Benefits of Music Intervention on Anxiety, Pain, and Physiologic Response in Adults Undergoing Surgery: A Systematic Review and Meta-analysis

Purpose@#Evidence on factors influencing the variations of music’s effect on anxiety and pain in surgical patients is unclear. We aimed to elucidate the effects of music intervention on anxiety and pain throughstudy characteristics. @*Methods@#We conducted a search on the PubMed, CINAHL, Embase, Cochrane, and Web of Science databases from March 7 to April 21, 2022, for randomized controlled trials (RCTs) for the effect of music intervention on anxiety, pain, and physiological responses in surgical patients. We included studies published within the last 10 years. We assessed the risk of bias in the study using the Cochrane risk of bias tool for randomized trials and performed meta-analyses using a random-effects model for all outcomes. We used change-from-baseline scores as summary statistics and computed bias-corrected standardized mean differences (Hedges'g) for anxiety and pain outcomes and mean differences (MD) for blood pressure and heart rate. @*Results@#Of the 454 records retrieved, 30 RCTs involving 2280 participants were found to be eligible. Music intervention was found to be superior to standard care in reducing anxiety (Hedges' g = −1.48, 95% confidence interval: −1.97 to −0.98), pain (Hedges's g = −0.67, −1.11 to −0.23), systolic blood pressure (MD = −4.62, −7.38 to −1.86), and heart rate (MD = −3.37, −6.65 to −0.10) in surgical patients. The impact of music on anxiety and pain relief varied significantly depending on the duration of the intervention. The largest effect was observed in interventions lasting between 30 and 60 minutes, with a decrease in anxiety and pain. @*Conclusions@#Music intervention is an effective way to reduce anxiety, pain, and physiological responses in surgical patients. Future reviews examining the influence of different types of surgery on the effects of music would add to the body of knowledge in this field. This study has been registered on the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42022340203, with a registration date of July 4, 2022.

Nursing students’ confidence in clinical competency and job readiness during the COVID-19 pandemic era / 한국간호교육학회지

Purpose@#This study explored nursing students’ experiences of attending clinical practicum courses in 2020 during the COVID-19 pandemic era, focusing on their confidence in clinical competency and job readiness. @*Methods@#The data for this study were collected using online questionnaires that were uploaded to a free online survey website and distributed via a link to the survey to 334 nursing students attending four-year nursing colleges at four national universities. Data analysis was done with descriptive statistics, independent t-tests, and ANOVA. @*Results@#The participants were mostly female (83.2%) college seniors (78.1%). About 60% of the participants practiced between 40% to 100% of their clinical practicum hours in alternative ways. Almost a third of the participants reported that they were not ready for a job (30.2%). However, participants’ confidence in clinical competency and job readiness was not related to the rate of alternative practice, but rather to both achievement of educational outcomes and satisfaction in the nursing practicum. @*Conclusion@#Due to COVID-19, it is evident that effective and efficient materials and ways of delivering clinical courses are constantly to be sought and developed. In particular, recently graduated nurses who experienced abrupt and considerable alterations in their clinical practicum courses due to COVID-19 are in need of attention while they strive to make clinical adaptations.

Effects of Lavender on Anxiety, Depression, and Physiological Parameters: Systematic Review and Meta-Analysis

