Search

Accessible summary What is known on the subject? Problematic parent-child relationships have been identified as one of the main predictors of adolescents' mental health problems, but there are few existing interventions that address this issue., The format and delivery method of existing interventions for parents are relatively inaccessible for parents with full-time jobs and families living in rural areas., What does this paper add to existing knowledge? The newly developed 'Stepping Stone' culturally specific web-based intervention, which is intended to help Korean parents of adolescents to acquire both knowledge and communication and conflict management skills, was found to be feasible and well-accepted by parents., This study enabled us to identify areas for improvement in the content and format of the intervention and strategies. This will potentially increase effect sizes for the outcome variables of parents' perception and behaviours., What are the implications for practice? This web-based intervention could be delivered across diverse settings, such as schools and community mental health centers, to increase parents' knowledge of adolescent's mental health and allow for early detection of mental health problems., Mental health nurses working in schools may spend a significant amount of time addressing students' mental health issues; thus, this web-based intervention could be a useful resource to share with parents and children. In this way, the mental health nurses could facilitate parental engagement in the intervention and then help them to continue to apply and practice the knowledge and skills obtained through the program., Abstract Introduction There is a need for accessible, culturally specific web-based interventions to address parent-child relationships and adolescents' mental health. Aims This study developed and conducted a preliminary evaluation of a 4-week web-based intervention for parents of adolescents aged 11 to 16 years in Korea. Methods We used a two-group, repeated measures, quasi-experimental study design to assess the feasibility of developing and implementing a web-based intervention for parents. Descriptive statistics, chi-square and t tests, and mixed effect modeling were used for data analysis. Results The intervention and 1-month follow-up survey were completed by 47 parents in the intervention group and 46 parents in the attention control (AC) group. The intervention was found to be feasible and well-accepted by parents. Discussion This culturally specific web-based intervention is a useful tool for knowledge dissemination among large numbers of parents. Areas for improvement in the content and format of the intervention and strategies to elicit significant parent-child interactions are provided. Implications for practice and conclusion The intervention could be disseminated in collaboration with mental health nurses working in schools to facilitate parents' participation. [ABSTRACT FROM AUTHOR]

Aims This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. Background No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. Design A descriptive, cross-country, comparative design was employed. Methods Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. Results A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Conclusions Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. [ABSTRACT FROM AUTHOR]

The composition of the workforce with regard to organizational tenure is rapidly changing. In this paper, we examine the cross-level effects of tenure diversity on individual-level creativity. In keeping with the categorization-elaboration model, we propose individual-level explicit knowledge as a mediating mechanism between tenure diversity and individual creativity, and knowledge sharing as moderating the relationship between tenure diversity and individual explicit knowledge. Using a sample of 341 Korean insurance agents from 76 groups, we find that knowledge sharing moderates the relationship between tenure diversity and individual explicit knowledge. Results further support the direction of the hypothesized relationships, with tenure diversity positively influencing individual explicit knowledge at high levels of knowledge sharing and exhibiting a negative influence at low levels. Individual explicit knowledge carries these indirect effects to individual creativity, although directional significance was only found at extremely high and low values. Practitioner Points Tenure diversity is now a fact of organizational life that managers need to embrace. While our results suggest that tenure diversity is positively related to individual creativity, individual explicit knowledge and knowledge sharing play important roles in the association., Knowledge sharing appears to be a key boundary condition, which modifies the influence of tenure diversity on individual explicit knowledge. Working in a diverse group is not enough; the knowledge has to be shared., Individual explicit knowledge mediates the relationship between tenure diversity and individual creativity; it carries a positive indirect effect when knowledge sharing is high and a negative indirect effect when knowledge sharing is low. For complex jobs, where creativity is desired, but much of the work is independent, managers need to encourage employees with diverse levels of tenure to share experiences and ways of performing their tasks. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a comparison of advice on lifestyle given by healthcare providers and subsequent action by recipients between Korean Americans and native Koreans with hypertension. Background. High blood pressure is controllable by having a healthy lifestyle, such as weight control, dietary change, exercise, low-sodium diet, alcohol restriction and ' smoking cessation, and by taking medication. Healthcare providers play an important role in teaching individuals with hypertension on healthy lifestyles. Method. This descriptive comparative study was conducted with a convenience sample of 100 Korean Americans and 100 native Koreans with hypertension. They were interviewed between May 2003 and June 2004 on the advice they received from healthcare providers on lifestyle and their subsequent action in terms of taking medication, weight control, dietary change, exercise, low-sodium diet, smoking cessation, alcohol restriction and tension reduction. Nutrient profiles were examined using the 24-hour dietary recall method. Findings. Korean Americans received advice on lifestyle less than did native Koreans, but more Korean Americans followed healthy lifestyle advice on dietary change and exercise than did native Koreans (P < 0.001). Weight control was the least adhered to behaviour among the Korean Americans, although almost two-thirds of them were overweight or obese. Both groups exceeded the Dietary Reference Intakes of sodium, but perceived their sodium consumption as low. Conclusion. Native Korean participants need to pay closer attention to carrying out the advice, whereas healthcare providers to Korean Americans need to give more advice on culturally acceptable healthy lifestyles, particularly on dietary changes and weight control. Both groups need to monitor their sodium intake more realistically. It is not only advice from healthcare providers that is integral to control of hypertension, but also that patients should follow that advice. [ABSTRACT FROM AUTHOR]

