• Research in Community and Public Health Nursing
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• v.32 no.3
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• pp.356-367
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• 2021

Purpose: This study conducted an economic evaluation of hospital-based home care services for the patients who had undergone breast cancer surgery. Methods: A total of 12,483 patients over 18 years of age who had received breast cancer surgery in 26 tertiary hospitals in 2018 were analyzed with the claim data from the Health Insurance Review & Assessment Service using cost-minimization analysis and societal perspectives. Results: There were 156 patients who utilized hospital-based home care services within 30 days after breast cancer surgery, and they received 2.17 (SD=1.17) hospital-based home care service on average. The average total cost was 5,250,028 KRW (SD=1,905,428) for the group receiving continuous hospital-based home care and 6,113,402 KRW (SD=2,033,739) for the group not receiving continuous hospital-based home care (p<.001). The results of the economic evaluation of continuous hospital-based home care services in patients who had undergone breast cancer surgery indicated a total benefit of 953,691,000 KRW, a total cost of 819,004,000 KRW, and a benefit-cost ratio of 1.16 in 2018. Conclusion: Continuous hospital-based home care was considered economically feasible as the total costs for the group receiving continuous hospital-based home care were lower than those of the group not receiving continuous hospital-based home care. Therefore, policy modification and financial incentives are recommended to increase the utilization of hospital-based home care services for patients who had undergone breast cancer surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7277-7280
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• 2014

This analysis was conducted to evaluate the efficacy and safety of carboplatin based chemotherapy in treating pediatric patients with Wilms tumors. Methods: Clinical studies evaluating the efficacy and safety of carboplatin based regimens on response and safety for pediatric patients with Wilms tumors were identified using a predefined search strategy. Pooled response rates (RRs) of treatment were calculated. Results: In carboplatin based regimens, 4 clinical studies which including 127 patients with advanced Wilms tumors were considered eligible for inclusion. With this carboplatin based chemotherapy, 2 clinical studies included carboplatin, ifosfamide and etoposide. Systemic analysis suggested that, in all patients, the pooled PR was 64.5% (82/127) in carboplatin based regimens. Thrombocytopenia and leukocytopenia were the main side effects. No grade III or IV renal or liver toxicity was observed. No treatment related death occurred with carboplatin based treatment. Conclusion: This systemic analysis suggests that carboplatine based regimens are associated with a reasonable response rate and accepted toxicities for treating pediatric patients with Wilms tumors.

• The Korean Journal of Pain
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• v.30 no.4
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• pp.265-271
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• 2017

Background: Health care services effort to provide alternative cardiac rehabilitation (CR) models to serve patients according to their preferences and needs. So, the present study aimed to assess and compare the effects of hospital-based and hybrid CR programs on chest pain intensity and discomfort in cardiac surgery patients. Methods: In this prospective study, 110 cardiac surgery patients were invited to the CR department of a hospital in the western part of Iran between March and July 2016. Patients were divided into two groups: hospital-based and hybrid CR. The hospital-based program included 26 sessions, and the hybrid program included 10 training sessions and exercise. The Brief Pain Inventory and Pain Discomfort Scale were used as research instrument, and data were analyzed using the paired t-test and ANCOVA. Results: The results indicated that both hospital-based and hybrid CR are effective in reducing the chest pain intensity and discomfort of cardiac surgery patients (P < 0.05). In addition, the comparison of scores before and after treatment using ANCOVA shows that no significant differences were observed between the two programs (P > 0.05). Conclusions: Traditional hospital-based CR delivery is still the first choice for treatment in developing countries. However, hybrid CR is as effective as a hospital-based program in reducing pain components and it includes only 38% of the total cost in comparison to hospital-based delivery. So, we recommend using hybrid CR according with the recommendations of American Heart Association about using CR for the management of angina symptoms.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.29 no.1
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• pp.5-17
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• 2022

