The influence of Digital Informatization Level, Self-efficacy, and Social Support on Digital Health Literacy in the Elderly with Cancer

Purpose@#This study aims to identify the level of digital informatization, self-efficacy, social support, and digital health literacy and the factors influencing digital health literacy in the elderly with cancer. @*Methods@#A cross-sectional and descriptive study was conducted on 140 cancer patients aged 65 years and over who are undergoing treatment or follow-up observation in university hospital. The data were analyzed using t-test, ANOVA, Pearson's correlation, and stepwise multiple regression. @*Results@#The mean score of digital health literacy was 2.78±0.79, and it showed a significant differences according to age, education level, and religion. Digital informatization and self-efficacy had a significant association with digital health literacy. With regard to social support, a significant correlation was found with friend support in relation to digital health literacy. The regression analyses showed that significant predictors on digital health literacy were digital informatization (β=.59, p<.001) and self-efficacy (β=.20, p=.003). These variables explained 42.0% of the digital health literacy in the elderly with cancer. @*Conclusion@#These results suggest that health care providers should consider individuals’ age and education level when developing digital intervention for elderly cancer patients. Moreover, greater focus on strategies to improve the digital informatization level and self-efficacy could enhance digital health literacy in the elderly with cancer.

Effects of the Antidiabetic Drugs Evogliptin and Sitagliptin on the Immune Function of CD26/DPP4 in Th1 Cells

This study aimed to investigate whether the antidiabetic drugs dipeptidyl peptidase 4 (DPP4) inhibitors such as evogliptin and sitagliptin affect the membrane DPP4 (mDPP4) enzymatic activity and immune function of T helper1 (Th1) cells in terms of cytokine expression and cell profiles. The mDPP4 enzymatic activity, cytokine expression, and cell profiles, including cell counts, cell viability, DNA synthesis, and apoptosis, were measured in pokeweed mitogen (PWM)-activated CD4 + CD26 + H9 Th1 cells with or without the DPP4 inhibitors, evogliptin and sitagliptin. PWM treatment alone strongly stimulated the expression of mDPP4 and cytokines such as interleukin (IL)-2, IL-10, tumor necrosis factor-alpha, interferon-gamma, IL-13, and granulocyte-macrophage colony stimulating factor in the CD4 + CD26 + H9 Th1 cells. Evogliptin or sitagliptin treatment potently inhibited mDPP4 activity in a dose-dependent manner but did not affect either the cytokine profile or cell viability in PWM-activated CD4 + CD26 + H9 Th1 cells.These results suggest that, following immune stimulation, Th1 cell signaling pathways for cytokine expression function normally after treatment with evogliptin or sitagliptin, which efficiently inhibit mDPP4 enzymatic activity in Th1 cells.

Predictive Factors for Non-Response to Neoadjuvant Chemotherapy for Breast Cancer

Purpose@#Neoadjuvant chemotherapy (NAC) can effectively downstage locally advanced breast cancer; however, in some cases the cancer remains clinically stable and in others, there is disease progression. Although factors predictive of the response to NAC have been established, those for a non-response remain unknown. This study investigated factors predicting a stable or progressive disease course, and the extent of the response, after NAC based on anthracycline and cyclophosphamide (AC), with or without taxane. @*Methods@#Data were collected retrospectively by reviewing medical records of patients who received NAC for breast cancer using AC, with or without taxane between January 2013 and December 2017. Patients with clinically stable or progressive disease after NAC were compared statistically with those who achieved a partial or complete response. @*Results@#In total, 297 patients received NAC with AC and 196 patients received AC followed by taxane. Of these, 45 (15.2%) and 64 (32.6%) patients respectively, showed no response (i.e., stable or progressive disease). Factors related to non-response after AC included large pretreatment tumor size, clinical T3 status, and high histologic grade. Factors related to non-response after taxane included clinical T3 status and estrogen receptor or progesterone receptor positivity. @*Conclusion@#Clinical T3 stage, grade III histological grade, and estrogen or progesterone receptor positivity were predictors of no response to NAC for breast cancer.

