Palliative care is a patient-centred, integrated approach for improving quality of life for both patients facing life-threatening illnesses and for their families. Although there has been increased ...interest in palliative care for non-cancer patients, the palliative care competency of nurses who care for non-cancer patients has rarely been investigated. This study described the palliative care knowledge, attitude, confidence, and educational needs in nurses who care for patients with congestive heart failure, stroke, end-stage renal disease, and end-stage liver disease; explored the relationships between those variables; and identified factors affecting nurses' palliative care confidence.
A cross-sectional, descriptive, correlational design was employed; data collection was conducted at a tertiary hospital in Seoul, Korea. Nurses who were working in general wards and intensive care units (N = 102) completed valid and reliable self-administered questionnaires. Descriptive statistics, frequencies, independent t-tests, one-way ANOVA, Pearson's correlations, and multiple regression were conducted to analyse the data.
Nurses' palliative care knowledge level was low (9.73 ± 2.10; range = 0-20) and their attitude toward palliative care was moderate (87.97 ± 6.93, range: 30-120). Knowledge was significantly correlated with attitude (r = .29, p = .003). Nurses were highly confident in pain and symptom management but demonstrated high educational needs for managing human and material resources to provide palliative care. Previous training in hospice, palliative, and EOL care was a significant and modifiable factor that affected nurses' confidence (std. β = 0.25, p = .010).
To facilitate high-quality palliative care for non-cancer patients and families, nursing education programs should be developed to address nurses' knowledge level, confidence level, and educational needs. This study provides relevant information that can be utilised to develop palliative care educational programs for nurses who care for non-cancer patients.
The regional and global scale of aerosols in the atmosphere can be quantified using the aerosol optical depth (AOD) retrieved from satellite observations. To obtain reliable satellite AODs, ...conducting consistent validations and refining retrieval algorithms are crucial. AODs and Ångström exponents (AEs) measured with the aerosol robotic network (AERONET) are considered as the ground truth for satellite validations. AERONET AEs are used to collocate the wavelength of the AERONET AODs to those of the satellite AODs when there is a discordancy in their wavelengths. However, numerous validation studies have proposed different strategies by applying the AERONET AODs and AEs, and spatiotemporal collocation criteria. This study examined the impact of the wavelength and spatial collocation radius variations by comparing AODs at 550 nm derived from the geostationary ocean color imager (GOCI) with those obtained from the AERONET for the year 2016. The estimated AERONET AODs at 550 nm varied from 5.18% to 11.73% depending on the selection of AOD and AE, and the spatial collocation radii from 0 to 40 km, respectively. The longer the collocation radius and the higher the AODs, the greater the variability observed in the validation results. Overall, the selection of the spatial collocation radius had a stronger impact on the variability in the validation results obtained compared to the selection of the wavelength. The variability was also found in seasonal analysis. Therefore, it is recommended to carefully select the data wavelength and spatial collocation radius, consider seasonal effects, and provide this information when validating satellite AODs using AERONET.
Abstract
Background
Non-cancer patients experience the chronic process of disease that increases the patients’ suffering as well as families’ care burden. Although two-thirds of deaths are caused by ...non-cancer diseases, there is a lack of studies on palliative care for non-cancer patients. This study identified the palliative care needs and satisfaction, anxiety and depression, and health-related quality of life (HRQOL) of non-cancer patients and identified the factors influencing their HRQOL.
Methods
A cross-sectional survey design was employed. Participants were 114 non-cancer patients with chronic heart failure, stroke, end-stage renal disease, or end-stage liver disease who were admitted to the general ward of a tertiary hospital in South Korea. Measures included the Palliative Care Needs and Satisfaction Scale, the Hospital Anxiety and Depression Scale, and the Medical Outcome Study 36-items Short Form Health Survey version 2. Data were analysed with descriptive statistics, independent
t
-tests, analyses of variance, Pearson’s correlations, and multiple linear regression analyses.
Results
The average score of palliative care needs was 3.66 ± 0.62, which falls between ‘moderate’ and ‘necessary’. Among the four domains, the average score of palliative care needs in the psychosocial domain was the highest: 3.83 ± 0.67. Anxiety was nearly in the normal range (7.48 ± 3.60; normal range = 0–7) but depression was higher than normal (9.17 ± 3.71; normal range = 0–7). Similar to patients with cancer, physical HRQOL (38.89 ± 8.69) and mental HRQOL (40.43 ± 11.19) were about 80% of the general population’s score (50 points). Duration of disease and physical performance were significant factors associated with physical HRQOL, whereas physical performance, anxiety, and depression were significant factors associated with mental HRQOL.
Conclusion
It is necessary to maintain non-cancer patients’ physical performance and assess and manage their mental health in advance for effective palliative care. This study provides relevant information that can be used to develop a tailored palliative care model for non-cancer patients.
The purpose of the study was to evaluate the construct validity and reliability of the Korean version of the revised Piper Fatigue Scale (PFS) in Koreans with chronic hepatitis B.
