A systematic review and meta-analysis of studies on extended reality-based pediatric nursing simulation program development

Purpose@#This systematic literature review and meta-analysis explored extended reality (XR)-based pediatric nursing simulation programs and analyzed their effectiveness. @*Methods@#A literature search was conducted between May 1 and 30, 2022 in the following electronic databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. The search period was from 2000 to 2022. In total, 6,095 articles were reviewed according to the inclusion and exclusion criteria, and 14 articles were selected for the final content analysis and 10 for the meta-analysis. Data analysis was performed using descriptive statistics and the Comprehensive Meta- Analysis program. @*Results@#XR-based pediatric nursing simulation programs have increased since 2019. Studies using virtual reality with manikins or high-fidelity simulators were the most common, with six studies. The total effect size was statistically significant at 0.84 (95% confidence interval=0.50-1.19, z=4.82, p<.001). @*Conclusion@#Based on the findings, we suggest developing standardized guidelines for the operation of virtual pediatric nursing simulation education and practice. Simultaneously, the application of more sophisticated research designs for effect measurement and the combined applications of various virtual simulation methods are needed to validate the most effective simulation methodology.

Palinacousis after Cerebral Venous Thrombosis in the Temporoparietal Lobe

Palinacousis is a rare auditory phenomenon characterized by the persistence of sounds beyond their actual duration. It has been associated with various brain conditions such as stroke, tumor, and seizure in the temporoparietal lobe. We present a case report of a 43-yearold man who developed palinacousis following cerebral venous thrombosis and seizure with lesions including the left auditory cortex. This case highlights the intriguing relationship between cerebral venous infarction, seizure, and the development of palinacousis in specific brain regions.

Types of perception toward non-face-to-face clinical practice among nursing students / 한국간호교육학회지

Purpose@#This study aimed to identify the types of perception toward non-face-to-face clinical practice and to characterize the types of students who experienced online clinical practice during the coronavirus disease 2019 (COVID-19) pandemic. @*Methods@#Q-methodology was used in this study, and 270 Q populations were formed based on in-depth interviews with 10 nursing students who had experienced non-face-to-face clinical practice, as well as related literature. Interviews were performed from August 1 to 31, 2022. A total of 42 Q samples were extracted, and Q sorting was performed on 33 nursing students who had experienced non-face-to-face clinical practice. A Q factor analysis was performed using the PC-QUANL program. @*Results@#The nursing students’ perceptions of non-face-to-face clinical practice were classified into the following five types: “future professional competency-focused type,” “realistic convenience priority type,” “task burden awareness type,” “negative critic type,” and “limited experience dissatisfaction type.” @*Conclusion@#This study revealed non-face-to-face clinical practice’s positive and negative aspects in nursing education. Moreover, it identified the aspects of clinical practice that cannot be replaced by non-face-to-face clinical practice and the elements of non-face-to-face practice that can complement clinical practice. These findings can be used as fundamental data to establish a stable and efficient system for improving the quality of clinical practice in the post-COVID-19 era and to implement effective non-face-to-face clinical practice according to student types.

Arterio-Biliary Fistula as a Rare Life-Threatening Complication of Transjugular Intrahepatic Portosystemic Shunt: A Case Report

A 46-year-old male with alcoholic liver cirrhosis underwent a transjugular intrahepatic portosystemic shunt (TIPS) for refractory ascites. On the 9th day after the procedure, he presented with melena and decreasing hemoglobin levels. Hemobilia due to fistula formation between the right intrahepatic bile duct and right hepatic artery was suspected on computed tomography. Angiography revealed a fistula of the small branches of the hepatic segmental arteries, and right intrahepatic bile duct was confirmed; embolization was successfully performed with a coil for the eighth segmental hepatic artery, a glue-lipiodol mixture for the fifth segmental hepatic artery, and gelfoam slurry for the right anterior hepatic artery. However, 2 days after embolization, the patient died owing to aggravated disseminated intravascular coagulopathy. When gastrointestinal bleeding occurs after TIPS, careful evaluation is immediately required, and hemobilia should be considered.