Purpose: This study aimed to investigate the role of hospital-based home health nursing in community care by examining the institutional progress of hospital-based home health nursing and the current status of home health nursing in Korea. Methods: Korean research data, national statistical data, government press releases, and related laws were investigated to clarify the role of hospital-based home health nursing in community care. Results: Korean visiting medical care services, including hospital-based home health nursing, was not found to be sufficient nationwide. The supply of home health nursing did not increase due to the nature of the visiting services that required transportation time, poor profitability due to insufficient insurance fees, and increase in acute beds. Conclusion: The nature of the Korean medical environment and visiting medical care makes it challenging to establish a visiting medical supply system for community care. Therefore, hospital-based home health nursing is an important infrastructure for visiting medical care, and will be a valuable resource to link discharged patients returning to the community when moving health care services. Hence, laws and institutional supplementation to expand the role of home health nursing agencies nationwide are needed along with addressing the limitations in the supply of home health nurses.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3395-3402
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• 2015

Background: Preoperative 5-fluorouracil (5-FU)-based chemoradiotherapy is a standard treatment for locally advanced colorectal cancer (CRC). However, CRC cells often develop chemoradiation resistance (CRR). Recent studies have shown that long non-coding RNA (lncRNA) plays critical roles in a myriad of biological processes and human diseases, as well as chemotherapy resistance. Since the roles of lncRNAs in 5-FU-based CRR in human CRC cells remain unknown, they were investigated in this study. Materials and Methods: A 5-FU-based concurrent CRR cell model was established using human CRC cell line HCT116. Microarray expression profiling of lncRNAs and mRNAs was undertaken in parental HCT116 and 5-FU-based CRR cell lines. Results: In total, 2,662 differentially expressed lncRNAs and 2,398 mRNAs were identified in 5-FU-based CRR HCT116 cells when compared with those in parental HCT116. Moreover, 6 lncRNAs and 6 mRNAs found to be differentially expressed were validated by quantitative real time PCR (qRT-PCR). Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis for the differentially expressed mRNAs indicated involvement of many, such as Jak-STAT, PI3K-Akt and NF-kappa B signaling pathways. To better understand the molecular basis of 5-FU-based CRR in CRC cells, correlated expression networks were constructed based on 8 intergenic lncRNAs and their nearby coding genes. Conclusions: Changes in lncRNA expression are involved in 5-FU-based CRR in CRC cells. These findings may provide novel insight for the prognosis and prediction of response to therapy in CRC patients.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.1
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• pp.14-25
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• 2018

Objectives: The aim of this study was to evaluate the effect of a school-based social skills training program on peer relationships in children and adolescents and to assess the plan for effective school-based mental health services. Methods: The Child and Adolescent Mental Health Promotion Team of Bugok National Hospital conducted 7-sessioned school-based social skills training for elementary and middle school students (n=90). Changes in peer relationships were evaluated before and after application of the program using a name generator question. Results: The social skills training program increased peer relations, indicating significant changes in social network indices. Conclusion: The social skills training program positively influenced peer relationships. The school-based social skills training program can be expected to have positive effects on school-based mental health services. Future investigation is needed to validate the long term effects of this program.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10769-10772
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• 2015

Purpose: This analysis was conducted to evaluate cardiovascular toxicity of commonly used anti-VEGF therapeutic agent, bevacizumab, in treating patients with cancer. Methods: Clinical studies evaluating the efficacy and safety of bevacizumab-based regimens on response and safety for patients with cancer were identified using a predefined search strategy, allowing cardiovascular toxicity and other side effects of treatment to be estimated. Results: In bevacizumab based regimens, 4 clinical studies including 282 patients with advanced cancer (including gliomas, cervical, breast and ovarian cancer) were considered eligible for inclusion. These bevacizumab-based regimens included docetaxel, irinitecan and carboplatin. Systematic analysis suggested that, of 282 patients treated by bevacizumab based regimens, hypertension and thrombo-embolism occurred in 2.5% (7/282), while only 3 patients reported cardiovascular events (1.1%). No treatment related death occurred in bevacizumab based treatment. Conclusion: This systemic analysis suggests that bevacizumab based regimens are associated with reasonable and accepted cardiovascular toxicity when treating patients with gliomas, cervical, breast and ovarian cancer.

