Healthy lifestyle interventions for childhood and adolescent cancer survivors: a systematic review and meta-analysis

Purpose@#This study investigated the effects of healthy lifestyle interventions (HLSIs) on health-related quality of life (HR-QoL) in childhood and adolescent cancer survivors (CACS). @*Methods@#Major databases were searched for English-language original articles published between January 1, 2000 and May 2, 2021. Randomized controlled trials (RCTs) and non-RCTs were included. Quality was assessed using the revised Cochrane risk-of-bias tool, and a meta-analysis was conducted using RevMan 5.3 software. @*Results@#Nineteen studies were included. Significant effects on HR-QoL were found for interventions using a multi-modal approach (exercise and education) (d=-0.46; 95% confidence interval [CI]=-0.84 to -0.07, p=.02), lasting not less than 6 months (d=-0.72; 95% CI=-1.15 to -0.29, p=.0010), and using a group approach (d=-0.46; 95% CI=-0.85 to -0.06, p=.02). Self-efficacy showed significant effects when HLSIs provided health education only (d=-0.55; 95% CI=-0.92 to -0.18; p=.003), lasted for less than 6 months (d=-0.40; 95% CI=-0.69 to -0.11, p=.006), and were conducted individually (d=-0.55; 95% CI=-0.92 to -0.18, p=.003). The physical outcomes (physical activity, fatigue, exercise capacity-VO2, exercise capacity-upper body, body mass index) revealed no statistical significance. @*Conclusion@#Areas of HLSIs for CACS requiring further study were identified, and needs and directions of research for holistic health management were suggested.

The Health Management Experience of Vietnamese Married Immigrant Women Living in the City

Purpose@#The purpose of this study was to explore the health management experience of Vietnamese Married Immigrant Women living in the city. @*Methods@#The study participants were 11 Vietnamese immigrant women residing in the urban area who felt bad about their health. Data collection was conducted in depth through individual interviews, and the collected data were analyzed through Strauss & Corbin data analysis. @*Results@#The core category was “health is not a necessity but a choice in a strange land called Korea”. The contextual conditions were, “The hard thing-exposing “myself” to the world”, and “Hurts hidden, to be away from people’s eyes”. For the causal condition, the categories of “Unfamiliar life to live alone”, “Unfamiliar life different from expectation”, and “Symptoms of body suddenly suffering alone”, were derived. Through action-interaction, the immigrant women revealed that in their Korean social-structural context, they tended to follow “Health pushed away in turbulent life”. The intervening conditions were “a person who is able to help me”, “places that can give a helping hand nearby”, and “Vietnamese women’s grit”. A Vietnamese married immigrant woman had her own “Health in the chain with life”. As a result, they gained “Health, which is a top priority in life” or “Health oppressed by the weight of life”. @*Conclusion@#This study enhanced the understanding of the healthcare process of Vietnamese married immigrant women living in urban areas.

Research trends related to childhood and adolescent cancer survivors in South Korea using word co-occurrence network analysis

Purpose@#This study analyzed research trends related to childhood and adolescent cancer survivors (CACS) using word co-occurrence network analysis on studies registered in the Korean Citation Index (KCI). @*Methods@#This word co-occurrence network analysis study explored major research trends by constructing a network based on relationships between keywords (semantic morphemes) in the abstracts of published articles. Research articles published in the KCI over the past 10 years were collected using the Biblio Data Collector tool included in the NetMiner Program (version 4), using "cancer survivors", "adolescent", and "child" as the main search terms. After pre-processing, analyses were conducted on centrality (degree and eigenvector), cohesion (community), and topic modeling. @*Results@#For centrality, the top 10 keywords included "treatment", "factor", "intervention", "group", "radiotherapy", "health", "risk", "measurement", "outcome", and "quality of life". In terms of cohesion and topic analysis, three categories were identified as the major research trends: "treatment and complications", "adaptation and support needs", and "management and quality of life". @*Conclusion@#The keywords from the three main categories reflected interdisciplinary identification. Many studies on adaptation and support needs were identified in our analysis of nursing literature. Further research on managing and evaluating the quality of life among CACS must also be conducted.

