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Background/Aims@#Bariatric intervention has been reported to be an effective way to improve metabolic dysfunction-associated steatotic liver disease (MASLD) in obese individuals. The current systemic review aimed to assess the changes in MRI-determined hepatic proton density fat fraction (MRI-PDFF) and nonalcoholic fatty liver disease activity score (NAS) after bariatric surgery or intragastric balloon/gastric banding in MASLD patients with obesity. @*Methods@#We searched various databases including PubMed, OVID Medline, EMBASE, and Cochrane Library. Primary outcomes were the changes in intrahepatic fat on MRI-PDFF and histologic features of metabolic dysfunction-associated steatohepatitis (MASH). @*Results@#Thirty studies with a total of 3,134 patients were selected for meta-analysis. Bariatric intervention significantly reduced BMI (ratio of means, 0.79) and showed 72% reduction of intrahepatic fat on MRI-PDFF at 6 months after bariatric intervention (ratio of means, 0.28). Eight studies revealed that NAS was reduced by 60% at 3–6 months compared to baseline, 40% at 12–24 months, and 50% at 36–60 months. Nineteen studies revealed that the proportion of patients with steatosis decreased by 44% at 3–6 months, 37% at 12–24 months, and 29% at 36–60 months; lobular inflammation by 36% at 12–24 months and 51% at 36–60 months; ballooning degeneration by 38% at 12–24 months; significant fibrosis (≥F2) by 18% at 12–24 months and by 17% at 36–60 months after intervention. @*Conclusions@#Bariatric intervention significantly improved MRI-PDFF and histologic features of MASH in patients with obesity. Bariatric intervention might be the effective alternative treatment option for patients with MASLD who do not respond to lifestyle modification or medical treatment.

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Purpose@#To evaluate the ocular adverse event (OAE) and the incidence rate that can occur after the COVID-19 vaccination. @*Methods@#Patients who visited with an ophthalmologic diagnosis within a month of COVID-19 vaccination were retrospectively analyzed. OAEs were categorized as ischemia and inflammation by their presumed pathogenesis and were compared by types of vaccine: messenger RNA (mRNA) and viral vector vaccine. The crude incidence rate was calculated using data from the Korea Disease Control and Prevention Agency. @*Results@#Twenty-four patients with OAEs after COVID-19 vaccination were reviewed: 10 patients after mRNA and 14 after viral vector vaccine. Retinal vein occlusion (nine patients) and paralytic strabismus (four patients) were the leading diagnoses. Ischemic OAE was likely to occur after viral vector vaccines, while inflammatory OAE was closely related to mRNA vaccine (p = 0.017). The overall incidence rate of OAE was 5.8 cases per million doses: 11.5 per million doses in viral vector vaccine and 3.4 per million doses in mRNA vaccine. @*Conclusions@#OAEs can be observed shortly after the COVID-19 vaccination, and their category was different based on the types of vaccine. The information and incidence of OAE based on the type of vaccine can help monitor patients who were administered the COVID-19 vaccine.

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Purpose@#This study aimed to identify the mediating effects of communication skills and pediatric nurse-parent partnership on the relationship between emotional intelligence and job satisfaction among pediatric nurses. @*Methods@#A survey was administered to 205 pediatric nurses working in children’s, general, and tertiary hospitals situated in Chungcheong province and Seoul. Data were collected in August and September 2022. The collected data were analyzed using SPSS Statistics version 26.0 along with the PROCESS macro program. @*Results@#Emotional intelligence had a significant effect, and was a critical factor affecting the job satisfaction of pediatric nurses. Furthermore, communication skills and nurse-parent partnership had a serial double mediating effect. @*Conclusion@#These findings underscore the significance of conducting job satisfaction improvement programs, including strategies for augmenting emotional intelligence, bolstering communication skills, and fostering nurse-parent partnership.

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Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for managing advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of the limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: adenoma ≥10 mm in size; 3 to 5 (or more) adenomas; tubulovillous or villous adenoma; adenoma containing high-grade dysplasia; traditional serrated adenoma; sessile serrated lesion containing any grade of dysplasia; serrated polyp of at least 10 mm in size; and 3 to 5 (or more) sessile serrated lesions. More studies are needed to fully comprehend the patients who are most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

