjective score from 53.9 ± 10.4 to 78.0 ± 7.7, and the TAS from 4.0 ± 0.5 to 5.1 ± 0.8. The limb symmetry index (LSI) (%) of the extensor peak torque at an angular velocity of 60°/s improved from 67.3 ± 19.2 to 88.4 ± 20.3% (p = 0.001). The LSI of the single-leg vertical jump test and single-leg hop for distance test improved from 62.8 ± 21.3 to 87.7 ± 19.5% and from 63.9 ± 20.8 to 85.5 ± 18.1%, respectively (all, p < 0.001). All patients were able to return to any sports activity and work. However, 67% and 90.5% returned to their defined or desired level of sports activity and occupation intensity, respectively. Further, 76.2% were very satisfied or somewhat satisfied with the outcome at the last follow-up. The JSW increased by 0.8 ± 0.4 to 2.3 ± 0.6 mm (p = 0.005). In more than 90% of patients, > 50% of cartilage lesion was covered. The mean graft extrusion was 2.6 ± 1.0 mm. CONCLUSION: All patients who underwent distraction arthroplasty plus lateral MAT combined with cartilage repair returned to any sports and work at the last follow-up. Significant improvements in clinical outcomes and the radiographic joint space width were observed. However, the activity ability was somewhat reduced compared with the best preoperative level. This one-stage joint salvage treatment is a promising option for young and active patients with advanced OA who wish to return to high levels of sports activity and occupation intensity (≥ Tegner activity scale 4). LEVEL OF EVIDENCE: III.

Oncologists' Experience of Delivering Bad News in Korea.

This study explored oncologists' experiences of delivering bad news to patients with cancer and their families. Nine oncologists recruited from three superior hospitals in Korea completed in-depth interviews. The results of thematic analyses identified four themes: precursors to bad news delivery, why it is difficult to deliver bad news, when it is more difficult to deliver bad news, and strategies of delivering bad news. The participants felt unprepared for the task and stressed because breaking bad news goes against their responsibility to do no harm and their professional objective to promote healing. Although they were unclear about best practices regarding communication styles, they individualized their communication style to meet the needs of their patients, who have an array of cultural, social, and spiritual backgrounds. Understanding oncologists' perceptions of bad news delivery can inform culturally appropriate interventions for alleviating their stress and improving patient-physician relationships in communication of bad news.

Layering sunscreen with facial makeup enhances its sun protection factor under real-use conditions.

BACKGROUND: The proper application of sunscreen is important to ensure protection of the skin against ultraviolet (UV) damage. Sunscreens are used in various ways in real world situations, which alters their UV protection efficacy. In this study, we simulated typical consumer use of sunscreen, which is often sequentially covered with facial makeup, in a laboratory study. METHODS: We compared the sun protection factors (SPF) of sunscreen and makeup products after consecutive layering of the products. RESULTS: The SPF of each sunscreen and makeup product was dramatically lower than stated on the label upon application of a typical amount used by a consumer, which is lower than recommended. For high-SPF products, the drop in effective protection was proportionally greater than those for the low-SPF products upon application of lower doses. However, layering sunscreen and makeup products greatly increased the effective SPF compared with that achieved by single application of each product, even when the amount of each product used was below the recommended level. CONCLUSION: Layering sunscreen with makeup may compensate for insufficient sunscreen application in real-life conditions by providing an additional source of UV protection and improving the homogeneity of coverage. Our results suggest that recommending consecutive application of sunscreen and makeup products may be a practical and useful approach to improving UV protection that would not require additional steps in the facial care routines of many individuals.

How do they grow out of their cancer experience? Korean adolescent and young adult cancer survivors' stories.

Objectives: Cancer experiences can bring positive as well as negative impacts. The current literature, however, focuses mainly on the negative impacts. This qualitative study examines Korean childhood cancer survivors' post-traumatic growth, which concerns how they respond positively to the cancer experience and how they change as a result of their experience.Design: In-person or telephone interviews were conducted with 31 adolescent and young adult survivors of childhood cancer post-treatment who were living in Korea.Results: Thematic analysis found that childhood cancer survivors experienced growth by feeling gratitude (being content with the present, making comparisons with worse situations), engaging in self-affirmation ('I am strong'; 'My example can help others'; 'I am ready for new challenges'), deepening faith (communicating with God, trusting God's direction), and finding the social meaning of cancer (becoming a self-advocate, mapping out a career path).Conclusions: The study findings can be used by psychosocial care professionals to support Korean cancer survivors to recognize post-traumatic growth and, thus, achieve improved well-being.