Psychometric Properties of Korean Version of Self-Efficacy of Evidence-Based Practice Scale

PURPOSE: This study is to evaluate the psychometric properties of the Korean version of the Self-Efficacy of Evidence-Based Practice (SE-EBP) scale, which was originally developed by Chang and Crowe. The beta-version of the SE-EBP is a modified version of the original SE-EBP, which measures the clinical nurses' confidence in finding, appraising, and implementing evidence into practice. Although the original SE-EBP has been validated, no study has been conducted to validate the Korean version of SE-EBP. METHODS: The original scale was translated into Korean through a process of forward and back translation of the original scale. After getting confirmation of the equivalence of the Korean forward translation by the original author, exploratory factor analysis and confirmatory factor analysis of data from 212 clinical nurses were used to test construct validity. Internal consistency was examined using Cronbach α coefficients. For the statistical analysis, STATA version 13.0 software program was used. RESULTS: Exploratory factor analysis of the 28 items revealed three factors with eigenvalues above 1, accounting for 60.2% of the total variance. Confirmatory factor analysis showed good fit of the three-factor structure which was statistically significant (χ2 = 718.61, df = 330, p < .01). For internal consistency, Cronbach a coefficient for the total scalewas .95, and itwas greater than .80 for each of the three subscales. CONCLUSIONS: The Korean version of SE-EBP scale showed evidence of adequate construct validity and reliability. This study might have contributed to a wider application of the SE-EBP scale, but further studies are needed to provide more evidence on the structure of the scale.

Mixed Method Research Investigating Evidence-Based Practice Self-efficacy, Course Needs, Barriers, and Facilitators: From the Academic Faculty and Clinical Nurse Preceptors

PURPOSE: The current challenges faced by nurses in providing high quality and evidence-based practice (EBP) supported care require profound changes in nursing education. To understand the changes needed to strengthen EBP education, the researchers examined EBP self-efficacy, course needs, barriers, and facilitators for academic faculty and clinical nurse preceptors to teach EBP in undergraduate nursing curricula. METHODS: For this study, mixed-method approach was used with survey data collected from 73 academic faculty members from 54 universities. Further, 17 clinical nurse preceptors in three academic hospitals provided qualitative data for exploration of barriers and facilitators to teaching EBP. Data analysis used SPSS/WIN 21.0 and content analysis. RESULTS: Quantitative data showed that although the overall level of self-efficacy among faculty was moderate, the implementation levels were relatively low. Most faculty members agreed with the need to integrate EBP courses into undergraduate nursing curricula. The qualitative data showed that the barriers to teaching EBP were lack of knowledge, skill, and initial investment for teaching EBP; hierarchical, rules-oriented nursing culture; potential learner overloads in processing EBP; limited research dissemination and application. Facilitators were identified as the importance of EBP to the profession of nursing; collaboration in schools and hospitals; and continuing education in teaching/utilizing EBP. CONCLUSION: The findings indicate that for successful integration of EBP ni nursing education there is a need for faculty training and integrated EBP courses.

Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services

PURPOSE: The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. METHODS: A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. RESULTS: Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. CONCLUSION: The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

Satisfaction with Korean Oncology Advanced Practice Nurses' Role: A Study of Patients, Physicians, and Nurses

PURPOSE: The purpose of this study was to describe the level of satisfaction with the role of Korean oncology advanced practice nurses (KOAPNs) among cancer patients, physicians, and nurses. METHODS: This study was conducted with 176 patients who had experienced KOPANs' care more than three times, as well as 82 physicians and 190 nurses who have worked with KOAPNs at four hospitals in Korea. RESULTS: The results indicate that 1) Overall satisfaction in the patient group was high (3.61) and they were most satisfied with the 'attentiveness' domain; 2) Overall satisfaction in the physician group was also high (3.61), however, that in the nurse group was relatively low (3.28); 'coordination & cooperation' showed the highest score for satisfaction in both groups, while 'research' domain showed the lowest score; 3) Cancer type in patients, working department in physicians or nurses, and duration working with KOAPNs in nurses showed significant association with satisfaction; and 4) The ratio of KOAPNs-to-patient, time since introduction of the KOAPNs policy, and incentive system were institutional factors showing significant association with it. CONCLUSION: These findings suggest the necessity for identification and standardization of the roles of KOAPNs, as well as promotion of awareness of KOAPNs' care.

