Purpose: This study aims to identify risk factors for falls or fractures in patients with stroke. Methods: In this secondary data analysis study, data were extracted from the 2020 patient sample dataset provided by the Health Insurance Review and Assessment Service (HIRA). The independent variables were categorized into 4 characteristics: 3 general characteristics, 13 diagnostic characteristics, 8 medication characteristics, and 5 treatment characteristics. The data were analyzed using SAS for Windows version 9.4 software. The frequencies of the independent variables were examined, and x 2 tests were conducted to determine whether there were significant differences between falls or fractures and the independent variables. To identify the risk factors for falls or fractures, Cox proportional hazards regression analysis was performed to determine hazard ratios. Results: Among 13,629 patients with stroke, 925 (6.78%) experienced falls or fractures. Eight risk factors for falls or fractures in patients with stroke were identified: elderly patients aged 75 years and above, degenerative arthritis, osteoporosis, opioid medication, antidepressant medication, fluid treatment, a history of surgery, and no specialized rehabilitation therapy Conclusion It is necessary to develop fall prevention education programs based on the identified eight risk factors, and to conduct studies to validate their effectiveness.

Objectives: The benefits of physical activity (PA) for breast cancer (BC) patients and survivors are well documented. With the widespread use of the internet and mobile phones, along with the recent coronavirus disease 2019 pandemic, there has been a growing interest in digital health interventions. This study conducted a systematic review and meta-analysis to evaluate the effects of digital PA interventions for BC patients and survivors in improving PA and quality of life (QoL). Methods: We searched eight databases, including PubMed, CINAHL, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials in the Cochrane Library, RISS, and DBpia. Studies were included if they provided digital PA interventions, assessed PA and QoL among BC patients and survivors, and were published from inception to December 31, 2022. Results: In total, 18 studies were identified. The meta-analysis showed significant improvement in the total PA duration (five studies; standardized mean difference [SMD] = 0.71; 95% confidence interval [CI], 0.25–1.18; I2 = 86.64%), functional capacity (three studies; SMD = 0.38; 95% CI, 0.10–0.66; I2 = 14.36%), and QoL (nine studies; SMD = 0.45; 95% CI, 0.22–0.69; I2 = 65.55%). Conclusions Digital PA interventions for BC patients and survivors may significantly improve PA, functional capacity, and QoL. Future research should focus on the long-term effects of digital PA interventions, using objective outcome measures.

BACKGROUND: Various cell-culture systems have been used to evaluate drug toxicity in vitro. However, factors that affect cytotoxicity outcomes in drug toxicity evaluation systems remain elusive. In this study, we used multilayered sheets of cardiac-mimetic cells, which were reprogrammed from human fibroblasts, to investigate the effects of the layer number on drug cytotoxicity outcomes. METHODS: Cell sheets of cardiac-mimetic cells were fabricated by reprogramming of human fibroblasts into cardiacmimetic cells via coculture with cardiac cells and electric stimulation, as previously described. Double-layered cell sheets were prepared by stacking the cell sheets. The mono- and double-layered cell sheets were treated with 5-fluorouracil (5-FU), an anticancer drug, in vitro. Subsequently, apoptosis and lipid peroxidation were analyzed. Furthermore, effects of cardiacmimetic cell density on cytotoxicity outcomes were evaluated by culturing cells in monolayer at various cell densities. RESULTS: The double-layered cell sheets exhibited lower cytotoxicity in terms of apoptosis and lipid peroxidation than the mono-layered sheets at the same 5-FU dose. In addition, the double-layered cell sheets showed better preservation of mitochondrial function and plasma membrane integrity than the monolayer sheets. The lower cytotoxicity outcomes in the double-layered cell sheets may be due to the higher intercellular interactions, as the cytotoxicity of 5-FU decreased with cell density in monolayer cultures of cardiac-mimetic cells. CONCLUSION The layer number of cardiac-mimetic cell sheets affects drug cytotoxicity outcomes in drug toxicity tests.The in vitro. cellular configuration that more closely mimics the in vivo configuration in the evaluation systems seems to exhibit lower cytotoxicity in response to drug.

