Purpose: This study explored current pediatric palliative care (PPC) in South Korea and suggests future directions based on the perspectives of full-time PPC workers. Methods: A mixed-methods secondary analysis was conducted using survey data from nurses and social workers involved in a government PPC project. The survey assessed services provided by hospitals, nurses, and social workers, and gathered perceptions of challenging tasks, evidence needs, the significance of PPC, and future expectations through open-ended questions. Data were analyzed using frequency and conventional content analyses. Results: Eighteen full-time workers from nine of the ten project hospitals participated. Eight hospitals provided pain and symptom management and all offered counseling and education for patients and parents. Only one provided respite care and legacy-making services. Bereavement care was offered in all hospitals primarily through individual counseling and there were also three self-help groups. Nurses have diverse roles including in practice, education, leadership, research, and consultation. Social workers address psychosocial and economic challenges, rehabilitation and social reintegration. The workers highlighted the challenges in end-of-life care and communication, stressing the need for protocols and further training.PPC was seen as meaningful by patients and families, as well as staff. Conclusion Despite significant progress in PPC in South Korea, quantitative capacity remains limited. Further qualitative improvements in policies, practices, human resource development, and healthcare training are essential. This study provides insights into current PPC practices and their limitations. The development of practical evidence to enhance employment stability warrants further investigation.

In a prehospital setting, the narrow therapeutic window of epinephrine necessitates its cautious administration to avoid anaphylaxis. In this case, a 46-year-old man presented severe anaphylactic symptoms. Following the standard protocol, the emergency medical technician (EMT) administered intramuscular epinephrine; however, symptoms persisted. Under the oversight of the emergency medical services (EMS) medical director, an additional intravenous bolus of epinephrine was administered, unfortunately leading to atrial fibrillation. This case underscores the potential risks of intravenous epinephrine, which is not typically recommended for anaphylaxis without continuous monitoring. Since 2019, Korea has initiated a pilot program to expand the EMT scope of practice, which gives them the authority to administer epinephrine for anaphylaxis. The ultimate decision regarding epinephrine use for anaphylaxis, emphasizing patient safety, rests with the EMS medical director. Proper training for EMTs, coupled with the EMS medical director’s comprehensive knowledge and meticulous protocol adherence, can ensure patient safety and optimal outcomes.

Purpose: This study aims to explore the trend of nursing education and major research themes in the Journal of Korean Academic Society of Nursing Education (JKASNE) over 30 years. Methods: A total of 1,026 articles, published in the JKASNE from 1995 to 2023, were analyzed using the Microsoft Excel program for descriptive statistics and NetMiner for a word cloud of Korean keywords. Results: Most research subjects were healthy people (n=841). Education-related research topics (n=619) were categorized into nine domains: educational methods, educational curriculum, study type and methods, knowledge level and contents, psychosocial variables related to knowledge and education, attitude, behavior, development and evaluation of educational programs, and effects of educational programs. Quantitative (n=835) and descriptive studies (n=497) were determined to be the most common research designs. Self-reported questionnaires were the most common method used in surveys (n=581) and experimental studies (n=153). Descriptive statistics, Pearson's correlation coefficient, and other statistical techniques were used. The keywords in the JKASNE reflected various aspects of nursing research. General terms related to nursing education, such as "nursing students," "nurses," and "nursing education," appeared with high frequency, while more specific terms and phrases reflecting educational competencies and characteristics, such as "self-efficacy," "clinical performance ability," and "communication knowledge," were also prominently featured. Conclusion The JKASNE has published mainly education-focused papers. Analyzing the full set of papers published in JKASNE and examining their characteristics is very meaningful and helpful for the future development of Korean nursing education.