Association of Immune Status with Recurrent Anal Condylomata in Human Immunodeficiency Virus-Positive Patients

PURPOSE: An anal condyloma is a proliferative disease of the genital epithelium caused by the human papillomavirus. This condition is most commonly seen in male homosexuals and is frequently recurrent. Some reports have suggested that immunosuppression is a risk factor for recurrence of a condyloma. Thus, we investigated the risk factors for a recurrent anal condyloma in human immunodeficiency virus (HIV)-positive patients. METHODS: We retrospectively analyzed 85 consecutive patients who were diagnosed with and underwent surgery for an anal condyloma from January 2007 to December 2011. Outcomes were analyzed based clinical and immunologic data. RESULTS: Recurrent anal condylomata were found in 25 patients (29.4%). Ten cases (40.0%) were within postoperative 3 months. At postoperative 6 months, the CD4 lymphocyte count in the recurrent group was lower than it was in the nonrecurrent group (P = 0.023). CONCLUSION: CD4-mediated immunosuppression is a risk factor for recurrent anal condylomata in HIV-positive patients.

The Experiences of Prayer in Christian Patients with Breast Cancer / 종양간호학회지

PURPOSE: The purpose of this study was to understand the meaning of prayer in Christian patients with breast cancer. METHODS: Data collection and analysis were conducted by the Colaizzi analysis of phenomenological method. Data were collected by in-depth interviewing the participants and by further follow-up observations. Sixteen patients participated in this study. RESULTS: The significant statements (188), formulated meanings (42), themes (38), clusters of theme (10), and categories (5) were emerged. The 5 categories were as follows: communication with God, healing and peace, spiritual growth, distrust in prayer, and method of prayer. CONCLUSION: Further studies need to consider the period of faith, comparison between christian and other religions, and length of diagnosis. A better understanding of the meaning of prayer will lead to a more comprehensive view of the spiritual care for patients with breast cancer, and can lead to guidelines for assessment and intervention to reduce suffering from cancer.

Pilot Study on Development of Telecommunication Guideline for Symptom Management of Lung Cancer Patients / 종양간호학회지

PURPOSE: This study was conducted to develop the telecommunication guideline that was possible to make the immediate, logical decisions and to evaluate the possibility of the use by verifying it from the specialists' group. METHODS: Telecommunication guideline was designed with selected six symptoms which were pain, dyspnea, nausea/vomiting, diarrhea, fever, and cough based on the results of literature. RESULTS: This study showed that the patients understood well about the contents of the questions, examination, and education. Also, 85% of them fulfilled the guidelines of the adjustment and more of them were satisfied with the results shown to all of them compared to the previous telecommunication. And 95% of them replied that the information from the telecommunication was more useful than any other information sources related to the information of cancer and self management that were used previously. CONCLUSION: The telecommunication was considered to complement the weakness during the time the cancer patients spent at home after the treatments. Also, it was expected to be a role as an immediate and comprehensive method of decision making and a passage for information supply which was considered the specialty of individual patient related to an inquiry of the self management.

Effects of the polymorphic MDR1 genotype on the single-dose simvastatin pharmacokinetics in healthy subjects / 대한내과학회지

BACKGROUND/AIMS: Simvastatin has dramatically reduced cardiovascular disease due to elevated cholesterol. The human multidrug resistance 1 gene (MDR1) encodes a 170-kDa transmembrane glycoprotein (P-glycoprotein), which plays an important role in regulating the absorption, distribution, and excretion of simvastatin. To clarify the effects of the MDR1 gene polymorphism on simvastatin pharmacokinetics, we investigated whether there is an association between genotype and the pharmacokinetic parameters for simvastatin. METHODS: Thirty-one healthy unrelated Korean volunteers were genotyped for MDR1. Genomic DNA from blood was analyzed using the polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Following an overnight fast, all of the subjects took a single 60-mg oral dose of simvastatin. Venous blood samples were taken for 12 hours after the oral drug intake. A statistical analysis of the MDR1 genotype and pharmacokinetic parameters of simvastatin was performed. RESULTS: The mean Tmax of the 1236TT genotype was significantly higher than that of CT and CC (p=0.02). The mean AUC0-12h of 3435TT was also significantly higher, compared with CT and CC (p=0.01). No significant difference was observed between the MDR1 single nucleotide polymorphism (SNP) for G2677A/T and the pharmacokinetic parameters. CONCLUSIONS: These findings suggest that polymorphic MDR1 genes are important in the inter-individual variation of the disposition of simvastatin in humans. s