Purpose@#The recent evidence suggested substantial anxiolytic efficacy of lavender. The aim of this study was to examine the efficacy of lavender for anxiety, depression, and physiological parameters and to elucidate the differential effects of lavender on anxiety and depression by study characteristics. @*Methods@#A systematic review and meta-analysis was performed following the PRISMA guidelines. We searched PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index of Nursing and Allied Health Literature databases for randomized controlled trials investigating the efficacy of lavender on anxiety, depression, or physiological parameters in humans. We assessed the risk of bias within studies with the revised Cochrane risk of bias tool for randomized trials. We used random effect model to estimate the average effect and computed bias-corrected standardized mean difference as effect size metric, Hedges’ ĝ for all outcomes. @*Results@#Lavender was superior to placebo or no treatment in reducing anxiety (Hedges' ĝ = −0.72, 95% confidence interval [CI] −0.90 to −0.55, p value <.001), depression (Hedges' ĝ = −0.43, 95% CI, −0.59 to −0.27, p value <.001), and systolic blood pressure (Hedges' ĝ = −0.23, 95% CI, −0.41to −0.05, p value = .01). The moderator analysis by meta-regression indicated that route of administration accounted 6.5% (p value = .187) for the heterogeneity in anxiolytic effects, sessions of treatment accounted 13.2% (p value = .055), and participants’ health state accounted 8.9% (p value = .131) for the variance in anxiolytic effects. @*Conclusion@#Lavender aromatherapy showed substantial effect in reducing anxiety and depression, and sessions of administration increased the anxiolytic effects. The effects on physiological parameters showed small with inconsistent significances and randomized controlled trials on the effect of lavender on depression were scarce. Future trials on depression and physiological parameters are recommended, and increasing the sessions of administration is recommended.

How Strong is the Evidence for the Anxiolytic Efficacy of Lavender?: Systematic Review and Meta-analysis of Randomized Controlled Trials

PURPOSE: Although lavender is purported to possess anxiolytic and sedative properties and is often recommended for relieving anxiety, the efficacy of lavender has not been well established. Thus, this review aimed to evaluate the anxiolytic effects of lavender aromatherapy.METHODS: Ten data bases were searched for studies published between 2000 and 2018. Randomized controlled trials investigating the anxiolytic effects of lavender aromatherapy with any type of application for persons with or without clinical anxiety were included. The outcome variables included self-rated anxiety, vital signs, and salivary cortisol and chromogranin A (CgA) levels. In the meta-analysis, standardized mean difference and 95% confidence interval were calculated as effect measures by applying the random effect model and inverse variance method.RESULTS: Twenty-two trials met our inclusion criteria. Lavender aromatherapy was found to have favorable effects in relieving anxiety (Hedges' ĝ = −0.65; 95% CI, −0.84 to −0.46) and decreasing systolic blood pressure (ĝ = −0.22; 95% CI, −0.43 to −0.02), heart rate (ĝ = −0.53; 95% CI, −0.74 to −0.32), and salivary cortisol (ĝ = −1.29; 95% CI, −2.23 to −0.35) and CgA (ĝ = −2.29; 95% CI, −3.24 to −1.34) levels. However, the meta-analysis did not reveal any significant effects of lavender on diastolic blood pressure (effect size: −0.17; 95% CI, −0.37e0.04).CONCLUSION: Aromatherapy using lavender oil might have favorable effects on anxiety and its physiological manifestations. Future studies are recommended with an emphasis on methodological quality. In nursing practice, it is suggested that lavender aromatherapy be included in programs intended to manage anxiety in patients across diverse healthcare settings.

Relationship among Oral Hygiene Management, Halitosis, Interpersonal Relationships and Oral Health-Related Quality of Life in Community-Dwelling Elderly

BACKGROUND: The purpose of this study was to determine the degree of oral care, perceived halitosis, halitosis, interpersonal relationships and oral health-related quality of life and to examine the relationships among these variables.METHODS: The participants were 94 elderly people. The questionnaire included questions on oral care, perceived halitosis, interpersonal relationships, and oral health-related quality of life. Halitosis was measured using odor breath tester.RESULTS: A total of 63.8% of the elderly did not receive regular oral care. The halitosis score was 1.59, thus indicating moderate halitosis. The current perceived halitosis figure was 1.54, participants responded that they feel slight. There was no significant correlation between halitosis and perceived halitosis. Furthermore, there was no significant difference in halitosis and perceived halitosis according to the oral care. Perceived halitosis was negatively correlated with oral health-related quality of life. Interpersonal relationships were correlated with oral health-related quality of life.CONCLUSIONS: It is necessary to actively promote the need for oral care among the elderly. Moreover, older people need regular oral care to prevent halitosis and improve their oral health-related quality of life.

