Purpose: Advance care planning (ACP) is widely understood to improve end-of-life care.This systematic review and meta-analysis aimed to examine the effects of ACP interventions on decision conflict and psychological distress. Methods: A search of PubMed, CINAHL, CENTRAL, EMBASE, KISS, KoreaMed, and RISS was conducted in November 2020. The study included randomized controlled trials. Data were pooled using fixed- and randomeffects models. Results: Fourteen studies were identified that cumulatively included 1,548 participants. ACP interventions were effective in alleviating decision conflict (d=-0.53; 95% CI: -0.83 to -0.23), depression (d=-1.22; 95% CI: -1.71 to -0.74) and anxiety (d=-0.76; 95% CI: -1.12 to -0.39). Conclusion ACP interventions have significant positive effects on reducing decision conflict and psychological distress. A high level of bias was shown related to allocation concealment and blinding. The results of this study are expected to be useful for end-of-life care providers to improve the effectiveness of ACP interventions.

Purpose: Advance care planning (ACP) is widely understood to improve end-of-life care.This systematic review and meta-analysis aimed to examine the effects of ACP interventions on decision conflict and psychological distress. Methods: A search of PubMed, CINAHL, CENTRAL, EMBASE, KISS, KoreaMed, and RISS was conducted in November 2020. The study included randomized controlled trials. Data were pooled using fixed- and randomeffects models. Results: Fourteen studies were identified that cumulatively included 1,548 participants. ACP interventions were effective in alleviating decision conflict (d=-0.53; 95% CI: -0.83 to -0.23), depression (d=-1.22; 95% CI: -1.71 to -0.74) and anxiety (d=-0.76; 95% CI: -1.12 to -0.39). Conclusion ACP interventions have significant positive effects on reducing decision conflict and psychological distress. A high level of bias was shown related to allocation concealment and blinding. The results of this study are expected to be useful for end-of-life care providers to improve the effectiveness of ACP interventions.

PURPOSE: This study was conducted to evaluate the impact of a two-week palliative care education program on Korean Hospice volunteers. METHODS: A total of 71 volunteers were assigned to two groups: Group A (intervention, n=34) and Group B (usual care, n=37). Group A received six sessions of palliative care education for two weeks. The level of volunteers' motivation, death anxiety, and communication with the dying were measured at baseline and after the program ended. RESULTS: The palliative care education program had positive influence on the volunteers' motivation (t=2.341, P=0.022), death anxiety (t=−2.166, P=0.034), and communication with the dying (t=−2.808, P=0.006). CONCLUSION: The findings of this study suggest that a palliative care education program may be an effective way to boost hospice volunteers' motivation, ease their death anxiety and improve their communication with the dying.
Anxiety* ; Education* ; Hospices* ; Motivation* ; Palliative Care* ; Volunteers*

OBJECTIVES: This study was conducted to perform an effect size analysis of psychosocial interventions for internet addiction and to identify the intervention moderators applied to school-aged children. METHODS: For the meta-analysis, studies were included that were published in English or Korean until January 2015, without limitation in terms of the year. They were retrieved from 11 electronic databases and by manual searches according to predefined inclusion criteria. RESULTS: A total of 37 studies were selected, which included 11 treatment conditions and covered a total of 1,490 participants. The effect size estimates showed that psychosocial interventions had a large effect for reducing internet addiction (standardized mean difference [SMD], -1.19; 95% confidence interval [CI], -1.52 to -0.87) and improving self-control (SMD, 0.29; 95% CI, 0.11 to 0.47) and self-esteem (mean difference, 3.58; 95% CI, 2.03 to 5.12). The moderator analyses reveals that group treatments, a selective approach, a long duration, a community setting, or higher school grade had a larger effect. CONCLUSIONS: The findings of this review suggest that psychosocial intervention may be used to prevent Internet addiction in school-aged children, although further research should be conducted using a randomized controlled trial design or diverse age groups to provide evidence-based recommendations.
Behavior, Addictive ; Child ; Humans ; Internet* ; Self-Control*

PURPOSE: This study aimed to develop a "Palliative Care Professional" education program and evaluate its effects on the recognition of good death, palliative care, and the meaning of life for nurses. METHODS: It was developed based on the hospice care program for volunteers being used in the Hospice Palliative Care Research Center of S University in Seoul. It was also based on the studies which investigated the educational needs of nurses in palliative care. This program consisted of 5 sessions and 16 content items for 2 weeks. A non-equivalent control group non-synchronized design was utilized and participants were assigned to the experimental group (n=42) or the control group (n=44). RESULTS: The recognition of a good death (F=11.44, p=.001), palliative care (F=4.15, p=.045), and the meaning of life (F=5.12, p=.026) increased more significantly for participants in the experimental group than in the control group. Participants felt that they gained further knowledge in palliative patient management and refined their clinical practice. CONCLUSION: The results of the study indicate that this program could serve as a practical program for palliative care nursing in the nursing field and suggests that more attention should be directed to the diverse educational needs of nurses.
Adult ; Attitude to Death ; Female ; *Health Knowledge, Attitudes, Practice ; Humans ; Male ; Nursing Staff/*psychology ; *Palliative Care ; *Program Development ; *Program Evaluation ; Young Adult