Gene Expression Profile of Lung Cancer Cells Following Photodynamic Therapy / 결핵및호흡기질환

BACKGROUND: Photodynamic therapy is a viable option for lung cancer treatment, and many studies have shown that it is capable of inducing cell death in lung cancer cells. However, the precise mechanism of this cell death has not been fully elucidated. To investigate the early changes in cancer cell transcription, we treated A549 cells with the photosensitizer DH-I-180-3 and then we illuminated the cells. METHODS: We investigated the gene expression profiles of the the A549 lung cancer cell line, using a DEG kit, following photodynamic therapy and we evaluated the cell viability by performing flow cytometry. We identified the genes that were significantly changed following photodynamic therapy by performing DNA sequencing. RESULTS: The FACS data showed that the cell death of the lung cancer cells was mainly caused by necrosis. We found nine genes that were significantly changed and we identified eight of these genes. We evaluated the expression of two genes, 3-phosphoglycerate dehydrogenase and ribosomal protein S29. The expressed level of carbonic anhydrase XII, clusterin, MRP3s1 protein, complement 3, membrane cofactor protein and integrin beta 1 were decreased. CONCLUSION: Many of the gene products are membrane-associated proteins. The main mechanism of photodynamic therapy with using the photosensitizing agent DH-I-180-3 appears to be necrosis and this may be associated with the altered production of membrane proteins.

Association Analysis of MUC5AC Promoter Polymorphism with Asthma / 결핵및호흡기질환

BACKGROUND: Airway mucus hypersecretion plays an important role in the pathogenesis of asthma, and is associated with the induction of MUC5AC expression in airway secretion. The MUC5AC gene is highly polymorphic; however, there are few studies about the association between the polymorphisms of the MUC5AC gene and asthma susceptibility or asthma phenotypes. We have investigated the association of MUC5AC promoter polymorphisms with the risk of asthma and asthma phenotypes. METHODS: We determined the genotypes of the MUC5AC promoter (-1274G>A) in 78 asthma patients and in 78 age, sex-matched control individuals in the Korean population. Genomic DNAs from blood were analyzed by PCR and RFLP (restriction fragment length polymorphism) determination. We examined FEV1, total eosinophil count, serum IgE level, PC20 and the presence of atopy (by a skin test) in asthma patients. RESULTS: The mean age of the patients was 47.7 +/- 16.1 years and 38.5% were men, and the mean FEV1 was 84.4 +/- 22.3% of predicted in the asthma patients. The -1274G>A polymorphism of the MUC5AC promoter in asthma patients was not significantly different as compared with normal individuals (GG 57.7%, AG 34.6% and AA 7.7% in asthma patients vs. GG 56.4%, AG 38.5% and AA 5.1% in control subject, p = 0.752, Cod). Several clinical parameters in asthma patients such as FEV1, total eosinophil count, serum IgE level, PC20 and the presence of atopy, were not associated with the -1274G>A polymorphism of the MUC5AC promoter. CONCLUSION: The -1274G>A single nucleotide polymorphism (SNP) frequency of the MUC5AC promoter was not associated with asthma in a Korean population.

Difference in Protein Markers According to the Survival of Sepsis Patients using Protein Chips / 결핵및호흡기질환

BACKGROUND: Several clinical scoring systems are currently being used to predict the outcome of sepsis, but they all have certain limitations. Therefore, we sought to identify the proteomic biomarkers, with wsing proteomic tools, that differed according to the outcome of sepsis patients. METHODS: Upon admission to the ICU, blood samples were obtained from the 16 patients with sepsis who were enrolled in this study. Surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) was used to identify the markers that could predict the outcome of sepsis. RESULTS: We found six peaks, by using cation and anion chips, that statistically differed between those patients who died and those who survived. CONCLUSION: The biomarkers we found by using proteomic tools may help predict the prognosis and also plan the treatment of sepsis.