Relationship among Oral Hygiene Management, Halitosis, Interpersonal Relationships and Oral Health-Related Quality of Life in Community-Dwelling Elderly

BACKGROUND@#The purpose of this study was to determine the degree of oral care, perceived halitosis, halitosis, interpersonal relationships and oral health-related quality of life and to examine the relationships among these variables.@*METHODS@#The participants were 94 elderly people. The questionnaire included questions on oral care, perceived halitosis, interpersonal relationships, and oral health-related quality of life. Halitosis was measured using odor breath tester.@*RESULTS@#A total of 63.8% of the elderly did not receive regular oral care. The halitosis score was 1.59, thus indicating moderate halitosis. The current perceived halitosis figure was 1.54, participants responded that they feel slight. There was no significant correlation between halitosis and perceived halitosis. Furthermore, there was no significant difference in halitosis and perceived halitosis according to the oral care. Perceived halitosis was negatively correlated with oral health-related quality of life. Interpersonal relationships were correlated with oral health-related quality of life.@*CONCLUSIONS@#It is necessary to actively promote the need for oral care among the elderly. Moreover, older people need regular oral care to prevent halitosis and improve their oral health-related quality of life.

Male Nurses' Experiences of Being Rejected in Nursing Practice / 한국간호교육학회지

PURPOSE: The purpose of this study is to examine and share experiences of male nurses who have been rejected during their nursing practice by their patients. METHODS: The participants were 12 male nurses who have worked in several hospitals. Data were collected through personalized in-depth interviews. Collected data were analyzed with the content analysis method. RESULTS: The results can be categorized into three main themes. 1. Rejection based on gender stereotypes of nurses' roles. 2. Nurses' reactions when nursing was rejected 3. Reestablishing the role as a nurse. The results of this study showed that male nurses were struggling to maintain their own positions as professional nurses. They were refused by their patients and they experienced a lack of skill and knowledge in nursing practice. They were harmed physically and psychologically from being turned down, and sometimes they had serious conflicts with female nurses. Meanwhile, the male nurses tried to be faithful to their role as professional nurses. CONCLUSION: The results of this study show the following findings. 1. The male nurses' experiences where mostly ones of understanding and cooperation with patients' caregivers. 2. The need for public relations advertising and systematic support from the media. 3. The need for improving gender equality for nurses. 4. Strengthening male nursing students' endeavors for sound nursing professionalism.

Renal Cholesterol Embolism during Warfarin Treatment

Cholesterol embolization syndrome (CES) usually occurs after endovascular procedures, it may also occurs after using anticoagulants and thrombolytics. We report a case of 66-year-old man with sudden elevation of creatinine after using warfarin due to cortical infarction. Histologic examinations revealed a cholesterol cleft on the arcuate artery. We concluded it as warfarin induced atheroembolic renal disease. Careful observation of kidneys is necessary in the case of renal abnormalities after using anticoagulation, considering the possibility of cholesterol embolism due to anticoagulant therapy.

Experiences of Caring for a Spouse with Schizophrenia / 정신간호학회지

PURPOSE: The aimof this phenomenological study was to qualitatively classify the experience of spouses caring for patients with schizophrenia. METHODS: Data were gathered using 2 hour in-depth, unstructured interviews with nine spouses of patients with schizophrenia. The data collection period was 2012 to 2013. Colaizzi's phenomenological method was used to analyze the resulting data. RESULTS: Five clusters of themes were identified. These were termed according to the experiences described by the spouses, as: suffering fromfalling into the abyss of despair; deepening heartbreak, clouds of misery hanging over one's family; possibly of losing the bond between familymembers; getting over one's hurt and stepping forward to the future. Participants experienced many burdens while caring for their spouse, however, they showed the ability to overcome difficulties positively and actively. CONCLUSION: The results of this study indicate that the spouse of a patient with schizophrenia experiences multiple sources of distress, and suggests a process to overcoming them. Recommendations include helping nurses be aware of the sufferings of both the patient and the spouse and to plan and provide for psychological interventions, such as stressmanagement programs and informational support on social welfare programs.