BACKGROUND: Various cell-culture systems have been used to evaluate drug toxicity in vitro. However, factors that affect cytotoxicity outcomes in drug toxicity evaluation systems remain elusive. In this study, we used multilayered sheets of cardiac-mimetic cells, which were reprogrammed from human fibroblasts, to investigate the effects of the layer number on drug cytotoxicity outcomes. METHODS: Cell sheets of cardiac-mimetic cells were fabricated by reprogramming of human fibroblasts into cardiacmimetic cells via coculture with cardiac cells and electric stimulation, as previously described. Double-layered cell sheets were prepared by stacking the cell sheets. The mono- and double-layered cell sheets were treated with 5-fluorouracil (5-FU), an anticancer drug, in vitro. Subsequently, apoptosis and lipid peroxidation were analyzed. Furthermore, effects of cardiacmimetic cell density on cytotoxicity outcomes were evaluated by culturing cells in monolayer at various cell densities. RESULTS: The double-layered cell sheets exhibited lower cytotoxicity in terms of apoptosis and lipid peroxidation than the mono-layered sheets at the same 5-FU dose. In addition, the double-layered cell sheets showed better preservation of mitochondrial function and plasma membrane integrity than the monolayer sheets. The lower cytotoxicity outcomes in the double-layered cell sheets may be due to the higher intercellular interactions, as the cytotoxicity of 5-FU decreased with cell density in monolayer cultures of cardiac-mimetic cells. CONCLUSION The layer number of cardiac-mimetic cell sheets affects drug cytotoxicity outcomes in drug toxicity tests.The in vitro. cellular configuration that more closely mimics the in vivo configuration in the evaluation systems seems to exhibit lower cytotoxicity in response to drug.

OBJECTIVES: The purpose of this study was to use decision tree analysis to explore the factors associated with pressure ulcers (PUs) among elderly people admitted to Korean long-term care facilities. METHODS: The data were extracted from the 2014 National Inpatient Sample (NIS)—data of Health Insurance Review and Assessment Service (HIRA). A MapReduce-based program was implemented to join and filter 5 tables of the NIS. The outcome predicted by the decision tree model was the prevalence of PUs as defined by the Korean Standard Classification of Disease-7 (KCD-7; code L89*). Using R 3.3.1, a decision tree was generated with the finalized 15,856 cases and 830 variables. RESULTS: The decision tree displayed 15 subgroups with 8 variables showing 0.804 accuracy, 0.820 sensitivity, and 0.787 specificity. The most significant primary predictor of PUs was length of stay less than 0.5 day. Other predictors were the presence of an infectious wound dressing, followed by having diagnoses numbering less than 3.5 and the presence of a simple dressing. Among diagnoses, “injuries to the hip and thigh” was the top predictor ranking 5th overall. Total hospital cost exceeding 2,200,000 Korean won (US $2,000) rounded out the top 7. CONCLUSIONS: These results support previous studies that showed length of stay, comorbidity, and total hospital cost were associated with PUs. Moreover, wound dressings were commonly used to treat PUs. They also show that machine learning, such as a decision tree, could effectively predict PUs using big data.
Aged ; Bandages ; Classification ; Comorbidity ; Data Mining ; Decision Trees* ; Diagnosis ; Hip ; Hospital Costs ; Humans ; Inpatients ; Insurance, Health ; Length of Stay ; Long-Term Care* ; Machine Learning ; Pressure Ulcer* ; Prevalence ; Risk Factors* ; Sensitivity and Specificity ; Suppuration ; Wounds and Injuries

PURPOSE: This study aimed to identify research trends in the Journal of Korean Academy of Nursing Administration from 2013 to 2015. METHODS: For this study, 171 articles were analyzed. Research designs, participants, research settings, sampling, and data analyses methods were reviewed using established analysis criteria. Keyword centrality and clusters were generated by keyword network analysis. RESULTS: Most of studies used quantitative methods (82.5%), and sampling mainly focused on nurses (68.8%). The most commonly used data analyses methods were t-test, ANOVA, correlation, and regression. The most central keywords were turnover and empowerment. Network analysis generated four network groups: 1) burnout; 2) turnover; 3) happiness; and 4) nursing professionalism. CONCLUSION: The results of this study identify current trends and interests in Korean nursing administration research. The findings from this study suggest that future studies include a variety of research methods and maintain appropriate research ethics.
Ethics, Research ; Happiness ; Nursing Administration Research ; Nursing Research ; Nursing* ; Power (Psychology) ; Professionalism ; Research Design ; Statistics as Topic

PURPOSE: The purpose of this study was to identify the effects of nursing professionalism, satisfaction with major, and self-leadership on nursing student career preparation behavior. METHODS: Data were collected from August 1 to August 31, 2014. Participants were 400 students who completed self-report questionnaires covering career preparation behavior, nursing professionalism, satisfaction with major and self-leadership. The SPSS/WIN/PC 21.0 program was used for descriptive statistics, t-test, ANOVA, Pearson correlational coefficients and stepwise multiple regression. RESULTS: The average scores for career preparation behavior, nursing professionalism, satisfaction with major, and self-leadership were 2.51, 3.80, 3,89, and 3.51 respectively. There were positive correlations among career preparation behavior, nursing professionalism, satisfaction with major, and self-leadership. Age, academic year, nursing professionalism, self-leadership, general satisfaction in satisfaction with major were significant predictors of career preparation behavior. CONCLUSION: It is necessary to provide career educational programs considering according to the academic year of nursing students and to develop educational programs to improve the nursing professionalism of nursing students.
Humans ; Nursing* ; Professionalism ; Students, Nursing*