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Purpose@#This study aimed to identify the longitudinal effects of children’s temperament on maternal depression. @*Methods@#Data from a longitudinal cohort of the Panel Study of Korean Children (PSKC) from 2010 to 2012 were analyzed using hierarchical linear modeling. The survey included 1,721 mother-child dyads. The mothers reported on their children’s temperament and on maternal depression. The children’s temperament was measured by the Emotionality, Activity and Sociability-Temperament Survey for Children-Parental Ratings, while maternal depression was measured by the Kessler 6 Psychological Distress Scale. @*Results@#The results showed that both children’s temperament and maternal depression were relatively stable when the children were between the ages of 2 to 4. The mean maternal depression scores were 11.83 in 2010, 11.88 in 2011, and 11.75 in 2012. There were significant negative correlations between the maternal depression scores and children’s ages, and sociability and activity subdomain scores ranged from r=-.05 to -.11 (p<.05). There was a significant positive correlation between children’s emotionality subdomain scores and maternal depression scores (r=.35, p<.001). Children’s temperament rament (emotionality: β=0.26, activity: β=-0.07, and sociability: β=-0.03) were significant factors in maternal depression. @*Conclusion@#These findings indicate the need for the early assessment of and intervention for children’s temperament and maternal depression. The results of this study will provide basic data for the development of nursing education programs related to early assessment and intervention to improve the health and quality of life of young children and mothers.

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Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis. Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.

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Purpose@#To define school nurseeparent partnerships in school health care for children with type 1 diabetes (T1D) and determine its attributes using a hybrid model. @*Methods@#This method involves a three-phase process: theoretical, fieldwork, and analytical. A literature review was conducted during the theoretical phase. A literature search of articles from January 1991 to February 2020 was conducted using relevant electronic databases. Eighty-three articles that met the inclusion criteria were completely read. Fieldwork data were collected through individual interviews from February to July 2019 in South Korea. In the fieldwork phase, interviews were conducted individually with 22 mothers of students with T1D and 20 school nurses recruited by purposeful sampling.Inductive content analysis was conducted. The findings from the theoretical phase were integrated with those from the fieldwork phase, and the final concept was derived. @*Results@#School nurseeparent partnership in school health care for children with T1D has been defined as an interactive process of maintaining a balanced responsibility and providing tailored care to meet needs by establishing trusting relationships and communicating transparently and openly. This analysis yielded four attributes: trusting relationships, transparent and open communication, balanced responsibility, and providing tailored care to meet needsdthis entails providing nursing actions by advocating for students and performing a negotiated role together or individually for student and family. @*Conclusion@#The findings of this study add to the importance of an attribute of balancing responsibility for partnership in school health care. The results show that this partnership could contribute to the development of a scale, theory, and nursing intervention in school health care for children with T1D.

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Purpose@#This study aimed to identify the factors influencing the interaction between mothers and preschool-age children and construct a structural equation model based on the factors identified. @*Methods@#The data were collected from the mothers of children aged three to six years enrolled in kindergartens in Seoul, Gyeonggi, Chungbuk, and Jeonbuk. A total of 328 questionnaires were used for the analysis. Analysis was performed using SPSS 26.0 and AMOS 26.0 programs. @*Results@#The child’s self-regulation (β = .42, p < .001) had the most significant influence on the interaction between mothers and preschool children, followed by the mother’s parenting stress (β = - .23, p = .008), social support (β = .17, p < .001), and the child’s active temperament (β = .15, p < .001). The child’s gender, emotional temperament, social temperament, and mother’s education level had indirect influences. @*Conclusion@#These results suggest that interventions considering the child’s temperament, mother’s parenting stress, and social support are required to promote the interaction between preschool-age children and mothers.

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Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis.Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.

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Purpose@#To evaluate the correction of vertical strabismus associated with exotropia by vertical transposition of the horizontal muscle to an extent equal to half the muscle width combined with muscle recession-resection. @*Methods@#We enrolled patients with vertical strabismus of 4-15 prism diopters (PD) associated with exotropia who were not scheduled for vertical rectus or oblique muscle surgery. Regardless of the strabismus angle, the insertion site of the horizontal muscle was vertically transposed by half the muscle width during surgery. Success was defined as a vertical strabismus angle of 2 PD or less. @*Results@#The preoperative mean exodeviation far angle in 41 patients was 27.8 PD and the average vertical strabismus far angle 8.1 PD. The success rate of exotropia surgery was 68.3%. The mean vertical strabismus angle was 2.8 PD on postoperative day 1 and the success rate of vertical strabismus surgery 92.7%. Undercorrection was evident in 4.9% of patients and overcorrection in 2.4%. The preoperative vertical strabismus angle was strongly associated with the residual angle after surgery (r = 0.386, p = 0.013). Receiver operating curve analysis revealed that the preoperative vertical strabismus far angle cutoff was 11 PDs. No patient factor significantly influenced vertical strabismus correction. @*Conclusions@#Vertical transposition of the horizontal muscle by half of the muscle width may correct vertical strabismus of far angle 11 PDs or less.