A photovoice study on the bereavement experience of mothers after the death of a child.

This study explored the bereavement experience of mothers after losing a child to cancer in Korea, using photovoice. The mothers took photos reflecting five subject areas they selected: (a) if I had one more day with my child, (b) memories with my child, (c) dreaming of my child's healthy future, (d) what gave me strength, and (e) fulfilling my child's wishes for the future. The findings show that mothers who lost a child to cancer need bereavement care to promote well-being. This study can help pediatric oncology providers develop bereavement interventions that address parental grief and improve quality of life.

A qualitative study on parents' concerns about adult children with intellectual disabilities amid the COVID-19 pandemic in South Korea.

BACKGROUND: This study aimed to understand parents' concerns about their adult child with intellectual disabilities due to the restriction of community-based services amid the COVID-19 pandemic in South Korea. METHODS: In-depth interviews were conducted face-to-face or by telephone with 19 parents of adult children with intellectual disabilities who had to stop using community-based services. RESULTS: Participants worried that their adult child was not aware of the seriousness of COVID-19, was more susceptible to the COVID-19 virus, could not recognize self-infection and could have fatal consequences of getting infected with COVID-19. They expected challenges in their adult child's life (losing a daily routine, being isolated, regression in skills, becoming bored, lacking physical activities and increased behavioural challenges) but also experienced adjustments and hopes. CONCLUSION: The study demonstrated parents' worry about their adult child becoming infected with COVID-19, highlighting the urgent need for community-based services to address psychosocial challenges during the pandemic.

A Photovoice Study: The life experiences of middle-aged adults with intellectual disabilities in Korea.

BACKGROUND: As adults with intellectual disabilities approach older adulthood, they face unique physical and psychosocial challenges. This study explored the lived experiences of middle-aged adults with intellectual disabilities living in their community. METHOD: Six sessions of Photovoice were conducted with a purposeful sample of six middle-aged adults with intellectual disabilities in South Korea. Participants were involved with the theme selection, taking photographs related to the themes, group discussion of photo stories and sharing Photovoice outcomes. RESULTS: Thematic analysis yielded 11 subthemes under the five major themes selected by the participants: health, free time, time in the centre, family and my future in old age. CONCLUSIONS: The study findings showed complex issues middle-aged adults with intellectual disabilities may face in later life, including bereavement and healthy lifestyle concerns. It is important to create a space for meaningful social support and social interactions without stigma.

Changes in Relationships in Bereaved Families: Perspectives of Mothers Who Lost a Child to Cancer.

The loss of a child greatly affects the dynamics of interpersonal relationships in bereaved families. This study explored the relationships in bereaved Korean families from the perspectives of mothers after the death of a child due to cancer. We conducted in-depth interviews with 15 bereaved mothers of a deceased child with childhood cancer. Thematic analysis identified 12 subthemes related to bereaved mothers' struggles in grief within three significant themes based on family relationships: (a) relationship with husband; (b) relationship with surviving child or children; and (c) relationships with extended family members. Findings highlight bereaved mothers' need to build supportive family relationships while acknowledging bereaved family members' different grieving styles and their own challenges in grieving the loss of a child.

Progress towards eliminating industrially produced trans-fatty acids in the Canadian marketplace, 2013-2017.

OBJECTIVE: To assess the prevalence of partially hydrogenated oils (PHO), hydrogenated oils (HO) and/or both in Canadian packaged foods in 2013 and 2017 and to determine the mean trans-fatty acid (TFA) content of products declaring such oils. DESIGN: Repeated cross-sectional study of the Food Label Information Program. SETTING: Food labels (n 32 875) were collected from top Canadian grocery retailers in 2013 and 2017. Proportions of products declaring PHO, HO and/or both in the Ingredients List were calculated by year and food category. The percentage contribution of TFA (g) to total fat (g) was calculated and compared against the voluntary TFA limits, defined as <2 % of total fat content for fats and oils, and <5 % for all other foods. Foods exceeding limits were identified. The mean TFA content (in g/serving and per 100 g) was calculated for products with these oils. RESULTS: The use of PHO, HO and/or both significantly decreased in Canadian foods from 2013 to 2017 (0·8 to 0·2 %, 5 to 2·4 % and 5·7 to 2·6 %, respectively, for PHO, HO and/or both). The mean TFA content of products containing PHO increased (0·34 to 0·57 g TFA/serving); although it was not statistically significant, it is still concerning that TFA content increased. The TFA content significantly decreased in foods with HO (0·24 to 0·16 g TFA/serving, P < 0·05) during 2013-2017. CONCLUSIONS: Products with PHO continue to be present in the Canadian marketplace, despite voluntary efforts to eliminate them. Products with HO should also be monitored, as they can also contribute to TFA content in foods.