shin s.m., kim m.j., kim e.s., lee h.w., park c.g. & kim h.k. (2010) Medical Aid service overuse assessed by case managers in Korea. Journal of Advanced Nursing 66(10), 2257–2265. Aim. This paper is a report of a study conducted to describe characteristics of overusers of the Medical Aid service, assess appropriateness of overusers’ medical service use, and determine contributing factors to medical aid overuse in Korea. Background. Medical Aid use in Korea has increased in recent years, but no systematic studies reported the characteristics of overusers and appropriateness of their medical service use. Method. In a cross-sectional study, case managers conducted interviews, evaluated participants’ insurance claim data, and determined overusers by the case managers’ determination of the appropriateness of their medical service use and their expenditures during the year of 2006. Descriptive statistics, chi-square analysis, analysis of variance, and multiple logistic regression were used for data analysis. Result. Most heavy users were elderly, female, less educated, and had stress, lower perceived health status and multiple clinic visits. Twenty-five per cent of inpatients and 63·9% of outpatients were classified as overusers. The average total cost per capita of an overuser was 43·3% higher than that of an optimal user. Age, education, stress, arthritis, multiple clinic visits and frequent clinic visit recommendations by providers were statistically significant contributing factors to the overuse. Conclusion. Preventive measures are needed to decrease the overuse of Medical Aid in Korea; such measures should focus on characteristics contributing to overuse, including the provider-induced demand for more clinic visits. Case managers could play an important role as gatekeepers, managers, and educators for optimal use of Medical Aid in Korea and elsewhere in the world that faces similar problems. [ABSTRACT FROM AUTHOR]

Kwak YG, Lee S-O, Kim TH, Choo EJ, Jeon M-H, Jun J-B, Kim K-M, Jeong JS, Kim YS. International Journal of Nursing Practice 2012; 18: 77-83 The use of multidose vials and fingerstick blood sampling devices in Korean emergency departments and intensive care units This study was performed to compare compliance with standard precautions for the use of multidose vials (MDVs) and fingerstick devices in emergency departments (EDs) and intensive care units (ICUs). Between December 2007 and February 2008, 389 nurses from the EDs or ICUs of six university-affiliated hospitals in Korea were asked to complete the questionnaire. A total of 338 (86.9%) nurses completed the survey, corresponding to 159 of 184 ED and 179 of 205 ICU nurses. A comparison of MDV use in EDs and ICUs indicated a significant difference only in disinfection of the rubber septum of heparin vials; 88.1% of ED nurses and 96.6% of ICU nurses stated that they always disinfected the rubber septum of heparin vials whenever drawing medication ( P = 0.003). The use of separate fingerstick devices for each patient (71.7% vs. 54.5%) and disinfection of these devices after each use (36.5% vs. 26.0%) were more common in ED nurses. The rate of good hand hygiene was lower in ED nurses, both before (43.7% vs. 74.3%) and after (64.6% vs. 91.6%) the use of fingerstick devices ( P < 0.001 for both). There is a need to improve compliance with standard precautions, especially hand hygiene, in EDs. [ABSTRACT FROM AUTHOR]