A total of 146 ...chronic hepatitis B patients completed the Korean version of the revised PFS. A descriptive analysis was performed to determine the subjects' demographic characteristics; the construct validity was examined using exploratory factor analysis; and internal consistency reliability of the scale was estimated for the meaningful total scale and factors.
The factor analysis supported the original four-factor structure based on Kaiser Criterion and Minimum Average Partial (MAP): Behavioral/Severity, Affective meaning, Sensory, & Cognitive/Mood. In the 22 items in the original instrument, patient/impatient, relaxed/tense, and exhilarated/depressed were re-identified from the cognitive/mood subscale and sensory subscale. The Cronbach's alpha of the 22-item Korean version of the revised PFS was 0.96 for the total scale, and the range of Cronbach's alpha for subscales was 0.90 to 0.93.
The results of the study revealed that the 22-item Korean version of the revised PFS is valid and reliable in Koreans with chronic hepatitis B. Further studies ascertaining the psychometric properties of the revised PFS need to be performed in Korean patients.
Digital care has become an essential component of health care. Interventions for patients with cancer need to be effective and safe, and digital health interventions must adhere to the same ...requirements.
The purpose of this study was to identify currently available digital health interventions developed and evaluated in randomized controlled trials (RCTs) targeting adult patients with cancer.
A scoping review using the JBI methodology was conducted. The participants were adult patients with cancer, and the concept was digital health interventions. The context was open, and sources were limited to RCT effectiveness studies. The PubMed, CINAHL, Embase, Cochrane Library, Research Information Sharing Service, and KoreaMed databases were searched. Data were extracted and analyzed to achieve summarized results about the participants, types, functions, and outcomes of digital health interventions.
A total of 231 studies were reviewed. Digital health interventions were used mostly at home (187/231, 81%), and the web-based intervention was the most frequently used intervention modality (116/231, 50.2%). Interventions consisting of multiple functional components were most frequently identified (69/231, 29.9%), followed by those with the self-manage function (67/231, 29%). Web-based interventions targeting symptoms with the self-manage and multiple functions and web-based interventions to treat cognitive function and fear of cancer recurrence consistently achieved positive outcomes. More studies supported the positive effects of web-based interventions to inform decision-making and knowledge. The effectiveness of digital health interventions targeting anxiety, depression, distress, fatigue, health-related quality of life or quality of life, pain, physical activity, and sleep was subject to their type and function. A relatively small number of digital health interventions specifically targeted older adults (6/231, 2.6%) or patients with advanced or metastatic cancer (22/231, 9.5%).
This scoping review summarized digital health interventions developed and evaluated in RCTs involving adult patients with cancer. Systematic reviews of the identified digital interventions are strongly recommended to integrate digital health interventions into clinical practice. The identified gaps in digital health interventions for cancer care need to be reflected in future digital health research.
This study proposes an improved approach for monitoring the spatial concentrations of hourly particulate matter less than 2.5 μm in diameter (PM2.5) via a deep neural network (DNN) using ...geostationary ocean color imager (GOCI) images and unified model (UM) reanalysis data over the Korean Peninsula. The DNN performance was optimized to determine the appropriate training model structures, incorporating hyperparameter tuning, regularization, early stopping, and input and output variable normalization to prevent training dataset overfitting. Near-surface atmospheric information from the UM was also used as an input variable to spatially generalize the DNN model. The retrieved PM2.5 from the DNN was compared with estimates from random forest, multiple linear regression, and the Community Multiscale Air Quality model. The DNN demonstrated the highest accuracy compared to that of the conventional methods for the hold-out validation (root mean square error (RMSE) = 7.042 μg/m3, mean bias error (MBE) = −0.340 μg/m3, and coefficient of determination (R2) = 0.698) and the cross-validation (RMSE = 9.166 μg/m3, MBE = 0.293 μg/m3, and R2 = 0.49). Although the R2 was low due to underestimated high PM2.5 concentration patterns, the RMSE and MBE demonstrated reliable accuracy values (<10 μg/m3 and 1 μg/m3, respectively) for the hold-out validation and cross-validation.
Adaptive behavioral prioritization requires flexible outputs from fixed neural circuits. In C. elegans, the prioritization of feeding versus mate searching depends on biological sex (males will ...abandon food to search for mates, whereas hermaphrodites will not) as well as developmental stage and feeding status. Previously, we found that males are less attracted than hermaphrodites to the food-associated odorant diacetyl, suggesting that sensory modulation may contribute to behavioral prioritization.
We show that somatic sex acts cell autonomously to reconfigure the olfactory circuit by regulating a key chemoreceptor, odr-10, in the AWA neurons. Moreover, we find that odr-10 has a significant role in food detection, the regulation of which contributes to sex differences in behavioral prioritization. Overexpression of odr-10 increases male food attraction and decreases off-food exploration; conversely, loss of odr-10 impairs food taxis in both sexes. In larvae, both sexes prioritize feeding over exploration; correspondingly, the sexes have equal odr-10 expression and food attraction. Food deprivation, which transiently favors feeding over exploration in adult males, increases male food attraction by activating odr-10 expression. Furthermore, the weak expression of odr-10 in well-fed adult males has important adaptive value, allowing males to efficiently locate mates in a patchy food environment.