In a prehospital setting, the narrow therapeutic window of epinephrine necessitates its cautious administration to avoid anaphylaxis. In this case, a 46-year-old man presented severe anaphylactic symptoms. Following the standard protocol, the emergency medical technician (EMT) administered intramuscular epinephrine; however, symptoms persisted. Under the oversight of the emergency medical services (EMS) medical director, an additional intravenous bolus of epinephrine was administered, unfortunately leading to atrial fibrillation. This case underscores the potential risks of intravenous epinephrine, which is not typically recommended for anaphylaxis without continuous monitoring. Since 2019, Korea has initiated a pilot program to expand the EMT scope of practice, which gives them the authority to administer epinephrine for anaphylaxis. The ultimate decision regarding epinephrine use for anaphylaxis, emphasizing patient safety, rests with the EMS medical director. Proper training for EMTs, coupled with the EMS medical director’s comprehensive knowledge and meticulous protocol adherence, can ensure patient safety and optimal outcomes.

Purpose: This study aims to explore the trend of nursing education and major research themes in the Journal of Korean Academic Society of Nursing Education (JKASNE) over 30 years. Methods: A total of 1,026 articles, published in the JKASNE from 1995 to 2023, were analyzed using the Microsoft Excel program for descriptive statistics and NetMiner for a word cloud of Korean keywords. Results: Most research subjects were healthy people (n=841). Education-related research topics (n=619) were categorized into nine domains: educational methods, educational curriculum, study type and methods, knowledge level and contents, psychosocial variables related to knowledge and education, attitude, behavior, development and evaluation of educational programs, and effects of educational programs. Quantitative (n=835) and descriptive studies (n=497) were determined to be the most common research designs. Self-reported questionnaires were the most common method used in surveys (n=581) and experimental studies (n=153). Descriptive statistics, Pearson's correlation coefficient, and other statistical techniques were used. The keywords in the JKASNE reflected various aspects of nursing research. General terms related to nursing education, such as "nursing students," "nurses," and "nursing education," appeared with high frequency, while more specific terms and phrases reflecting educational competencies and characteristics, such as "self-efficacy," "clinical performance ability," and "communication knowledge," were also prominently featured. Conclusion The JKASNE has published mainly education-focused papers. Analyzing the full set of papers published in JKASNE and examining their characteristics is very meaningful and helpful for the future development of Korean nursing education.

In a prehospital setting, the narrow therapeutic window of epinephrine necessitates its cautious administration to avoid anaphylaxis. In this case, a 46-year-old man presented severe anaphylactic symptoms. Following the standard protocol, the emergency medical technician (EMT) administered intramuscular epinephrine; however, symptoms persisted. Under the oversight of the emergency medical services (EMS) medical director, an additional intravenous bolus of epinephrine was administered, unfortunately leading to atrial fibrillation. This case underscores the potential risks of intravenous epinephrine, which is not typically recommended for anaphylaxis without continuous monitoring. Since 2019, Korea has initiated a pilot program to expand the EMT scope of practice, which gives them the authority to administer epinephrine for anaphylaxis. The ultimate decision regarding epinephrine use for anaphylaxis, emphasizing patient safety, rests with the EMS medical director. Proper training for EMTs, coupled with the EMS medical director’s comprehensive knowledge and meticulous protocol adherence, can ensure patient safety and optimal outcomes.

Purpose: This study aims to explore the trend of nursing education and major research themes in the Journal of Korean Academic Society of Nursing Education (JKASNE) over 30 years. Methods: A total of 1,026 articles, published in the JKASNE from 1995 to 2023, were analyzed using the Microsoft Excel program for descriptive statistics and NetMiner for a word cloud of Korean keywords. Results: Most research subjects were healthy people (n=841). Education-related research topics (n=619) were categorized into nine domains: educational methods, educational curriculum, study type and methods, knowledge level and contents, psychosocial variables related to knowledge and education, attitude, behavior, development and evaluation of educational programs, and effects of educational programs. Quantitative (n=835) and descriptive studies (n=497) were determined to be the most common research designs. Self-reported questionnaires were the most common method used in surveys (n=581) and experimental studies (n=153). Descriptive statistics, Pearson's correlation coefficient, and other statistical techniques were used. The keywords in the JKASNE reflected various aspects of nursing research. General terms related to nursing education, such as "nursing students," "nurses," and "nursing education," appeared with high frequency, while more specific terms and phrases reflecting educational competencies and characteristics, such as "self-efficacy," "clinical performance ability," and "communication knowledge," were also prominently featured. Conclusion The JKASNE has published mainly education-focused papers. Analyzing the full set of papers published in JKASNE and examining their characteristics is very meaningful and helpful for the future development of Korean nursing education.