Urine biomarkers for monitoring acute kidney injury in premature infants

Background@#Premature infants are at high risk for acute kidney injury (AKI). Serum creatinine (Cr) has limitations for evaluating kidney function in premature infants. We evaluated whether urine biomarkers could be used to monitor AKI in premature infants. @*Methods@#A prospective cohort study was conducted among infants born at < 37 weeks. Urine biomarkers and serum Cr were measured on postnatal days 1, 3, 5, 7, 10, and 14. Infants were divided into 3 groups according to gestational age (GA); < 28, 28 to < 32 and 32 to < 37 weeks. @*Results@#AKI occurred in 17 of 83 (20.5%) recruited infants at a median age of 7 (interquartile range 5–10) days. While the most common cause of AKI was hemodynamically significant patent ductus arteriosus (53.8%) in infants of GA < 28 weeks, necrotizing enterocolitis was the leading cause (50.0%) in infants of GA 28 to < 32 weeks. Urinary levels of neutrophil-gelatinase-associated lipocalin/Cr were higher and epidermal growth factor/Cr were lower in AKI group before the onset of AKI in infants of GA < 28 weeks. In infants of GA 28 to < 32 weeks, urinary interleukin-8/Cr levels were higher in AKI group at approximately the time of AKI onset. @*Conclusion@#Several urine biomarkers were significantly different between AKI and no AKI groups, and some had changed before the onset of AKI. These groups were distinct according to causative factors of AKI and GA. Urine biomarkers could be useful for monitoring the development of AKI in premature infants.

Comparison of Spiritual Needs between Patients with Progressive Terminal Kidney Disease and Their Family Caregivers / 한국호스피스완화의료학회지

Purpose@#The purpose of this study was to compare differences in spiritual needs (SNs) and factors influencing SNs between patients with progressive terminal kidney disease and their family caregivers. @*Methods@#An explorative comparative survey was used to identify the SNs of patients (N=102) with progressive terminal kidney disease undergoing hemodialysis and their family caregivers (N=88) at a general hospital located in Seoul, South Korea. The data were analyzed using descriptive statistics, the chi-square test, the independent t-test, one way analysis of variance, the Scheffé test, and multiple regression with dummy variables. @*Results@#The SNs among family caregivers were higher than in the patient group. SNs were higher among those who were religious in both groups. Loving others was the highest-ranked subdimension in the patient group, followed in descending order by maintaining positive perspective, finding meaning, Reevaluating beliefs and life, asking “why?”, receiving love and spiritual support, preparing for death, and relating to God. In the family group, the corresponding order was maintaining positive perspective, loving others, finding meaning, receiving love and spiritual support, preparing for death, relating to God, and asking “why?”. The factors that had a negative influence on the level of SNs were not being religious in the patient group and having only a middle school level of education in the family group. @*Conclusion@#The results of this study may serve as evidence that spiritual care for non-cancer patients’ family caregivers should be considered as an important part of hospice and palliative care.

Current usage and effects of steroids in the management of childhood mycoplasma pneumonia in a secondary hospital