OBJECTIVES: The purpose of this study was to explore the use of mobile applications about pregnancy, birth, and child care among pregnant women and to review the characteristics, contents, and credibility of the applications used by these women. METHODS: This study was cross-sectional and was conducted using a survey method. One hundred and ninety-three pregnant women participated in this study. The questionnaire was developed to examine the pattern and reasons for pregnancy-related application usage. The 47 mobile apps used by participants were reviewed and categorized based on functions and developers. The credibility of the information provided by the mobile applications was evaluated using a structured measurement. RESULTS: Fifty-five percent of the participants were using mobile apps related to pregnancy, birth, and/or child care. First-time mothers used the apps significantly more often than women who were pregnant for the second time. Women who had used a smartphone for a longer period of time were more likely to use apps related to pregnancy, birth, and/or child care. The most frequently-used information concerned signs of risk and disease during pregnancy. Experts' quick opinions and Q&A formats related to diet and medication administration during pregnancy were the women's most cited need for content in applications. Information was the most common function of the apps. In the evaluation of information credibility, the 'information source' category had the lowest score. CONCLUSIONS: The results showed that applications related to pregnancy, birth, and child care have become an important information source for pregnant women. To fulfill the needs of users, credible applications related to pregnancy, birth, and child care should be developed and managed by qualified healthcare professionals.
Child Care* ; Child* ; Delivery of Health Care ; Diet ; Female ; Humans ; Mobile Applications* ; Mothers ; Parturition* ; Pregnancy* ; Pregnant Women ; Surveys and Questionnaires

Vitamin D (vit-D) is essential for bone health, although many osteoporosis patients have low levels of 25-hydroxy-vit-D [25(OH)D]. This randomized, open-label study compared the effects of once weekly alendronate 70 mg containing 5600 IU vit-D3 (ALN/D5600) to alendronate 70 mg without additional vit-D (ALN) on the percent of patients with vit-D insufficiency [25(OH)D <15 ng/mL, primary endpoint] and serum parathyroid hormone (PTH, secondary endpoint) levels in postmenopausal, osteoporotic Korean women. Neuromuscular function was also measured. A total of 268 subjects were randomized. Overall, 35% of patients had vit-D insufficiency at baseline. After 16-weeks, there were fewer patients with vit-D insufficiency in the ALN/D5600 group (1.47%) than in the ALN group (41.67%) (p<0.001). Patients receiving ALN/D5600 compared with ALN were at a significantly decreased risk of vit-D insufficiency [odds ratio=0.02, 95% confidence interval (CI) 0.00-0.08]. In the ALN/D5600 group, significant increases in serum 25(OH)D were observed at weeks 8 (9.60 ng/mL) and 16 (11.41 ng/mL), where as a significant decrease was recorded in the ALN group at week 16 (-1.61 ng/mL). By multiple regression analysis, major determinants of increases in serum 25(OH)D were ALN/D5600 administration, seasonal variation, and baseline 25(OH)D. The least squares mean percent change from baseline in serum PTH in the ALN/D5600 group (8.17%) was lower than that in the ALN group (29.98%) (p=0.0091). There was no significant difference between treatment groups in neuromuscular function. Overall safety was similar between groups. In conclusion, the administration of 5600 IU vit-D in the ALN/D5600 group improved vit-D status and reduced the magnitude of PTH increase without significant side-effects after 16 weeks in Korean osteoporotic patients.
Adult ; Aged ; Alendronate/adverse effects/*therapeutic use ; Cholecalciferol/adverse effects/deficiency/*therapeutic use ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal/*drug therapy ; Vitamin D Deficiency/*drug therapy

PURPOSE: The study assessed whether nurse staffing was associated with 3 nursing sensitive outcomes used in intensive care unit (ICU) nursing care plans. METHOD: This study was a retrospective and descriptive study using clinical data extracted from the data warehouse of a large acute care hospital in the Midwest. One-way analysis of variance was used to analyze the records of 578 ICU patients admitted from March 25 to May 31, 2010. RESULTS: 79 Nursing Outcomes Classification (NOC) outcomes were used in the nursing care plans. The 3 most commonly used NOC outcomes (Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes) were analyzed to determine their relationship to nurse staffing. As a nurse staffing ratio, the skill mix of nursing caregivers ranged from 0.74 to 1 with an average of 0.90. This skill mix of nursing caregivers significantly differed among the changes in Infection Severity scores. However, the mean difference was only 0.02. CONCLUSION: The results did not support that greater nurse staffing was associated with better outcomes. More research is still needed to determine the usefulness of Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes in evaluating the impact of nurse staffing.
Caregivers ; Humans ; Intensive Care Units ; Mucous Membrane ; Nursing Care ; Nursing Staff ; Patient Care Planning ; Retrospective Studies ; Skin