Evaluation of anisotropic properties of striae distensae with regard to skin surface texture and viscoelasticity.

BACKGROUND: Striae distensae (SD) are skin lesions of parallel streaks, which mostly occur during rapid tissue expansion. Considering the etiological mechanism of SD, including dermal network ruptures and alignment to mechanical stretch, structural directionality or anisotropy could be expected. Non-invasive objective methods for measuring the anisotropy of SD have not been suggested yet. Therefore, we evaluated the anisotropic properties of SD with regard to skin surface texture and viscoelasticity, to verify them as new objective evaluation parameters of SD. METHODS: Thirty-two healthy subjects with SD on their body participated. Anisotropy of skin surface texture and biomechanical properties of SD-involved skin and adjacent normal skin was assessed and compared. RESULTS: Analysis of skin surface texture, based on the ×60 magnified images, revealed that SD have more disordered patterns compared to the regular honeycomb patterns seen in the normal surrounding skin. SD have bigger sizes of each blob than normal skin. The overall anisotropy of skin texture was significantly higher in SD. Skin biomechanical parameters, measured using Cutiscan® , indicated the less deformable, less recovered, and less viscoelastic properties of SD. When comparing viscoelastic properties over 360°, SD were more anisotropic than the adjacent normal skin as well. CONCLUSION: We observed that SD were significantly more anisotropic than adjacent normal skin with regard to skin surface texture and viscoelasticity. Therefore, anisotropy could be an objective evaluation parameter to represent the distinctive features of SD. It can be applied for evaluation of the SD severity and clinical efficacy of various treatments.

Compassion satisfaction and compassion fatigue among medical social workers in Korea: the role of empathy.

Medical social workers are affected by their clients' suffering, which has an impact on social workers' professional quality of life. This study examined the role of empathy in relation to professional quality of life among medical social workers in South Korea. Using the Professional Quality of Life Scale and Interpersonal Reactivity Index, we found that empathic concern and personal distress were significant components of empathy and were correlated with professional quality of life. Empathic concern was positively associated with compassion satisfaction and negatively associated with burnout. Personal distress was correlated with all components of quality of life: compassion satisfaction, secondary traumatic stress, and burnout. Women had significantly higher levels of burnout than men; religious affiliation was associated with higher levels of compassion satisfaction; and longer years of employment was associated with higher levels of secondary traumatic stress. Medical social workers should be educated on and trained in how empathy can help them address compassion fatigue and promote compassion satisfaction.

Beliefs About Etiology and Treatment of Mental Illness Among Korean Presbyterian Pastors.

This descriptive study explored pastors' beliefs about etiology and treatment of mental illness. Surveys were completed by mail by 202 Korean and Euro-American Presbyterian clergy. Nearly one-third of Korean pastors viewed bad parenting and demon possession as very important causes of mental illness, in contrast to the more than two-thirds of Euro-American pastors who viewed genetics and chemical imbalances as the most important causes. Compared with their Euro-American counterparts, Korean pastors soundly endorsed spiritual treatment of mental illness. The findings of this study suggest the value of understanding the views of pastors working with populations that underutilize formal mental health services.

Natural melanin-loaded nanovesicles for near-infrared mediated tumor ablation by photothermal conversion.

Photothermal therapy requires a biocompatible material to absorb near-infrared (NIR) light and generate sufficient heat. Herein, we suggest natural melanin-loaded nanovesicles (melasicles) as photothermal therapeutic agents (PTA) for NIR mediated cancer therapy in vivo. The mean size of these melasicles was 140 ± 15 nm. They showed excellent colloidal stability. After irradiation from 808 nm NIR laser at 1.5 W cm-2, the melasicles showed good photothermal conversion efficiencies both in vitro and in vivo. In drug release study, laser irradiation increased fluidity of vesicle membrane due to photothermal generation from melanin. Initial drug release in the laser irradiation group was higher than that in the no laser irradiation group. After injecting the melasicles into tail veins of CT-26 bearing mice, tumors were suppressed or eliminated after irradiation at 1.5 W cm-2 for 5 min once or twice. These results suggest that melasicles could be used as attractive PTA for cancer therapy and localized drug release.

The effects of individual- and network-level factors on discussion of cancer experiences: Survivors of childhood cancer in Korea.