A Rare Case of Polyneuropathy and Monoclonalgammopathy with Recurrent Acute Kidney Injury

POEMS syndrome is a rare paraneoplastic syndrome and there are few reports of polyneuropathy and monoclonal gammopathy associated with kidney dysfunction. Here, we report a case of POEMS syndrome with recurrent acute kidney injury (AKI). A 52-year-old man presented with bilateral aggravating paresthesia and latermotor weakness of the lower extremities accompanied by repeated elevation of serum creatinine. The patient was finally diagnosed with POEMS syndrome on the basis of fulfilling the two mandatory major criteria (polyneuropathy and monoclonal gammopathy), one other major criterion (sclerotic bone lesion), and several minor criteria. A renal biopsy was performed to clarify the cause of AKI and showed membranoproliferative glomerulonephritis-like lesions with mesangiolysis and endothelial cell injury. This case illustrates that renal manifestations, not included in the diagnostic criteria for POEMS, can be apparent before various other systemic symptoms.

In vitro evaluation of bioactive potential of Bacillus methylotrophicus YML008 against Propionibacterium acnes

Acne vulgaris is the most common skin diseases that people experience during their lives. Thirteen rhizosphere isolates were screened against Propionibacterium acnes. The bacterium exhibited the highest activity against P. acnes was identified as Bacillus methylotrophicus YML008 by 16S rRNA gene sequencing. Scanning electron microscopy was used to assess the changes in morphology of P. acnes. Preliminary studies on the antimicrobial substance demonstrated the hydrophilic nature of compound with MIC of 0.17mg/ml and MBC of 0.3mg/ml. The cytotoxic effect of the extract was least [80% survival] as compared to benzyperoxide [40% survival]. These results suggest YML008 as a promising bioresource and may be useful as a lead bacterium to develop a new type of anti-acne skin care prep to cure or prevent acne. Further, mechanism of action and proper clinical trials may be promising for this research

A Case of Multiple Hypervascular Hyperplastic Liver Nodules in a Patient with No History of Alcohol Abuse or Chronic Liver Diseases / 대한소화기학회지

Up-to-date imaging modalities such as three-dimensional dynamic contrast-enhanced CT (3D CT) and MRI may contribute to detection of hypervascular nodules in the liver. Nevertheless, distinguishing a malignancy such as hepatocellular carcinoma from benign hypervascular hyperplastic nodules (HHN) based on the radiological findings is sometimes difficult. Multiple incidental liver masses were detected via abdominal ultrasonography (US) in a 65-year-old male patient. He had no history of alcohol intake and no remarkable past medical history or relevant family history, and his physical examination results and laboratory findings were normal. 3D CT and MRI showed numerous enhanced nodules with hypervascularity during the arterial phase. After US guided liver biopsy, the pathological diagnosis was HHN. To date, several cases of HHN have been reported in patients with chronic alcoholic liver disease or cirrhosis. Herein, we report on a case of HHN in a patient with no history of alcoholic liver disease or cirrhosis.

Factors Affecting Job-Seeking Stress in Nursing Students / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to investigate what factors are affecting job-seeking stress in nursing students. METHODS: Subjects were 463 students from two 3-year and two 4-year colleges of nursing in K-Province in Korea. Data was collected from self-administered questionnaires. t-test, ANOVA, Pearson's and Spearman's correlation coefficients, and hierarchical multiple regression with dummy variables were used for statistical analysis of data. RESULTS: Job-seeking stress was significantly different by school system (t=2.76, p=.006), family economic status (F=3.40, p=.005), characteristics (t=1.99, p=.047), academic achievement (F=6.54, p=.002), current weight control status (t=2.23, p=.026), times of cosmetic surgery (r=.11, p=.022), self-esteem (r=-.47, p<.001) and appearance stress (r=.40, p<.001). However, after controlling for general characteristics, self-esteem, and perceived appearance stress, job-seeking stress was significantly different by grade (1st vs 3rd, beta=0.163, p<.001), academic achievement (low vs. high, beta=-0.121, p=.0321), self-esteem (beta=-0.224, p<.001), and appearance stress (beta=0.099, p<.001). The explanation power of self-esteem on job-seeking stress was greater compared with that of appearance stress. CONCLUSION: Results of this study suggest that it is necessary for nursing students to develop intervention program aimed at reducing job-seeking stress, and it would be effective to focus on improving self-esteem for them.