Evaluation of craniofacial growth prediction method on Class III malocclusion patients / 대한치과교정학회지

This study was performed to evaluate whether growth prediction method can be used to diagnose and make treatment plan in skeletal Class III malocclusion patients or not. The sample was consisted of 25 patients(13 males, 12 females) who had been diagnosed with skeletal Class III malocclusion at first visit and after that had returned to take orthognathic surgery. Growth prediction performed with Ricketts' growth prediction method from first cephalogram was compared with actual growth of the second cephalogram. The findings of this study were as follows ; 1. There was significant difference between actual growth and growth prediction in Porion Location, Ramus Position, Facial Depth, Facial Axis, Mandibular Plane angle, Maxillary Convexity. So, for these items Ricketts' growth prediction method is not proper to predict growth. 2. Although the growth amount of mandibular body was similar to normal growth amount, mandible was positioned anteriorly because of Porion Location and Ramus Position. 3. In skeletal Class III malocclusion patients, the tendency of mandibular prognathism might be aggreviated because of anterior placement of ramus and anterosuperior rotation of pogonion.

The relationship between posterior dental compensation and skeletal discrepancy in class III malocclusion / 대한치과교정학회지

This study examined the relations between degree of posterior dental compensation and skeletal discrepancy in Class III malocclusion. The pretreatment lateral cephalograms and dental casts of 87 skeletal Class III adults were selected to provide a random sampling of skeletal Class III malocclusion. Skeletal discrepancy was described with ANB angle, Wits appraisal, SN-Mn plane angle, FMA and ratios of basal arch width. Degree of posterior dental compensation was described with maxillary intermolar angle, mandibular intermolar angle and sum of intermoloar angle. The relationships between skeletal discrepancy and degree of posterior dental compensation were analyzed with simple correlation analysis, stepwise multiple regression analysis. The results were as follows : 1. A strong association was found between the variation in the anteroposterior measure, ANB angle and the variation of posterior dental compensation measures, sum of intermolar angle and mandibular intermolar angle in skeletal Class III malocclusion. 2. There was no statistically significant relationship between the variation in the vertical measures and the variation of posterior dental compensation measures in skeletal Class III malocclusion. 3. There was no statistically significant relationship between the variation in the anteroposterior and vertical measures and degree of basal arch width discrepancy.

Characterization of Extended-Spectrum-beta-Lactamase Genes from Clinical Isolates of Enterobacter species / 대한임상미생물학회지

BACKGROUND: Among Enterobacter spp. isolates from clinical specimens in Korea, the incidence of resistance to expanded-spectrum cephalosporins is becoming an ever-increasing problem. This study was designed to determine the prevalence of expanded-spectrum cephalosporins-resistant Enterobacter spp. isolates from patients in a tertiary care hospital in Busan, Korea, and to characterize the mechanism of resistance. MATERIALS AND METHODS: Nonduplicated clinical isolates of Enterobacter spp. were collected during the period of 1999-2000 in Kosin Medical Center, Busan, Korea. Antimicrobial susceptibilities were tested by disk diffusion method. Cefotaxime-resistant or intermediate isolates were examined for extended-spectrum beta-lactamase (ESBL)-production by double disk synergy (DDS) test. Minimal inhibitory concentrations were determined by agar dilution method. For detection of blaTEM and blaSHV genes, polymerase chain reactions (PCRs) were performed, and the DNA sequences of blaTEM and blaSHV genes were determined by using dideoxy-chain termination method. RESULTS: From 1999 to 2000, a total of 306 Enterobacter spp. strains were isolated from patients in Kosin Medical Center. Forty one percents of Enterobacter spp. isolates were susceptible to cefotaxime. Among 90 isolates resistant or intermediate to cefotaxime, 26 isolates (29%) showed positive results in double disk synergy test. Among DDS-positive- isolates, 22 isolates contained both of blaTEM and blaSHV genes, while one isolate only contained blaTEM gene and two isolates only contained blaSHV gene. Among 64 DDS-negative isolates, 47 isolates contained blaTEM genes, and 12 isolates also contained blaSHV genes. Nucleotide sequence analysis of PCR products from 10 DDS-positive and 6 DDS-negative isolates, which contained both of blaTEM and blaSHV genes, revealed that blaTEM-1b and blaSHV-12 genes were the dominant types of beta-lactamase gene. CONCLUSION: Expanded-spectrum cephalosporins-resistant Enterobacter spp. were wide spread in Kosin Medical Center, Busan, Korea. Some of the resistant isolates acquired resistance by production of ESBLs, and blaSHV-12 gene was the most frequent ESBL gene in cefotaxime-resistant Enterobacter spp.