An electronic medical record-based fall risk assessment tool for pediatric inpatients in South Korea: Improved sensitivity and specificity

Purpose@#To develop a fall risk assessment tool to predict fall risk in pediatric inpatients. @*Methods@#Three tools widely used in clinical practice (Humpty Dumpty Fall Scale, General Risk Assessment for Pediatric Inpatient Falls, and Seoul National University Hospital Pediatric Fall Risk Scale) were examined, and assessment items were extracted. Employing a case-control design, 29 children who experienced falls during hospital stays were selected as the "fall" group, and a control group (93 children) was selected based on age and sex matching. The sensitivity, specificity, and positive and negative predictive values of the newly developed tool ("Newfs-PI") were analyzed. @*Results@#The Newfs-PI consisted of seven items: age, activity, history of falls, length of hospital stay, and medication. The total score ranged from 0 to 15. Its sensitivity and specificity were 62.07% and 74.19%, respectively. @*Conclusion@#The Newfs-PI has high specificity and sensitivity, which are essential for a fall risk assessment tool that complements existing tools. These values are high relative to those of existing assessment tools and satisfy both sensitivity and specificity criteria. As the EMR enables monitoring of the components of the Newfs-PI, the tool can be used as a fall risk assessment and prevention scale for pediatric inpatients.

Angiographic Findings of an Isolated Meandering Pulmonary Vein: A Case Report

A meandering pulmonary vein (MPV) is a rare pulmonary vascular anomaly characterized by an abnormal course of the pulmonary vein draining into the left atrium. We report the case of a 55-year-old female who was diagnosed with a right MPV on pulmonary angiography. Enhanced chest CT revealed a vascular structure with an abnormal course that drained into the right superior pulmonary vein in the right upper lobe, which resembled a pulmonary arteriovenous malformation (AVM). Pulmonary angiography performed to discriminate between an MPV and pulmonary AVM showed no feeding artery, normal parenchymal staining, and drainage to the left atrium via the culprit vessel. Thus, the patient was diagnosed with MPV. When an MPV is difficult to differentiate from other vascular anomalies on enhanced chest CT, pulmonary angiography can be helpful. By recognizing the angiographic findings of an MPV, unnecessary treatment can be prevented.

Types of Perception Toward Quarantine Measures among Patients Infected with COVID-19

Purpose@#This study was conducted to identify the types of perception toward quarantine measures at hospitals or community treatment centers among patients infected with COVID-19. @*Methods@#This study applied Q-methodology. Two hundred and nineteen Q populations were constructed based on related literature and in-depth interviews with 5 adults infected with COVID-19 and who experienced quarantine and hospitalization. Interviews were performed from November 14 to 29, 2020. A total of 45 Q samples were extracted and Q sorting was performed using a 9-point scale for 30 adult subjects who experienced quarantine at hospitals and community treatment centers. The data were analyzed using the PC-QUANL program. @*Results@#The perception of subjects toward quarantine measures was classified into the following six types: ‘passive acceptance’, ‘social stigma perception’, ‘appreciation of daily life through awareness of the realities of illness’, ‘why me?’, ‘fearful perception’, and ‘positive meaning’. @*Conclusion@#The perception of quarantine measure among patients with COVID-19 is identified as six types with positive and negative emotional characteristics. This result will contribute to the development of individualized strategies to address psychosocial health problems among patients with infectious diseases.

Angiographic Findings of an Isolated Meandering Pulmonary Vein: A Case Report

A meandering pulmonary vein (MPV) is a rare pulmonary vascular anomaly characterized by an abnormal course of the pulmonary vein draining into the left atrium. We report the case of a 55-year-old female who was diagnosed with a right MPV on pulmonary angiography. Enhanced chest CT revealed a vascular structure with an abnormal course that drained into the right superior pulmonary vein in the right upper lobe, which resembled a pulmonary arteriovenous malformation (AVM). Pulmonary angiography performed to discriminate between an MPV and pulmonary AVM showed no feeding artery, normal parenchymal staining, and drainage to the left atrium via the culprit vessel. Thus, the patient was diagnosed with MPV. When an MPV is difficult to differentiate from other vascular anomalies on enhanced chest CT, pulmonary angiography can be helpful. By recognizing the angiographic findings of an MPV, unnecessary treatment can be prevented.