P2X7 Receptor Expression in Coexistence of Papillary Thyroid Carcinoma with Hashimoto's Thyroiditis

BACKGROUND: This study was aimed at investigating the relation of P2X7 receptor (P2X7R) expression with the clinicopathological features of papillary thyroid carcinoma (PTC) coexisting with Hashimoto's thyroiditis (HT). METHODS: We examined 170 patients (84, PTC with HT; 86, PTC without HT). P2X7R expression was examined by immunohistochemical methods. The staining intensity and patterns were evaluated and scored using a semi-quantitative method. RESULTS: The PTC with HT group was more likely to contain women and had less extrathyroid extension, lymph node (LN) metastasis, lymphovascular invasion, and recurrence than the PTC without HT group. Patients positive for P2X7R had significantly higher frequencies of lymphovascular invasion, extrathyroid extension, LN metastasis, and absence of HT. As shown by multivariate analysis, the expression of P2X7R was significantly higher if HT was absent and extrathyroid extension was present. In the PTC with HT group, the expression of P2X7R was significantly higher in patients with tumor multifocality, lymphovascular invasion, and extrathyroid extension. In the PTC without HT group, the expression of P2X7R was significantly higher in women and those having tumor multifocality. CONCLUSIONS: Coexistence of PTC with HT is associated with good prognostic factors, and P2X7R expression in PTC was correlated with poor prognostic factors and the absence of HT.

Inter-generation Occupational Mobility Experience of Nurses: Focus on Mother's Experience / 한국간호교육학회지

PURPOSE: The purpose of this study is to analyze how the experiences of nurses influence their role model function when they are mothers of children who in turn have become nurses or nursing students. METHOD: The subjects of this study were 12 nurses, 8 of their children who became nurses and another 4 children then in training to become one. Data were collected through in-depth personal interviews and subsequently analyzed through a phenomenological approach. RESULTS: Four main themes were identified as follows; 'Persuasion and dissuasion,' 'Proud but still pathetic,' 'As mom and senior nurse' and 'Great to pass it down.' CONCLUSION: The results of this study show that the nurse as mother could be a positive professional role model for her children. However, they tended to stress the arduous clinical routines and poor work conditions nurses currently experience. Should such routines and conditions improve, mothers who are nurses would be more willing to recommend the nursing profession to their children. Improving the professional environment is thus important because inter-generation nursing mobility provides a reliable resource to recruit qualified and dedicated nursing personnel.

Harmonic ultrasonography for the detection of microlithiasis in the gallbladder

PURPOSE: To validate the use of harmonic ultrasonography (US) in the detection of gallbladder microlithiasis. METHODS: From November 30, 2012, to January 18, 2014, fundamental US (FUS) and harmonic US with a high background noise (HUS-N) were performed for evaluation of gallbladder during the routine abdomen US. During the US, a dot-like stone (or stones) with Brownian motion was regarded as a positive finding of microlithiasis. Fifty-five patients with microlithiasis in the gallbladder detected on US were enrolled as the subjects of a retrospective review. With respect to the obtained images, two abdominal radiologists independently scored the conspicuity of gallbladder microlithiasis on FUS and HUS-N by using a 4-grade scale. The statistical analysis employed a kappa test and a Wilcoxon rank-sum test. RESULTS: For FUS, the conspicuity grades of gallbladder microlithiasis were G1 in 25 and 37, G2 in 21 and 9, G3 in 6 and 6, G4 in 3 and 3 patients, while HUS-N showed G1 in 0 and 0, G2 in 3 and 2, G3 in 12 and 15, and G4 in 40 and 38 patients, respectively, by each of the two radiologists. The kappa value was 0.633 for FUS between the two radiologists and 0.708 for HUS-N. HUS-N showed better conspicuity of gallbladder microlithiasis than FUS with significant P-values of less than 0.001 and 0.001 for the two radiologists, respectively. CONCLUSION: Compared with FUS, HUS-N enables better detection of microlithiasis in the gallbladder.