We find that modulated expression of a single chemoreceptor plays a key role in naturally occurring variation in the prioritization of feeding and exploration. The convergence of three independent regulatory inputs—somatic sex, age, and feeding status—on chemoreceptor expression highlights sensory function as a key source of plasticity in neural circuits.
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•Somatic sex of the C. elegans AWA neurons regulates the diacetyl chemoreceptor ODR-10•ODR-10 has a prominent role in mediating food attraction•Low ODR-10 in males reduces food attraction and promotes mate searching•Sex, age, and hunger converge on sensory function to guide adaptive behavioral choice
In C. elegans, well-fed adult males prioritize mate searching, whereas hermaphrodites, larval males, and starved adult males prioritize feeding. Here, Ryan et al. show that sensory plasticity is central to this decision. By targeting a key chemoreceptor, sex, age, and hunger regulate food attraction to guide adaptive behavioral plasticity.
To improve PM2.5 predictions in Northeast Asia, we estimated a new background error covariance matrix (BEC) for aerosol data assimilation using surface PM2.5 observations. In contrast to the ...conventional method of BEC estimation that uses perturbations in meteorological data, this method additionally considered the perturbations using two different emission inventories. By taking the emission uncertainty into account, we found that the standard deviations in the BEC were significantly increased. The standard deviations became around three times larger than those in the conventional method at the surface. The impacts of the new BEC were then tested for the prediction of surface PM2.5 over Northeast Asia using the Community Multiscale Air Quality (CMAQ) model initialized by three-dimensional variational method (3D-VAR). The surface PM2.5 data measured at 154 sites in South Korea and 1535 sites in China were assimilated every 6 h during the campaign period of the Korea-United States Air Quality Study (KORUS-AQ) (1 May–14 June 2016). The data assimilation with the new BEC showed better agreement with the surface PM2.5 observations than with the BEC from the conventional method. Our method was also more consistent with the observations in 24-h PM2.5 predictions than the conventional method (specifically, with a ∼44% reduction of negative biases). We concluded that increased standard deviations, together with updated horizontal and vertical length scales in the new BEC, improved the data assimilation and short-term predictions of the surface PM2.5. This paper also suggests several research efforts to further improve the BEC for better short-term PM2.5 predictions in Northeast Asia.
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•A new background error covariance (BEC) for PM2.5 predictions was developed.•The new BEC considers the uncertainties in anthropogenic emissions.•Two different emission inventories were used to account for the uncertainty.•24-h PM2.5 predictions were improved with ∼44% fewer negative biases.
Endometrial cancer (EC) cells metastasize to various regions, including the ovaries, fallopian tubes, cervix, blood, liver, bone, and brain. Various carcinogens are known to cause EC. Exosomes are ...released from several types of cells and contain various cellular components. In this study, flow cytometry and quantitative PCR were used to evaluate marker levels, cell migration, cell invasion, and mitochondrial membrane potential, and cellular senescence tests were used to estimate cancer activity. The microRNAs were profiled using next-generation sequencing. Although tocopherol-α and rutin content in
is high,
extract was more useful in modulating tumor activity compared to the two aforementioned substances. Notably, we established that the extract induced bioactive exosomes in EC cells, and profiling of miRNAs in the extract-inducing exosomes (EIE) indicated their potency to be developed as a biological drug. The extract and EIE contributed to the following five biological process categories for EC cells: (1) cell migration and invasion suppression, (2) cellular senescence activation by attenuating mitochondrial membrane potential and enhancing autophagy, (3) reproductive cancer activity attenuation, (4) drug susceptibility activation, and (5) EIE containing miRNAs associated with decreasing inflammation.
The purpose of this study was to conduct a psychometric evaluation of the Korean version of the Hepatitis B Quality of Life Questionnaire (K-HBQOL), which is designed to assess the quality of life of ...patients with the hepatitis B virus (HBV).
The K-HBQOL was developed by converting the original English version to Korean using a back-and-forth translation method. The translated questionnaire was distributed to 168 adults with HBV. Descriptive statistics were used to summarize the demographic characteristics of these participants. Confirmatory factor analysis and exploratory principal components analysis (CFA and PCA) were performed, applying varimax rotation and using Kaiser's eigenvalue-greater-than-one rule to examine the factor structure. The minimum average partial rule was also used to identify the number of components.
The original factor model was not confirmed by CFA in this sample. Six components (Psychological Well-being, Stigmatization, Anticipation Anxiety, Weakness, Vitality, and Vulnerability) were extracted by PCA, with 69.11% of the total variance explained. In this process, one component present in the original factor model (Transmission) was not found, while another component (Weakness) was extracted.
This study revealed the psychometric characteristics of the Korean version of the HBQOL for patients with hepatitis B. We suggest a study with a larger sample is needed to evaluate validity and reliability of the K-HBQOL for other Korean populations.
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