Purpose: The purpose of this study is to determine the effect of group education reflecting unmet needs led by Nurse Practitioners (NPs) on essential knowledge regarding chemotherapy for cancer patients and their families undergoing chemotherapy. Methods: Conducted at a tertiary general hospital in Seoul from December 30, 2020, to April 30, 2022, this study, which is based on a one group pre-post design, involved 104 cancer patients and their families. It assessed differences in knowledge regarding chemotherapy and satisfaction levels by means of participation through video-based group education led by NPs. The data were analyzed with SAS version 9.4 using paired t-tests and multiple logistic regression analysis. Results: The average score of knowledge regarding chemotherapy increased from 80.0 to 89.8 (p<.001). In multivariable logistic regression analysis, being less than 50 years old (adjusted Odds Ratio [aOR]=13.56, 95% Confidence Interval [CI]: 1.76~10.20) and having a college degree or higher (aOR=3.99, 95% CI: 1.15~13.82) were associated with an increase in knowledge regarding chemotherapy. Satisfaction with participation in the group education program was also reported to be high. Conclusion This study aimed to develop and implement a group education program for cancer patients and their families undergoing chemotherapy, assess changes in knowledge levels, and investigate satisfaction with the program. As a result of the study, the average score of patients who received the group education program increased; thus, it is an effective method for improving the degree of knowledge about the daily life of cancer patients and the management of side effects.

Purpose: The female sex is reported to have a higher risk of adverse events (AEs) from cytotoxic chemotherapy. Few studies examined the sex differences in AEs and their impact on the use of medical services during adjuvant chemotherapy. This sub-study aimed to compare the incidence of any grade and grade ≥ 3 AEs, healthcare utilization, chemotherapy completion rate, and dose intensity according to sex. Materials and Methods: This is a sub-study of a multicenter cohort conducted in Korea that evaluated the impact of healthcare reimbursement on AE evaluation in patients who received adjuvant chemotherapy between September 2013 and December 2016 at four hospitals in Korea. Results: A total of 1,170 patients with colorectal, gastric, or non–small cell lung cancer were included in the study. Female patients were younger, had fewer comorbidities, and experienced less postoperative weight loss of > 10%. Females had significantly higher rates of any grade AEs including nausea, abdominal pain, stomatitis, vomiting, and neutropenia, and experienced more grade ≥ 3 neutropenia, nausea, and vomiting. The dose intensity of chemotherapy was significantly lower in females, and they also experienced more frequent dose reduction after the first cycle. Moreover, female patients receiving platinum-containing regimens had significantly higher rates of unscheduled outpatient visits. Conclusion Our study found that females experienced a higher incidence of multiple any-grade AEs and severe neutropenia, nausea, and vomiting, across various cancer types, leading to more frequent dose reductions. Physicians should be aware of sex differences in AEs for chemotherapy decisions.

During the coronavirus disease 2019 (COVID-19) pandemic, conclusively evaluating possible associations between COVID-19 vaccines and potential adverse events was of critical importance. The National Academy of Medicine of Korea established the COVID-19 Vaccine Safety Research Center (CoVaSC) with support from the Korea Disease Control and Prevention Agency to investigate the scientific relationship between COVID-19 vaccines and suspected adverse events. Although determining whether the COVID-19 vaccine was responsible for any suspected adverse event necessitated a systematic approach, traditional causal inference theories, such as Hill's criteria, encountered certain limitations and criticisms. To facilitate a systematic and evidence-based evaluation, the United States Institute of Medicine, at the request of the Centers for Disease Control and Prevention, offered a detailed causality assessment framework in 2012, which was updated in the recent report by the National Academies of Sciences, Engineering, and Medicine (NASEM) in 2024.This framework, based on a weight-of-evidence approach, allows the independent evaluation of both epidemiological and mechanistic evidence, culminating in a comprehensive conclusion about causality. Epidemiological evidence derived from population studies is categorized into four levels—high, moderate, limited, or insufficient—while mechanistic evidence, primarily from biological and clinical studies in animals and individuals, is classified as strong, intermediate, weak, or lacking. The committee then synthesizes these two types of evidence to draw a conclusion about the causal relationship, which can be described as “convincingly supports” (“evidence established” in the 2024 NASEM report), “favors acceptance,” “favors rejection,” or “inadequate to accept or reject.” The CoVaSC has established an independent committee to conduct causality assessments using the weightof-evidence framework, specifically for evaluating the causality of adverse events associated with COVID-19 vaccines. The aim of this study is to provide an overview of the weight-ofevidence framework and to detail the considerations involved in its practical application in the CoVaSC.

A seven-month pregnant four-year-old Thoroughbred mare with colic weighing 600 kg was referred to the Jeju National University Equine Hospital. A physical examination and ultrasound suggested epiploic foramen entrapment. The patient underwent ileum resection and end-to-side jejunocecostomy. After surgery, the horse showed a consistent pain when introduced to feeding. A repeat laparotomy was performed to enlarge the stoma size with side-to-side jejunocecostomy. The repeat laparotomy was successful, and the mare gave birth uneventfully. This report describes a case of small intestinal epiploic foramen entrapment and the clinical outcomes of the 2 consecutive laparotomies a Thoroughbred mare in late gestation.