Histopathologic Predictors of Lymph Node Metastasis and Prognosis in Tonsillar Squamous Cell Carcinoma

BACKGROUND: Risk factors for lymph node metastasis in tonsillar squamous cell carcinoma (TSCC) need to be established to determine the degree of surgery required to achieve high curative rates. However, little is known currently about the histopathological features predicting prognosis, specifically in TSCC. METHODS: This study included 53 patients who underwent surgical resection with neck dissection. Clinicopathological factors investigated included age, gender, alcohol use, tobacco consumption, tumor stage, adjacent structure involvement, cell differentiation, squamous dysplasia, in situ carcinoma associated with primary invasive cancer, carcinoma in situ skip lesions, necrosis, invasive front, depth of invasion, and lymphatic, muscle, or perineural invasion. RESULTS: Contralateral cervical metastasis was associated with higher T stages and soft palate invasion. Lymphatic and muscle invasion were associated with ipsilateral cervical metastasis. Advanced T stage, invasion to the base of tongue, and skip lesions were associated with decreased disease-free survival. Advanced T stage and skip lesions were associated with worse overall survival. CONCLUSIONS: Advanced T stage and soft palate invasion may predict a high risk of contralateral nodal metastasis. T stage and skip lesion are worse prognostic factors in TSCC and should be commented in pathology reports.

A Case of Primary Endobronchial Actinomycosis Presenting as a Complicated Parapneumonic Effusion

Endobronchial actinomycosis is a rare but important and challenging diagnosis to make. We report a case of 57 year-old man who presented with a fever and a right-sided chest pain diagnosed as an endobronchial actinomycosis. Chest computed tomography showed a segmental obstruction and consolidations in right middle lobe combined with an ipsilateral multiloculated pleural effusion. Bronchoscopic biopsy of a mass obstructing the medial segmental bronchus of right middle lobe revealed actinomycosis. This is the first reported case of primary endobronchial actinomycosis that presented with a chest pain and a complicated parapneumonic effusion. Primary endobronchial actinomycosis can be a cause of complicated parapneumonic effusion.

Ectopic Intrapulmonary Thyroid: A Case Report

An ectopic thyroid is caused by abnormalities in migration of the thyroid during development and rarely occurs in the thoracic cavity or the abdominal cavity. We report the case of a 64-year-old female who had abnormal findings from a thyroid hormone test during follow-up after thyroid cancer surgery. Based on the radioisotope diagnostic test, an ectopic thyroid inside the thoracic cavity was suspected. Through surgical treatment, the patient was diagnosed with ectopic intrapulmonary thyroid. Ectopic intrapulmonary thyroid is reported to be very rare and the case is described along with a literature review.

Ectopic Intrapulmonary Thyroid: A Case Report

An ectopic thyroid is caused by abnormalities in migration of the thyroid during development and rarely occurs in the thoracic cavity or the abdominal cavity. We report the case of a 64-year-old female who had abnormal findings from a thyroid hormone test during follow-up after thyroid cancer surgery. Based on the radioisotope diagnostic test, an ectopic thyroid inside the thoracic cavity was suspected. Through surgical treatment, the patient was diagnosed with ectopic intrapulmonary thyroid. Ectopic intrapulmonary thyroid is reported to be very rare and the case is described along with a literature review.