PURPOSE: This study was conducted to examine the effects of a marital relationship enrichment program on communication, conflict resolution and marital satisfaction in multicultural couples. METHODS: A quasi-experimental study with a non-equivalent control group pre-post test design was used. Participants were sampled from couples registered at 2 local centers and 2 multicultural family support centers in Seoul and Gyeonggi Province. Sixteen pairs each were randomly assigned to the experimental or control group. The experimental group received the marital relationship enrichment program for 120 minutes/session/week for 6 weeks. Data were analyzed using chi2-test, Fisher's exact test, Mann-Whitney U test, and t-test for subject homogeneity verification, and ANCOVA to examine the hypotheses. RESULTS: Communication and marital satisfaction increased significantly after the program in experimental group compared with control group. Among conflict solution styles, collaborating and compromising increased and avoiding decreased significantly after the program in the experimental group. Competing decreased significantly after the program for wives in the experimental group. Accommodating did not change significantly in either experimental or control groups. CONCLUSION: Results of the study confirm that marital relationship enrichment programs are effective in promoting multicultural couples' communication and marital satisfaction, and causing positive changes in conflict resolution.
Evaluation Studies as Topic ; Family Characteristics ; Humans ; Marriage ; Negotiating ; Spouses

The Japanese encephalitis virus (JEV), a member of the Flaviviridae family and Flavivirus genus, is transmitted by mosquitoes. JEV, of which some 35,000 cases are recorded every year, is a positive RNA virus. Two types of JEV vaccines have been developed to prevent the onset of encephalitis in humans, namely formalin-inactivated and liveattenuated vaccines. JEV inactivated vaccines are usually made using the Nakayama-NIH or Beijing-1 strains of the JEV virus. In this study, the immunological response to the Nakayama-NIH and Beijing-1 strains was analyzed as part of the effort to compile basic data which could lead to the selection of a suitable vaccine strain. To this end, the virus titer of Beijing-1 was found to be two-fold higher than that of Nakayama-NIH by plaque assay. Moreover, Beijing-1-induced neutralizing antibodies showed a higher level of titers when confronted by Korean JEV isolates than Nakayama-NIH-induced neutralizing antibodies (1:320 vs. 1:160, respectively). However, as a minimum ratio of 1:10 neutralizing antibody titers are required to protect against JEV infection, both strains in effect exhibited a sufficient level of neutralizing antibody titers. What's more, Beijing-1 was found to induce a somewhat higher cytotoxic T lymphocyte (CTL) response than Nakayama-NIH. Taken together, this can be taken to mean that Beijing-1 may in fact be a more effective vaccine candidate strain when it comes to inducing a high level of protective immunity against JEV infection.
Antibodies, Neutralizing* ; Asian Continental Ancestry Group* ; Culicidae ; Encephalitis ; Encephalitis Virus, Japanese* ; Encephalitis, Japanese* ; Flaviviridae ; Flavivirus ; Humans ; Lymphocytes* ; RNA Viruses ; Vaccines ; Vaccines, Inactivated ; Viral Load

McCune-Albright syndrome (MAS) is a sporadic disease classically including polyostotic fibrous dysplasia, cafe -au-lait spots, sexual precocity, and other hyperfunctional endocrinopathies. Recent investigations suggest an etiological role for activating embryonic somatic missense mutations in the gene for the a subunit of Gs (Gsa), the G protein that stimulates adenylyl cyclase. DNA from bone, ovary, and blood was analyzed by using polymerase chain reaction and sequenced. A embryological somatic mutation of Gsa gene encoding substitution of a Cys for Arg at amino acid 201 from cells of dysplastic bone and ovary was observed, and the distribution of mutant gene reveals mosaic pattern. We report a case of McCune-Albright syndrome with an activating mutation at codon 201 of Gsa subunit on ovary and bone tissue that was experienced recently.
Adenylyl Cyclases ; Bone and Bones ; Codon ; DNA ; Female ; Fibrous Dysplasia, Polyostotic* ; GTP-Binding Proteins* ; Mutation, Missense ; Ovary ; Polymerase Chain Reaction

BACKGROUND/AIMS: Plasminogen activator inhibitor-1 (PAI-1) is important for tumor growth, Invasion, and metastasis. In this study, we investigated the relationship between plasma levels of PAI-1 and colorectal adenomas. METHODS: We reviewed the medical records of 3,136 subjects who underwent colonoscopy as a screening exam. The subjects were classified into a case group with adenomas (n=990) and a control group (n=2,146). Plasma PAI-1 levels were categorized into three groups based on tertile. RESULTS: The plasma levels of PAI-1 were significantly higher in adenoma cases than in controls (p=0.023). The prevalence of colorectal adenomas increased significantly with increasing levels of PAI-1 (p=0.038). In the adenoma group, advanced pathologic features, size, and number of adenomas did not differ among the three groups based on tertiles for plasma PAI-1 levels. Using multivariate analysis, we found that plasma level of PAI-1 was not associated with the risk of colorectal adenomas (p=0.675). Adjusted odds ratios for colorectal adenomas according to increasing plasma levels of PAI-1 were 0.980 (95% confidence interval [CI], 0.768 to 1.251) for the second-highest plasma level and 1.091 (95% CI, 0.898 to 1.326) for the highest level, compared with the lowest levels. CONCLUSIONS: These results suggest that elevated plasma PAI-1 levels are not associated with the risk of colorectal neoplasms.
Adenoma ; Colonoscopy ; Colorectal Neoplasms ; Mass Screening ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Odds Ratio ; Plasma ; Plasminogen ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Prevalence