Development of the Nursing Start-up Attitude Scale for Student Nurses / 간호행정학회지

Purpose@#The purpose of this study was to develop and psychometrically test the nursing start-up attitude scale for student nurses. @*Methods@#The initial items were based on the second analysis of systematic review of previous studies and in-depth interview data with 9 nurse entrepreneurs. In total, 25 items were derived based on the pilot survey.Psychometric testing was conducted with 324 student nurses. Data were analyzed using validity and reliability test methods. @*Results@#Six factors, including 12 items explaining 74.4% of the total variance, were verified. The factors were opportunity of self actualization, network building, enhacing start-up competencies, outcomes of start-up, preparation for start-ups, and risk taking. Cronbach's ⍺ was .75. @*Conclusion@#As validity and reliability have been verified through various methods, the developed scale in this study can contribute to assessing student nurses’ attitudes to nursing start-ups.

Meta-analysis of the Diagnostic Test Accuracy of Pediatric Inpatient Fall Risk Assessment Scales

PURPOSE: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. METHODS: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. RESULTS: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. CONCLUSION: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.

MRI Findings of Intercostal Schwannoma: A Case Report

Intercostal schwannomas are uncommon, encapsulated neoplasms that originate in nerve sheaths of intercostal nerves. They account for less than 10% of primary neural tumors of the chest wall. Herein, we report a pathologically confirmed case of intercostal schwannoma with typical magnetic resonance imaging findings.

Structured Model on the Health related Quality of Life in University Students focused on Personal Competency Health Care / 재활간호학회지

PURPOSE: This research was conducted to construct a model explaining the quality of life (QOL) related to undergraduate students' health. Social support, self-efficacy and self-esteem were used as exogenous variables while health promotion lifestyles, personal health care competency were endogenous variables. METHODS: A survey was conducted with a structured questionnaire including QOL, health promotion lifestyles, personal health care competency, social support, self-efficacy, and self-esteem. Data were collected from 269 undergraduate students with random sampling and then analyzed using structural equation modeling. RESULTS: Personal health care competency, health promotion lifestyles, social support, self-esteem had both direct and indirect effects while self-efficacy had indirect effects on the QOL of undergraduate students. Especially, social support, self-efficacy and self-esteem influenced positively to the QOL while greater health promotion lifestyles and personal health care competency improved QOL. Thus, personal health care competency and health promotion lifestyles were important mediator for positive QOL in undergraduate students. CONCLUSION: Interventions aiming to enhance health promotion lifestyles and personal health care competency, based on the results of this study, are required to help positive QOL in undergraduate students. Our results can serve as basic data for designing such interventions.

Awareness of Nursing Students' Biomedical Ethics and Attitudes toward Withdrawal of Life-Sustaining Treatment

PURPOSE: This study was done to analyze nursing students' attitudes to life-sustaining treatment by measuring their awareness of biomedical ethics and resulting attitude toward withdrawal of life-sustaining treatment. METHODS: This study was a descriptive research to assess the level of nursing students' awareness of biomedical ethics, attitude toward withdrawal of life-sustaining treatment, and correlations between these variables. After the nursing students signed a consent form they were assessed. Data collection was done from September 1 to October 25, 2016, and analyzed using SPSS 23.0 WIM Program. RESULTS: There was a negative correlation and significant difference between nursing students' awareness of biomedical ethics and attitude toward withdrawal of life-sustaining treatment. There was a significant correlation among attitude toward withdrawal of life-sustaining treatment and medical ethics, mortality ethics. CONCLUSION: The findings in the study indicate that it is necessary to provide nursing students with easy access to continuous education to help them establish an acceptable view of withdrawal of life-sustaining treatment.

Intra-Appendiceal Air at CT: Is It a Useful or a Confusing Sign for the Diagnosis of Acute Appendicitis?