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Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis.Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.

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Purpose@#To evaluate the correction of vertical strabismus associated with exotropia by vertical transposition of the horizontal muscle to an extent equal to half the muscle width combined with muscle recession-resection. @*Methods@#We enrolled patients with vertical strabismus of 4-15 prism diopters (PD) associated with exotropia who were not scheduled for vertical rectus or oblique muscle surgery. Regardless of the strabismus angle, the insertion site of the horizontal muscle was vertically transposed by half the muscle width during surgery. Success was defined as a vertical strabismus angle of 2 PD or less. @*Results@#The preoperative mean exodeviation far angle in 41 patients was 27.8 PD and the average vertical strabismus far angle 8.1 PD. The success rate of exotropia surgery was 68.3%. The mean vertical strabismus angle was 2.8 PD on postoperative day 1 and the success rate of vertical strabismus surgery 92.7%. Undercorrection was evident in 4.9% of patients and overcorrection in 2.4%. The preoperative vertical strabismus angle was strongly associated with the residual angle after surgery (r = 0.386, p = 0.013). Receiver operating curve analysis revealed that the preoperative vertical strabismus far angle cutoff was 11 PDs. No patient factor significantly influenced vertical strabismus correction. @*Conclusions@#Vertical transposition of the horizontal muscle by half of the muscle width may correct vertical strabismus of far angle 11 PDs or less.

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Purpose@#This study aimed to update the previously published nursing practice guideline for oral care. @*Methods@#The guideline were updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 1.0. @*Results@#Updated nursing practice guideline for oral care was consisted of 10 domains and 79 recommendations. The number of recommendations in each domain were: 5 general issues, 2 oral care indications, 9 oral assessment, 16 general oral care, 12 oral care for critically ill patients, 16 oral care for cancer patients, 12 oral care for cancer patients with oral complications, 5 oral care education, 1 oral care referral, and 1 documentation and report. In terms of grades for recommendations, 11.4% was grade A, 17.0% was grade B, and 68.2% was grade C. Twelve new recommendations were developed and 7 previous recommendations were deleted. @*Conclusion@#Updated nursing practice guideline for oral care is expected to serve as an evidence-based practice guideline for oral care in South Korea. It is recommended that this guideline be spread to clinical nursing settings nationwide to improve the effectiveness of oral care practice.

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Purpose@#The purpose of this integrative review was to synthesize previous research on perceptions of school health care among school-aged children and adolescents with chronic diseases. @*Methods@#This study was performed in accordance with Whittemore and Knafl's stages of an integrative review (problem identification, literature search, data evaluation, data analysis, and presentation of the results). Four databases (PubMed, CINAHL, Embase, and Web of Science) were used to retrieve relevant articles. @*Results@#Eighteen articles were included in this review. We identified five thematic categories: peer-related issues, a safe school environment, self-perception of an existing disease, self-management, and a supportive school environment. @*Conclusion@#It is necessary to establish a school health care system with a supportive environment for children and adolescents with chronic diseases.

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Purpose@#This study explored the relationships of maturity fears and appearance interest(interest in appearance, interest in weight) with self-concept among girls with precocious puberty. @*Methods@#The participants for this study were 120 elementary school students (8 to 10 years old) and their parents from two hospitals located in Chungcheong Province. Data were collected from January to February 2019 using self-reported questionnaires. The collected data were analyzed using descriptive statistics, the independent t-test, the Mann-Whitney U test, one-way analysis of variance, Pearson correlation coefficients, and multiple regression analysis in SPSS for Windows version 23.0. @*Results@#Statistically significant negative correlations were found between self-concept and maturity fears (r=-.34, p<.001) and interest in weight (r=-.29, p=.001). Maturity fears were identified as a factor affecting the self-concept of girls with precocious puberty (β=-.34, p<.001). This variable explained 11.5% of the variance in the self-concept of girls who experienced precocious puberty. @*Conclusion@#This study confirmed that maturity fears had a major influence on self-concept in girls with precocious puberty. The results of this study can be used as basic data for the development of a psychosocial nursing intervention program for girls who experience precocious puberty.

