This study was undertaken to compare the diagnostic performance and biopsy reduction rate of combined shear-wave elastography (SWE) and B-mode ultrasonography (US) versus B-mode US alone for breast lesions and to determine the most discriminatory parameter in SWE. Methods: A systematic review and meta-analysis were conducted. The resources for the study were obtained from MEDLINE, Embase, Cochrane Library, and KoreaMed on August 17, 2018. The quality of the articles was evaluated using the Scottish Intercollegiate Guidelines Network (SIGN) tool. Results: Twenty-five articles with 5,147 breast lesions were selected. The meta-analysis showed pooled sensitivities of 0.94 and 0.97 (P=0.083), pooled specificities of 0.85 and 0.61 (P=0.009), and area under the receiver operating characteristic curve (AUC) of 0.96 and 0.96 (P=0.095) for combined SWE and B-mode US versus B-mode US alone. When SWE was combined with B-mode US, the Breast Imaging Reporting and Data System category changed from 4 to 3 in 71.3% of the tests, decreasing the frequency of unnecessary biopsies by 41.1%. All four parameters of SWE (the color grade of lesion stiffness, maximum elasticity, mean elasticity, and color grade of lesion stiffness/homogeneity of the lesion) improved the specificity when they were added to B-mode US. The AUC for each SWE parameter was 0.99, 0.96, 0.96, and 0.93, respectively. Conclusion: Adding SWE to B-mode US not only provides additional diagnostic information for differentiating between benign and malignant breast lesions, but also decreases the likelihood of unnecessary biopsies.

The aim of this study was to evaluate the effectiveness of interventions for workplace bullying among nurses. Methods: First, risk factors of workplace bullying were categorized in order to create analysis criteria. A search of 8 databases, and manual searching resulted in the identification of 3,096 relevant articles. Three of the authors did article selection, data extraction, and quality assessment using the Risk of Bias (RoB) and the Risk of Bias for Nonrandomized studies (ROBANS). Results: Interventions in workplace bullying were classified as individual, interactions, and organizational approach. Twelve intervention studies (10 individual interventions, 1 team approach, 1 multi-level approach) were selected. Four of the individual interventions decreased bullying, but three had no effect. One multi-level intervention reported that bullying did not occur. Individual interventions improved bullying awareness in four articles, decreased turnover intention in two articles, and increased skill and knowledge of bullying management in five articles. One team approach increased nurse interactions and group cohesion. The quality of selected articles was low overall. Conclusion: Individual interventions have a possibility to improve awareness and knowledge about bullying, but there is a lack of evidence on preventing bullying. Further research is required on multi-levels interventions with well-designed controlled trials.

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BackgroundNew graduate nurses experience difficulty in adapting to a new environment, which affects intent to leave. However, data on the factors contributing to difficulty in adapting and intent to leave among new graduate nurses are insufficient.PurposeThe aim of the study was to explore and compare factors associated with difficulty in adapting and the intent to leave among new graduate nurses in South Korea.MethodologyThis cross-sectional study used secondary data analysis. Primary data were obtained from the 2015–2016 Korean National Graduates Occupational Mobility Survey. Descriptive statistics, independent t tests, and chi-square statistics with weighted samples besides multivariate logistic regression analyses were conducted (N = 467).ResultsRoughly 46% of nurses reported difficulty adapting, and 16% expressed their intent to leave. The factors linked to difficulty in adapting were working at large hospitals with rotating shifts, low person–job fit, and low satisfaction with personal competency; intent to leave was associated with high monthly salary and low satisfaction with the workplace (all ps < .05). Difficulty in adapting did not equate to their intent to leave.ConclusionsThere were high rates of difficulty in adapting and intent to leave among new graduate nurses. Although different factors were associated with difficulty adapting and intent to leave, workplace condition is a common factor.Practice ImplicationsDifferent strategies are needed to improve adaptation and intention of leaving among new graduate nurses. For better adaptation, developing training programs enhancing professional competency with a sufficient training period is required. In addition, providing staff and resources to reduce the intent to leave is crucial.