Purpose: This study aimed to describe nurses’ perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through openended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: “children and adolescents,” “families,” “PPC management system,” and “community-based PPC.” Meanwhile, PPC barriers were divided into 3 categories: “healthcare delivery system,” “healthcare provider,” and “client.” The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion In this study, by using mixed-methods, items of nurses’ perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

An allergy skin test is used to diagnose certain allergies by identifying sensitized allergens. In other words, it is a test for patients who are already sensitized to certain allergens. Because of the prevailing perception that beta-lactam allergy can be dangerous and potentially lethal, the intradermal test has long been routinely performed before use to screen beta-lactam allergy in Korea. The prevalence of penicillin allergy is estimated to be 1% to 2%. However, only 14% of the subjects with perceived penicillin allergy is considered to have true penicillin allergy. Moreover, it is difficult to justify performing a skin test on subjects who are very unlikely to be sensitized to beta-lactam, such as those who never used beta-lactam or never experienced allergy after previous use of beta-lactam.Therefore, allergists recommend beta-lactam skin testing in those who have allergy after the use of beta-lactam. Nevertheless, many hospitals in Korea are conducting routine skin tests on patients regardless of a history of beta-lactam allergy, which are not clinically validated but consume considerable human and material resources. False-positive results can consequently result in inappropriate labeling of beta-lactam allergy, leading to the unnecessary restriction of medication prescriptions and the increase in medical expenses. Herein, the drug allergy working group affiliated with the Korean Academy of Asthma, Allergy, and Clinical Immunology announces an expert opinion on the preuse beta-lactam skin test for subjects without a history of beta-lactam allergy based on the objective evidence from the literature and clinical relevance.

Background: Post-transplant immunosuppression with calcineurin inhibitors (CNIs) is associated with kidney function impairment while mammalian target of rapamycin (mTOR) inhibitors, such as everolimus, can be used for its renal-sparing effects. In this study, we compared the efficacy and safety of everolimus with low dose tacrolimus (EVR+Low TAC) and conventional dose tacrolimus (TAC) in liver transplantation recipients. Methods: Medical records of recipients who received liver transplantation at Seoul National University Bundang Hospital from January 1st 2009 to December 31st 2018 were retrospectively reviewed. Cohort entry date was defined as the day everolimus was initiated and tacrolimus dosage was reduced. All patients were followed up for 1 year. Indicator of efficacy was the incidence of rejection and safety was evaluated by incidence of drug adverse events including renal function. Results: Among 118 patients, there were 40 patients (33.9%) in EVR+Low TAC group. Incidence of rejection, including both biopsy proven acute rejection and clinical rejection, was similar in two groups [7.5% (n=3) vs. 6.4% (n=5), p=1.000]. Renal dysfunction was less frequent in EVR+Low TAC [17.5% (n=7) vs. 35.9% (n=28), p=0.038]. However, incidence rates of dyslipidemia, oral ulcer were more frequent in EVR+Low TAC [45.0% (n=18) vs. 21.8% (n=17), p=0.009; 15.0% (n=6) vs. 1.3% (n=1), p=0.006]. Conclusions In terms of prevention of rejection, EVR+Low TAC was as effective as TAC and had renal-sparing effect but was associated with increased risk of dyslipidemia and oral ulcer. This study demonstrates that EVR+Low TAC could be an alternative to liver transplant recipients with nephrotoxicity after administration of conventional dose tacrolimus.