PURPOSE: The purpose of this study is to examine the level of understanding of hospice palliative care (HPC) and shared decision making (SDM) among middle-aged adults. METHODS: Data were collected from 90 middle-aged adults living in D city using a self-reported questionnaire. The SPSS program was used to analyze the data. RESULTS: Among the participants, 76.7% were aware of the HPC while 82.2% of the participants were not aware of SDM. Among all, 85.6% responded positively for needs of HPC, and 77.8% of participants for SDM. Participants with Christian faith (Protestants and Catholics), high income level and present illness were better aware of HPC than others. The most needed services were nursing care and treatment along with systematic counseling and explanation provided by the medical staff. There was also a significant relationship between the HPC factors, gender, income, current health status and current illness status. Participants with high income level were well aware of SDM. Stronger SDM needs were observed among participants with professional jobs or current illness. CONCLUSION: For continued discussion on HPC and SDM, it is necessary to implement and promote various education programs for medical staff and the public.
Adult* ; Counseling ; Decision Making* ; Education ; Health Services Needs and Demand ; Hospice Care ; Hospices* ; Humans ; Medical Staff ; Middle Aged ; Nursing Care ; Palliative Care*

OBJECTIVES: Patients with schizophrenia often present idea of reference in social situations, but there has been a limitation in quantitatively measuring their reactions to the social stimuli. The aim of this study was to investigate behavioral characteristics of patients with schizophrenia in social situations in which idea of reference can be provoked. METHODS: Forty subjects with schizophrenia (21 males) and 26 healthy volunteers (17 males) performed the idea-of-reference-provoking task, which was composed of movie clips with scenes of two women sitting on a bench of 1 or 5 m away. The conditions consisted of "referential conversation", "non-referential conversation" or "no conversation". The reactions of the participants were rated by the questionnaires for self-referential perception, malevolent interpretation and anxiety reaction. RESULTS: There were significant group differences in the reactions on self-referential perception, malevolent interpretation and anxiety reaction. After the treatment, patients with schizophrenia showed improved scores of the reactions. In particular, score changes of malevolent interpretation and anxiety reaction in patients with schizophrenia were correlated with change of paranoia scale (rs=0.65, p<0.05 and rs =0.73, p<0.05, respectively). CONCLUSION: Patients with schizophrenia revealed self-referential bias and paranoid responses to social situations, which were improved after psychiatric treatment. Self-referential perceptions and paranoid responses may be state dependent rather than trait of schizophrenia.
Anxiety ; Bias (Epidemiology) ; Female ; Healthy Volunteers ; Humans ; Paranoid Disorders ; Surveys and Questionnaires ; Schizophrenia* ; Social Perception*

PURPOSE: Early sexual intercourse is associated with poor health outcomes in adolescents. It is known that sexual intercourse coincides with other health risk behaviors such as smoking, drinking, and using drugs. The purpose of this study is to identify the relationships between sexual intercourse and health risk behaviors among Korean and US adolescents using nationally representative data. METHODS: Data were collected from the 2011 Korea Youth Risk Behavior Web-based Survey (29,676 students) and 2011 Youth Risk Behavior Surveillance System (10,135 high school students). Logistic regression analysis was performed. RESULTS: In Korea, students who had sexual intercourse accounted for 7.0% in total. Among these, 9.7% were male and 4.2% were female students. In the US, a total of 51.3% students had sexual intercourse, and the proportion of the US male (49.3%) and female (53.4%) students who had sexual intercourse was similar. Korean and US students who experienced sexual intercourse were more likely to smoke, drink alcohol, and use drugs. CONCLUSION: Since the results of this study show the relationships between sexual intercourse and health risk behaviors, it is necessary to develop comprehensive sex education programs with effective strategies to reduce health risk behaviors in adolescents.
Adolescent* ; Coitus* ; Drinking ; Female ; Humans ; Korea ; Logistic Models ; Male ; Risk-Taking* ; Sex Education ; Sexual Behavior ; Smoke ; Smoking ; United States

Proximal humerus fractures are the third most common fractures, totaling 4% to 5% of all fractures. Here, we present the case of a 39-yearold man with a dislocated four-part fracture of the proximal humerus with a huge bony Bankart lesion. Preoperatively, the bony Bankart lesion of the glenoid was not visualized on computed tomography scans or magnetic resonance imaging because the fracture of the proximal humerus was comminuted, displaced, and complex. It was planned for only the humerus fracture to be treated by open reduction and internal fixation using a locking plate. However, a fractured fragment remained under the scapula after reduction of the dislocated humeral head. This was mistaken for a dislocated bone fragment of the greater tuberosity and repositioning was attempted. After failure, visual confirmation showed that the bone fragment was a piece of the glenoid. After reduction and fixation of this glenoid part with suture anchors, we acquired a well-reduced fluoroscopic image. Given this case of complex proximal humerus fracture, a glenoid fracture such as a bony Bankart lesion should be considered preoperatively and intraoperatively in such cases.