This study aimed to identify young adult Korean cancer survivors' individual- (psychological distress, stigma, sociodemographic variables, and cancer-related variables) and network-level factors (relationship type, social support type) that influence discussion of their cancer experiences. Sixty-eight survivors of childhood cancer who were recruited using snowball sampling nominated 245 individuals from their networks, including family and intimate partners (40%) and friends and acquaintances (60%), as people with whom they most frequently interacted. Results of multilevel modeling analysis indicated that higher levels of internalized shame were a prominent individual-level factor associated with a lack of discussion of cancer experiences. Relationship type and support type at the network-level were also significant correlates of discussion of cancer experiences. Programs for reducing the survivors' shame, improving illness identity, and providing professional training for building social relationships that are intimate and in which they could exchange reciprocal support may help Korean childhood cancer survivors to openly share their cancer experiences with others in their social network and to be successful in the journey of cancer survivorship.

Why did I get cancer? Perceptions of childhood cancer survivors in Korea.

This study explored whether and how childhood cancer survivors in Korea ask and resolve the question of what may have caused their cancer. Thirty-one childhood cancer survivors participated in in-depth interviews about their self-questioning process in this regard. The findings indicate that Korean childhood cancer survivors pondered this question alone due to the stigma attached to cancer in the family and society. Their answers included internal factors (doing "bad things," having unhealthy eating habits, engaging in magical thinking, having a stress-prone personality, or having a biological susceptibility) or external factors (stressors, random events, the environment, or medical conditions). How they perceived the cause of cancer had an impact on aspects of their current lives. Psychosocial care standards or guidelines are needed in regard to the provision of a safe environment in which Korean cancer survivors and their parents can share their perceptions and process their thoughts.

Experiences of Korean mothers of children with cancer: A Photovoice study.

Using Photovoice, a participatory action research methodology, we investigated Korean mothers' lives postdiagnosis of their child with cancer. Photovoice was used to understand the mothers' perceptions of how they have adapted to their children's illnesses. Five mothers of children with cancer participated in five sessions of the Photovoice project, during which they took and shared photographs and narratives about their experiences and joined weekly group discussions on their selected themes. The following themes and subthemes emerged: "What I would like to do (taking a break, socializing with friends, spending time with other family members, developing my career)," "My child and food (whatever my child wants to eat, love of family)," "My days for my child (doing what my child wants to do, being a playmate, changing for my child)," and "Power sources for me (family, courage of children, mom is strong, hope)." Having a child with cancer greatly affects the mother's social and work lives as well as emotional well-being. Services and programs such as respite care, parenting education, and psychological support are recommended based on the study findings.

An Exploratory Study of the Knowledge of Personal Safety Skills Among Children with Developmental Disabilities and Their Parents.

BACKGROUND: This study assessed the knowledge of personal safety skills among children with developmental disabilities and their parents' perceptions of children's knowledge. METHOD: This exploratory study examined the mental health records of 37 children with developmental disabilities referred for an abuse risk reduction group in a community mental health setting. Qualitative analysis of children's responses to questions about personal safety skills (knowledge related to physical development and personal safety, an appropriate and inappropriate touch and safety skills to respond to an inappropriate touch) indicated participants' varied and inconsistent levels of knowledge. RESULTS: Consistent with the literature, the results indicate risk factors for sexual abuse among children with developmental disabilities, including children's difficulty distinguishing between an appropriate and inappropriate touch and the lack of knowledge regarding appropriate venues for disclosing an inappropriate touch. Among parents, a lack of certainty regarding their children's knowledge and the ability to keep themselves safe was identified. CONCLUSION: Results support the need for education about personal safety for children with developmental disabilities and their families.

Synthesis and evaluation of (+)-decursin derivatives as inhibitors of the Wnt/ß-catenin pathway.

We synthesized (+)-decursin derivatives substituted with cinnamoyl- and phenyl propionyl groups originating from (+)-CGK062 and screened them using a cell-based assay to detect relative luciferase reporter activity. Of this series, compound 8b, in which a 3-acetoxy cinnamoyl group was introduced, most potently inhibited (97.0%) the Wnt/ß-catenin pathway. Specifically, compound 8b dose-dependently inhibited Wnt3a-induced expression of the ß-catenin response transcription (CRT) and increased ß-catenin degradation in HEK293 reporter cells. Furthermore, compound 8b suppressed expression of the downstream ß-catenin target genes cyclin D1 and c-myc and suppressed PC3 cell growth in a concentration-dependent manner.