OBJECTIVE: To investigate the significance of intra-appendiceal air at CT for the evaluation of appendicitis. MATERIALS AND METHODS: We retrospectively analyzed 458 patients (216 men, 242 women; age range, 18-91 years) who underwent CT for suspected appendicitis. Two independent readers reviewed the CT. Prevalence, amount, and appearance of intra-appendiceal air were assessed and compared between the patients with and without appendicitis. Performance of CT diagnosis was evaluated in two reading strategies: once ignoring appendiceal air (strategy 1), and the other time considering presence of appendiceal air as indicative of no appendicitis in otherwise indeterminate cases (strategy 2), using receiver operating characteristic (ROC) analysis. RESULTS: Of the 458 patients, 102 had confirmed appendicitis. The prevalence of intra-appendiceal air was significantly different between patients with (13.2%) and without (79.8%) appendicitis (p < 0.001). The amount of appendiceal air was significantly lesser in patients having appendicitis as compared with the normal group, for both reader 1 (p = 0.011) and reader 2 (p = 0.002). Stool-like appearance and air-fluid levels were more common in the appendicitis group than in the normal appendix for both readers (p < 0.05). Areas under the ROC curves were not significantly different between strategies 1 and 2 in reader 1 (0.971 vs. 0.985, respectively; p = 0.056), but showed a small difference in reader 2 (0.969 vs. 0.986, respectively; p = 0.042). CONCLUSION: Although significant differences were seen in the prevalence, amount, and appearance of intra-appendiceal air between patients with and without appendicitis, it has a limited incremental value for the diagnosis of acute appendicitis.

A Case of a Large, Gastric Intramural Hematoma Caused by Endoscopic Mucosal Resection, and Treated with Transcatheter Arterial Embolization / 대한내과학회지

Only two cases of gastric intramural hematoma (IMH) caused by endoscopic mucosal resection (EMR) have been reported to date. This is the first reported case of gastric IMH caused by EMR, treatment of which required hemoclipping and transcatheter arterial embolization. The patient had a normal coagulation profile and no relevant medical history. About 8 h after completing the EMR, the patient vomited approximately 150 mL fresh blood and complained of abdominal pain. Endoscopy showed a 3 x 7 cm hematoma with active surface bleeding in the gastric antrum. Hemoclipping of the bleeding site on the surface and transcatheter arterial embolization of the left gastric artery were performed. Thereafter, conservative management including administration of a proton pump inhibitor was performed, and the lesion resolved. A review of relevant previous cases and this case suggested vessel damage secondary to the submucosal injection itself to be a reasonable causative mechanism for the gastric IMH.

Pigmented Eccrine Porocarcinoma / 대한피부과학회지

Eccrine porocarcinoma is a rare cutaneous neoplasm arising from the eccrine sweat duct. It may arise de novo or evolve from a pre-existing poroma or hidroacanthoma simplex. The pigmented variant of porocarcinoma is very rare, and its heavy pigmentation can lead to misdiagnosis of seborrheic keratosis or melanoma. An 82-year-old male patient presented with a painful, brown-to-black colored plaque measuring 4x4.5 cm with a central pedunculated nodule that measured 2.5x2 cm on his right posterior thigh. A small, pigmented papule had developed 10 years prior and had gradually increased in size. Histopathologic examination of the nodule revealed lobulated tumor islands composed of atypical basaloid cells in the periphery, eosinophilic squamous cells in the center, and pigmented dendritic cells scattered throughout nests of the tumor. Carcinoembryonic antigen and epithelial membrane antigen were expressed in the tumor cells and the dendritic cells stained positive for S-100 and HMB45. Histopathologic findings from the plaque showed many pigmented nests embedded within the epidermis that were composed of small, polygonal, pigmented basaloid cells. Pigmented eccrine porocarcinoma arising from pigmented hidroacanthoma simplex was diagnosed clinically and histopathologically. The tumor was completely excised. We report a case of pigmented porocarcinoma, which should be included among clinically important differential diagnoses apart from melanoma.

Disconnection of the Rubber Tip of Arrow-Trerotola Percutaneous Thrombolytic Device

A rubber tip disconnection of Arrow-Trerotola percutaneous thrombolytic device (PTD) may occur occasionally. We experienced 5 cases of a rubber tip disconnection among 453 mechanical thrombectomy sessions with the use of PTD. We present a report about these five cases and suggest possible causes for the occurrences.