Background/Aims: The World Health Organization (WHO) aims to eliminate hepatitis C virus (HCV) by 2030; therefore, widespread HCV screening is required. The WHO recommends HCV self-testing (HCVST) as a new approach. We aimed to evaluate disease burden reduction using the HCVST screening strategy and identify the most cost-effective approach. Methods: We developed a dynamic open-cohort Markov model to assess the long-term effects and costeffectiveness of HCVST in the Republic of Korea from 2024 to 2030. Strategies for comparison included universal, birth cohort, high-risk group screening, and no screening, focusing on the following: (1) incremental costeffectiveness ratio (ICER) per disability-adjusted life-year (DALY) saved; (2) severe liver disease cases; and (3) liverrelated death reduction. Results: Universal HCVST screening is the most effective strategy for achieving the WHO goal by 2030, substantially lowering the incidence of severe liver disease by 71% and preventing liver-related deaths by 69%, thereby averting 267,942 DALYs. Moreover, with an ICER of US$8,078 per DALY and high cost-effectiveness, the sensitivity results prove that cost-effectiveness is robust. Although high-risk group screening offers the lowest cost compared with other strategies, its effectiveness in preventing severe liver disease is minimal, falling short of the current WHO goal. Conclusions Our study confirms that universal HCVST screening is a cost-effective strategy aligned with the WHO goal to eliminate HCV by 2030. Despite its higher costs compared to risk-based screening, the disease burden can be significantly reduced by providing effective HCVST access to individuals who might otherwise not be tested.

Imatinib mesylate (also known as Gleevec) is a selective tyrosine kinase inhibitor, primarily used for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors. Despite its effectiveness, the use of imatinib has been associated with various adverse skin reactions such as maculopapular rash, edema, and lichenoid or psoriasiform lesions. We report the case of a 71-year-old female presented with follicular hyperkeratotic papular eruption that affected her entire body. The lesions had developed 2 weeks ago. The patient had been diagnosed with a malignant gastrointestinal stromal tumor and had been receiving imatinib mesylate since 2013. Three weeks before the onset of the skin eruptions, the imatinib dosage was increased to 800 mg/d. Skin biopsies were performed on the chin and forearms. Based on the clinical and histopathological results, the patient was diagnosed with imatinib-induced keratosis pilaris. Following the discontinuation of imatinib and retinoid therapy, her skin condition markedly improved, and the lesions resolved within a few weeks. Herein, we report a case that highlights the association between imatinib mesylate and keratosis of the pilaris.

Background/Aims: The World Health Organization (WHO) aims to eliminate hepatitis C virus (HCV) by 2030; therefore, widespread HCV screening is required. The WHO recommends HCV self-testing (HCVST) as a new approach. We aimed to evaluate disease burden reduction using the HCVST screening strategy and identify the most cost-effective approach. Methods: We developed a dynamic open-cohort Markov model to assess the long-term effects and costeffectiveness of HCVST in the Republic of Korea from 2024 to 2030. Strategies for comparison included universal, birth cohort, high-risk group screening, and no screening, focusing on the following: (1) incremental costeffectiveness ratio (ICER) per disability-adjusted life-year (DALY) saved; (2) severe liver disease cases; and (3) liverrelated death reduction. Results: Universal HCVST screening is the most effective strategy for achieving the WHO goal by 2030, substantially lowering the incidence of severe liver disease by 71% and preventing liver-related deaths by 69%, thereby averting 267,942 DALYs. Moreover, with an ICER of US$8,078 per DALY and high cost-effectiveness, the sensitivity results prove that cost-effectiveness is robust. Although high-risk group screening offers the lowest cost compared with other strategies, its effectiveness in preventing severe liver disease is minimal, falling short of the current WHO goal. Conclusions Our study confirms that universal HCVST screening is a cost-effective strategy aligned with the WHO goal to eliminate HCV by 2030. Despite its higher costs compared to risk-based screening, the disease burden can be significantly reduced by providing effective HCVST access to individuals who might otherwise not be tested.

Imatinib mesylate (also known as Gleevec) is a selective tyrosine kinase inhibitor, primarily used for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors. Despite its effectiveness, the use of imatinib has been associated with various adverse skin reactions such as maculopapular rash, edema, and lichenoid or psoriasiform lesions. We report the case of a 71-year-old female presented with follicular hyperkeratotic papular eruption that affected her entire body. The lesions had developed 2 weeks ago. The patient had been diagnosed with a malignant gastrointestinal stromal tumor and had been receiving imatinib mesylate since 2013. Three weeks before the onset of the skin eruptions, the imatinib dosage was increased to 800 mg/d. Skin biopsies were performed on the chin and forearms. Based on the clinical and histopathological results, the patient was diagnosed with imatinib-induced keratosis pilaris. Following the discontinuation of imatinib and retinoid therapy, her skin condition markedly improved, and the lesions resolved within a few weeks. Herein, we report a case that highlights the association between imatinib mesylate and keratosis of the pilaris.