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Purpose@#We investigated the reading speeds of elementary school-aged children with or without intermittent exotropia. @*Methods@#Children between the ages of 7 and 12 years with intermittent exotropia without amblyopia (n = 37) and normal-sighted children (n = 37) were included. Near-stereopsis and fusion were evaluated. Reading speeds were calculated using a Korean reading speed application, twice: once for reading the sentence silently (reading only) and a second time for reading the sentence aloud (reading & speaking). Reading speed was recorded in words per minute (WPM) and letters per minute (LPM) according to the size of the letters. The factors related to reading speed were analyzed, and the reading speeds of the two groups were compared. @*Results@#The rate of fusion at far and near extremes was lower in the intermittent exotropia group than in the control group (p = 0.028). There was a significant correlation between age and reading only speed and reading & speaking speed for both groups (p = 0.006, p = 0.004). Both WPM and LPM reading speeds of the reading only intermittent exotropia group were slower than those of the control group (p = 0.048, p = 0.050); however, the differences between groups became more pronounced after correction for the age distribution (p = 0.029, p = 0.035). LPM reading speed for middle-sized letters was significantly slower in the intermittent exotropia group than in the control group (p = 0.046). There was no statistical difference between the two groups regarding the reading speed or reading & speaking speed. @*Conclusions@#the reading only and reading & speaking speeds increased with the age of the student, regardless of whether the student had intermittent exotropia. The reading only speed was considerably slower in the intermittent exotropia group. Thus, measures should be taken to monitor the reading development of younger school-aged children with intermittent exotropia carefully to allow for early intervention should issues arise.

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PURPOSE: This study was conducted to determine the influence of ego-identity, parenting efficacy, and stress coping style on depression in mothers of toddlers. METHODS: This was a cross-sectional, descriptive study. Data were collected from 164 mothers of toddlers, and analyzed using descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and multiple regression analysis using SPSS for Windows version 24.0. RESULTS: The factors influencing depression in mothers of toddlers included ego-identity, economic status, and perceived health status. These variables explained 60.0% of depression in mothers of toddlers. CONCLUSION: Lower ego-identity was associated with more intense depression. Therefore, healthcare providers should develop intervention programs that can improve ego-identity to decrease depression among mothers of toddlers.

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PURPOSE: This study aimed to examine the effects of compassion competence and organizational commitment on customer orientation in hospital nurses. METHODS: The participant of this study was 223 nurses who have worked at a tertiary hospital in Chungcheong Province for at least one year. The general characteristics, compassion competence, organizational commitment, and customer orientation of the participants were collected, using self-reported questionnaires, from June 15 to June 29, 2018. The data were analyzed by descriptive statistics, independent t-test, ANOVA (Scheffé test), Pearson's correlation coefficient, and multiple regression using an SPSS/WIN 22.0 program. RESULTS: Customer orientation was significantly associated with organizational commitment (r=.51, p<.001), and compassion competence (r=.74, p<.001). Compassion competence (β=.62, p<.001), organizational commitment (β=.17, p=.004), and marital status (β=.11, p=.034) were identified as the predictors of customer orientation. These variables explained 59.1% of the variance in customer orientation. CONCLUSION: This study confirmed that compassion competence and organizational commitment may have an impact on customer orientation in hospital Nurses. Therefore, to improve customer orientation in hospital nurses, it is necessary to develop interventions and education programs considering these factors.

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PURPOSE: This descriptive study was conducted to identify the effects of hospital organizational culture and work environment on nurses' intent to stay at work. METHODS: Participants of this study were 234 nurses who have worked at a local general hospital in the Chungcheong province for at least 6 months. The data were collected from July 17 to 28, 2017, using self-reported questionnaires and analyzed with multiple regression using SPSS version 22.0. RESULTS: Clinical experience (β=.38, p<.001), institutional support (β=.33, p<.001), and relation-oriented culture (β=.24, p<.001) affected intent to stay at work among nurses. These variables accounted for 34.8% of the variance in intent to stay at work among nurses. CONCLUSION: This study confirms the effects of the work environment and organizational culture on nurses' intent to stay at work. Efforts for improving the work environment and organizational culture need for retaining nurses in a hospital. We suggest further research to identify the other factors associated with intent to stay at work among nurses.

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PURPOSE: Quality of life is important to everyone including school-age children. Therefore this study was done to identify the effects perceived daily stress and sense of humor on quality of life for these children. METHODS: The study was a cross-sectional, descriptive study design with 371 participants from 5th and 6th grade children in 5 elementary schools. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression analysis with SPSS/WIN 24.0 program. RESULTS: Factors influencing quality of life in school-age children were daily stress, sense of humor, satisfaction with daily life, academic performance and home atmosphere. These variables explained 63.0% of quality of life in school-age children. CONCLUSION: Results showed that lower daily stress and higher sense of humor are associated with higher quality of life. Therefore, to improve quality of life in school-age children, healthcare providers should develop intervention programs considering these factors.

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