Effectiveness of Home-use Light Emitting Diode Device for Seborrheic Dermatitis of the Scalp: a Preliminary Study / 대한의진균학회지

BACKGROUND: Seborrheic dermatitis (SD) is a chronic, relapsing inflammatory disease, mainly affecting the scalp and face. The pathogenesis of SD has been not fully understood yet, but may be related to the skin colonization of Malassezia species, lipophilic yeasts. Phototherapy with light emitting diode (LED) device has been become a new therapeutic modality for some skin diseases such as acne. OBJECTIVE: To evaluate effectiveness and safety of phototherapy with home-use LED in the treatment of patients with SD of the scalp. METHODS: Eight patients with mild-to-moderate SD of the scalp participated. The patients used a home-use LED device combined 395 nm blue light with 660 nm red light for 6~7 min twice daily for 8 weeks. Patients' assessments were made by clinical findings including erythema (0~15), scales (0~15), itching (0~10), and lesional extent (0~15). And clinical photographs were taken at 0, 2, 4 and 8 weeks, respectively. RESULTS: At 8 weeks after LED treatment, erythema (7.75 to 5.13, p=0.018), scales (7.38 to 4.13, p=0.017), itching (6 to 3, p=0.011) and lesional extent (8.25 to 5.25, p=0.017) were significantly decreased, respectively. Satisfactory scores were also relatively high (mean 8.13 of 10). No severe adverse reaction was reported, excepting hair dryness (n=1) and brief stinging sense (n=1). CONCLUSION: Home-use LED was effective and safe in the treatment of SD of the scalp. These results suggest the LED device might be an adjuvant therapeutic tool in the treatment of Malassezia species associated diseases such as dandruff and SD. Further long-term and large-scale studies are required to assess the efficacy and safety of home-use LED.

The Analysis of Trends and Contents of Nursing Intervention Research for Stroke Patients in Korea / 기본간호학회지

PURPOSE: This study was conducted to provide background information on nursing interventions to further enhance the quality of nursing practice and related professions, based on those performed for stroke patients. METHODS: The analysis was performed in light of 84 researches papers on nursing intervention published between 1990 and 2010, and based on NIC(Nursing Interventions Classification) and NOC(Nursing Outcomes Classification). RESULTS: 1. The quasi-experimental design was used as the most primary form of research design across 69 papers that constitute 82% of the total. 2. The number of nursing intervention methods identified throughout 84 research papers was 144. Based on the NIC that 90(62.5%) of those interventions fell into the physiological basic domain while 53(36.8%) belonged to the behavioral domain. 2) Interventions on activity and exercise management, physical comfort promotion, patient education conducted by class level of NIC were 40(27.78%), 34(23.61%), and 31(21.53%) respectively. 3) Outcomes of mobility, psychological well-being, energy maintenance, health & life quality measured by class of NOC among 317 dependent variables 79(24.92%), 64(20.19%), and 63(19.87%) respectively. CONCLUSION: Most interventions were classified as belonging to few particular domain types, which triggers needs for the development and application of multidisciplinary intervention methods through a more collective approach.

Patterns of Anger Expression among Middle-aged Korean Women: Q methodology

PURPOSE: The purpose of this study was to identify the characteristics of anger expression in middle-aged Korean women by categorizing their patterns of expression while considering the complexity and multidimensionality of anger, and by investigating the characteristics relative to the patterns. METHODS: The research design was a descriptive design using Q methodology, which is a method of measuring subjectivity. A convenience sample of 42 participants aged 40-60 years and living in the community in Korea was recruited. The PC-QUANL software program (a factor analysis program for the Q technique) was used to analyze the Q-sort data. RESULTS: Four factors were extracted that described different expressions of anger among middle-aged Korean women; these factors explained 50.1% of the total variance. The frames of reference of the four factors were a) direct diversion, b) silent masking with remaining anger, c) self digestion, and d) controlling anger with objectification. CONCLUSION: In this study has identified patterns and characteristics of anger expression among middle-aged Korean women were identified, which will aid the development of effective anger-management programs for controlling anger in this population. In future studies, it would be helpful to investigate how the patterns of anger expression established herein are associated with specific health problems such as cardiovascular disorder and cancer.