• Korean Journal of Radiology
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• v.22 no.7
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• pp.1213-1224
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• 2021

Objective: To develop a machine learning (ML) pipeline based on radiomics to predict Coronavirus Disease 2019 (COVID-19) severity and the future deterioration to critical illness using CT and clinical variables. Materials and Methods: Clinical data were collected from 981 patients from a multi-institutional international cohort with real-time polymerase chain reaction-confirmed COVID-19. Radiomics features were extracted from chest CT of the patients. The data of the cohort were randomly divided into training, validation, and test sets using a 7:1:2 ratio. A ML pipeline consisting of a model to predict severity and time-to-event model to predict progression to critical illness were trained on radiomics features and clinical variables. The receiver operating characteristic area under the curve (ROC-AUC), concordance index (C-index), and time-dependent ROC-AUC were calculated to determine model performance, which was compared with consensus CT severity scores obtained by visual interpretation by radiologists. Results: Among 981 patients with confirmed COVID-19, 274 patients developed critical illness. Radiomics features and clinical variables resulted in the best performance for the prediction of disease severity with a highest test ROC-AUC of 0.76 compared with 0.70 (0.76 vs. 0.70, p = 0.023) for visual CT severity score and clinical variables. The progression prediction model achieved a test C-index of 0.868 when it was based on the combination of CT radiomics and clinical variables compared with 0.767 when based on CT radiomics features alone (p < 0.001), 0.847 when based on clinical variables alone (p = 0.110), and 0.860 when based on the combination of visual CT severity scores and clinical variables (p = 0.549). Furthermore, the model based on the combination of CT radiomics and clinical variables achieved time-dependent ROC-AUCs of 0.897, 0.933, and 0.927 for the prediction of progression risks at 3, 5 and 7 days, respectively. Conclusion: CT radiomics features combined with clinical variables were predictive of COVID-19 severity and progression to critical illness with fairly high accuracy.

• Journal of Korean Clinical Nursing Research
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• v.15 no.1
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• pp.133-147
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• 2009

Purpose: This study was conducted to construct evidence based clinical guidelines and to develop nursing process based performance measures for prevention and management of pressure ulcers, falls and pain. Method: Clinical guidelines were drafted through a comprehensive review of relevant literature, national guidelines and hospital protocols. The proposed guidelines were reviewed by a panel of experts and 90 hospital nurses, and refined on the basis of their suggestions. Nursing process based performance measures were developed based on the clinical guidelines and content validity was examined by surveys from 90 hospital nurses. Results: All items, except timetable for position change and pressure ulcer nursing record, in the guidelines for prevention and management of pressure ulcer were appropriate. Most items, except fall risk assessment tools, were appropriate for the guidelines of fall prevention. All other items, except the purpose of pain management, were appropriate for the guidelines of pain management. Performance measures developed in this study were acceptable as a tool to evaluate quality of nursing care. Conclusion: Nursing process based performance measures provide important indicators to monitor whether necessary nursing care is implemented and can be used as the primary resources to improve quality of nursing services.

• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.18-40
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• 2001

This study purports to investigate the readiness of the university hospital employees in the knowledge-based management. Data were collected from 550 employees including administrative, nursing, and technical staff of 9 university hospitals located in Seoul and Kyunggi Province through the self-administered questionnaires. The response rate was 79% and 425 questionnaires were used as final data and analyzed using 2 test, t-test, and ANOVA. The main findings of the study are as follows. 1) It seems that most employees of the study hospitals have basic knowledge on the concept of knowledge-based management. This finding implies that the implementation of the knowledge-based management in Korean university hospitals will not likely to face strong resistance from their employees. 2) The results show that Korean hospital employees are still not so accustomed to using e-mail as the main communication tool. This finding suggests that it is necessary to use various communication tools which include electronic data interchange, teleconference, and cyber chatting for facilitating the knowledge-based management in Korean university hospitals. 3) It is desirable to appoint a chief knowledge officer(CKO) for operating knowledge-based management system effectively. 4) A reward system for employees who show a distinguished performance in the creation and sharing of new knowledge should be established. Knowledge mileage system, selection of the best knowledge employee and team will be a good example of the effective reward system. 5) The participation and support from the chief executive officers (CEO) of the hospitals is an important factor for successful knowledge-based management. Furthermore, to make physicians actively participate in the knowledge-based management is another important factor for obtaining valuable outputs from the system. 6) It is found that the knowledge and skills of the hospitals employees on the information technology (IT) are not sufficient for making knowledge-based management more popular. This implies that it is very important to select IT-oriented employees and educate them continuously on the knowledge-based management.