Purpose: Human papillomavirus (HPV) is one of the most common sexually transmitted infections affecting both males and females but there is an apparent lack of knowledge and apprehension towards male HPV vaccination South Korea. The purpose of the present study was to examine the associations between knowledge and perceptions of male HPV vaccination and vaccination intent among Korean mothers of adolescent sons. Materials and Methods: We conducted a cross-sectional study using a nationwide online survey. The independent variables were mothers’ sociodemographic characteristics, history of HPV diagnosis, general HPV knowledge, HPV vaccine knowledge, and attitudes and beliefs towards male HPV vaccination. The outcome variable was mothers’ intent to vaccinate their sons, which was classified into three categories: non-intent, undecided and intend to vaccinate. We performed univariate analysis and multinomial logistic regression analysis. Results: A total of 906 eligible mothers completed the survey. Mothers received low scores on the HPV-related knowledge scales with low ratings on the scale measuring perceived risk of HPV. Approximately 10% of the mothers intended to vaccinate their sons against HPV, 61.0% were undecided and 1.5% already had their sons vaccinated. According to the multinominal logistic regression analysis, having a daughter in the family, mothers’ previous diagnosis with HPV, general HPV knowledge, influence, harm, and risk were significantly associated with being undecided and having intentions to vaccinate their sons (p<0.05). Conclusions Our study revealed that Korean mothers are generally less aware of male HPV vaccination, have low perceived risk of HPV, and remain highly hesitant on vaccinating their sons against HPV. It is therefore important to raise public awareness about male HPV vaccination and alleviate vaccine hesitancy. Such efforts will contribute to improving parents’ vaccination intent, increasing vaccine uptake among male adolescents and prevention of HPV-associated diseases.

We explored the annual risks of mild and severe preeclampsia (PE) among nulliparous women. Using the National Health Information Database of South Korea, 1,317,944 nulliparous women who gave live births were identified. Mild PE increased from 0.9% in 2010 to 1.4% in 2019 (P for trend=0.006), while severe PE decreased from 0.4% in 2010 to 0.3% in 2019 (P=0.049). The incidence of all types of PE (mild and severe) showed no linear change (P=0.514). Adjusted odds ratio (OR) of severe PE decreased in 2013 (0.68; 95% confidence interval [CI]: 0.60, 0.77) and beyond compared to that in 2010, while the OR of mild PE increased in 2017 (1.14; 95% CI: 1.06, 1.22) and beyond. Mild PE was found to be less likely to progress to the severe form since 2010; however, the overall risk of PE among women did not change.

Purpose: This study aimed to confirm the decision-making patterns for life-sustaining treatment (LST) and analyze medical service utilization changes after enforcement of the Life-Sustaining Treatment Decision-Making Act. Materials and Methods: Of 1,237 patients who completed legal forms for life-sustaining treatment (hereafter called the LST form) at three academic hospitals and died at the same institutions, 1,018 cancer patients were included. Medical service utilization and costs were analyzed using claims data. Results: The median time to death from completion of the LST form was three days (range, 0 to 248 days). Of these, 517 people died within two days of completing the document, and 36.1% of all patients prepared the LST form themselves. The frequency of use of the intensive care unit, continuous renal replacement therapy, and mechanical ventilation was significantly higher when the families filled out the form without knowing the patient’s intention. In the top 10% of the medical expense groups, the decision-makers for LST were family members rather than patients (28% patients vs. 32% family members who knew and 40% family members who did not know the patient’s intention). Conclusion The cancer patient’s own decision-making rather than the family’s decision was associated with earlier decision-making, less use of some critical treatments (except chemotherapy) and expensive evaluations, and a trend toward lower medical costs.

Background: The equine temporomandibular joint (TMJ) has a complex anatomical structure that makes diagnosis of TMJ disorders difficult. Computed tomography (CT) is now available in equine medicine; hence, TMJ evaluation has become more convenient. Objectives: The objectives of this study were to describe the CT features of the TMJ in Jeju horses and to compare these features with those of Thoroughbreds. Methods: In this report, the TMJs of 10 Jeju horses (mean age: 4.5 ± 1.9 yr; mean body weight: 282.6 ± 40.3 kg) and 6 Thoroughbreds (mean age: 7.3 ± 1.6 yr; mean body weight: 479.7 ± 44.0 kg) were examined using CT. After CT scanning, the Hounsfield units (HU) and height to width ratio (H:W) of the mandibular condyle were measured. Results: The mean H:W in Jeju horses was significantly lower than that in Thoroughbreds.The mean HU in Jeju horses was lower than that in Thoroughbreds; however, the difference was not significant. The most frequent CT finding was an irregular medial margin of the mandibular condyle in both breeds. Conclusions In this study, the shape of the mandibular condyle in Jeju horses was flatter than that in Thoroughbreds. This report could be useful in evaluating the TMJ in Jeju horses. Moreover, CT could be a pragmatic choice for the examination of the TMJ in horses.

Purpose: Nurses’ burnout is at risk due to increased of respiratory infections and their high demand and expectations. This study aimed to identify the factors that influence burnout among nurses caring for patients with respiratory infections. Methods: A total of 196 nurses caring for patients with respiratory infections from nine hospitals in Korea participated in this study. Data were collected through a structured, self-administered survey that included general characteristics, risk perception of respiratory infections, infection control fatigue, positive psychological capital, and burnout. Results: Burnout was significantly positively correlated with infection control fatigue and significantly negatively correlated with positive psychological capital; burnout was not significantly related to risk perception of respiratory infections. Infection control fatigue, positive psychological capital and total career significantly influenced burnout. These variables accounted for 38% of the burnout among nurses caring for patients with respiratory infections. Conclusion Evidence-based guidelines are needed to support the ability of nurses with little experience in responding to infectious diseases and reducing infection control fatigue and providing effective educational programs at institutions that can improve the positive psychological capital of individual nurses.