PURPOSE: Steroids can be used as an adjuvant therapy in the management of mycoplasma pneumonia, but no definite guidelines for the use of steroids have been established. The purpose of this study was to analyze the current usage and effects of steroids in the management of childhood mycoplasma pneumonia in a secondary hospital in Korea. METHODS: We retrospectively reviewed the medical records of 152 patients who were admitted due to mycoplasma pneumonia. The patients were divided into 3 groups as follows: those who did not use steroids (81 patients, 53%), those who used steroids after their fever subsided (42 patients, 28%) and those who used steroids during fever (29 patients, 19%). RESULTS: In decreasing order of values, the duration of fever during hospitalization (60.0±40.2 hours vs. 37.3±28.5 hours vs. 29.7±29.5 hours, P=0.006) and duration of hospitalization (5.9±1.7 days vs. 5.0±1.4 days vs. 4.0±1.5 days, P < 0.001) were reported in the group which received steroids during fever, the group which received steroids after the fever subsided and the group which did not receive steroids. In the group which received steroids during fever, patients with early steroid use (within 24 hours) had a shorter fever duration in the hospital (12.0 hours vs. 73.5 hours, P < 0.001) and a hospitalization duration (5.0 days vs. 6.5 days, P=0.007) than those with late steroid use (after 24 hours). CONCLUSION: Steroids were used in 47% of patients with mycoplasma pneumonia. The patients who received early steroids had a shorter fever duration and a shorter hospital stay than those who received late steroids.

Successful Management of Severe Peripheral Tissue Ischemia after Arterial Catheterization in Micro Preemies using Humidification & Topical Nitroglycerin

Micro preemies usually undergo arterial catheterization for frequent blood pressure monitoring and blood sampling. Peripheral tissue injury associated arterial catheterization is a well-described morbidity observed in neonates. Despite the potential permanent disability associated with this complication, the currently available therapeutic options remain limited. We report a unique case of a preterm infant who developed severe tissue ischemia after arterial catheterization of the radial artery and was successfully treated using extensive humidification and topical nitroglycerin ointment application over an extended period (36 days) until complete clinical recovery.

The Relationships among Social Discrimination, Subjective Health, and Personal Satisfaction of Immigrants

PURPOSE: This study aims to examine the relationships among social discrimination, subjective health, and personal satisfaction based on the country of origin. METHODS: The analysis was based on 16,958 immigrants who participated in the National Survey of Multicultural Family 2015 in Korea. This study conducted stratified cross-analysis of social discrimination for the differences in subjective health and personal satisfaction. Multivariate-adjusted odds ratios and 95% confidence intervals for the relationships among social discrimination, subjective health, and personal satisfaction were examined with multivariable logistic regression. RESULTS: There were differences in experience of social discrimination, subjective health status, and personal satisfaction according to the country of origin. Groups without the experience of social discrimination had better subjective health and personal satisfaction than the other groups. CONCLUSION: This study demonstrates that a discrimination prevention program needs to be developed based on a cultural approach.

Prophylactic versus Early Rescue Surfactant Treatment in Preterm Infants Born at Less than 30 Weeks Gestation or with Birth Weight Less than or Equal 1,250 Grams

Prophylactic surfactant is known to be effective to reduce chronic lung disease in preterm infants compared with rescue surfactant treatment. In Korea, early prophylactic surfactant therapy was introduced in 2011. However, recently, the increased utilization of antenatal steroids and early stabilization through continuous positive airway pressure (CPAP) in the delivery room may have changed the risks and benefits of prophylactic surfactant therapy of infants at high risk of respiratory distress syndrome (RDS). We compared the effects and safety of prophylactic surfactant therapy (within 30 minutes after birth) and early selective surfactant therapy (within 3 hours after birth) in preterm infants born at < 30 weeks gestation or with birth weight ≤ 1,250 g. The clinical data of 193 infants in period 1 (from 2008 to 2010, early selective surfactant therapy group) were collected retrospectively; those of 191 infants in period 2 (from 2012 to 2014, prophylactic surfactant therapy group) were collected prospectively. Compared to period 1, the rate of intubation and surfactant use were significantly increased in period 2. The use of multiple doses of surfactant in period 2 was significantly increased compared with period 1. Despite more invasive and aggressive management in period 2, there was no difference in the duration of mechanical ventilation, the incidence of bronchopulmonary dysplasia (BPD) or death, and the risk of other adverse neonatal outcomes between the 2 groups. In conclusion, the benefit of prophylactic surfactant therapy in infants treated under current practices is no longer clear compared to early selective surfactant therapy.