Purpose: This paper identified the effects of kangaroo care (KC) on maternal self-esteem and the growth and physiological stability of premature infants hospitalized in the neonatal intensive care unit. Methods: The experiment was conducted with an experimental group of 17 infants, and a control group of 17 infants selected by convenience sampling. KC was given to the infants one time a day for 30 minutes after feeding for two weeks. Their weight was measured every morning, and their physiological stability was measured in terms of their body temperature, respiratory rate, heart rate, oxygen saturation, and stability of the cardio-respiratory system in premature infants (SCRIP) score, as physiological responses at every 10 minutes during the intervention. Maternal self-esteem was assessed by a maternal self-report inventory. Results: The experimental group showed significant increase in the self-esteem of mothers. Also, KC was effective on physiological stabilization of preterm infants. Conclusion: This study suggests that KC can be provided in clinical settings more widely in Korea as one of the nursing interventions aimed at promoting maternal self-esteem as well as infants' physiological stabilization. [ABSTRACT FROM AUTHOR]

Purpose: This study was done to evaluate the accuracy and adequacy of research studies reporting statistical testing for mean differences in studies of the Korean Journal of Women Health. Methods: Among articles published in the journal from 2007 to 2009, 75 studies using t-test, χ2-test, and ANOVA were identified. The studies were evaluated using structured analysis format for adequacy of research title, accuracy of statistical methods and presentation styles, and errors in reported statistical outcomes. Results: In this study, the research titles generally reflected the purpose of research and study designs. Thus the research titles were quite comprehensive. Also, there was compatibility between the research purpose and research design. Most important though, many errors were identified in the tables of results of the statistical analysis in articles published from 2004 to 2006. Conclusion: Over six years, 2004 to 2009, accuracy and adequacy of research studies has improved in many aspects. In order to enhance the completeness of the published papers and to be an internationally recognized nursing journal, close attention of the researchers, reviewers and editors is necessary to avoid errors and present adequate and accurate research. [ABSTRACT FROM AUTHOR]

This research investigated patterns of the use of dietary supplement and doping awareness among high-ranked judoists from 2 countries. Korean (70 men and 31 women) and Japanese (37 men and 34 women) national judo team members were divided into 2 groups (high and low competitive performance levels) according to their international and national rankings. Fifty-nine percent of Korean and 61% of Japanese judoists consumed dietary supplements. Eighty-eight percent of high- and 51% of low-competitive-performance-level Korean judoists consumed dietary supplements. Sixty-eight percent of high- and 57% of low-competitiveperformance- level Japanese judoists consumed dietary supplements. Oriental supplements (34%), vitamins (23%), and protein powder (12%) were the most commonly consumed dietary supplements in Korean judoists. Vitamins (45%), protein powder (33%), and minerals (15%) were the most commonly consumed dietary supplements in Japanese judoists. Thirty-eight percent of judoists from both countries had not received any proper education about antidoping, and 44% of judoists from both countries had not received knowledge of antidoping legislation. There was a significant difference in education about antidoping between high and low competitive-performance levels of Korean judoists (p < .001). Korean judoists received significantly less antidoping education than Japanese judoists (p < .001). The associations for antidoping education and knowledge of antidoping legislation with the use of dietary supplements were 3.46 (95% CI = 1.31-9.12) and 1.63 (95% CI = 0.71-3.76), respectively. Our findings showed that use of dietary supplements in judoists from both countries was increased after experiencing antidoping education. [ABSTRACT FROM AUTHOR]

In the present study, researchers examined the association between depressive symptoms and family stress and conflict from multiple roles, along with the combined effect of family stress and family-work conflict. We used data from the 2008-2012 Korean Welfare Panel Study, consisting of 4,663 baseline participants. We measured depressive symptoms using the 11- item Center for Epidemiologic Studies Depression Scale. There was a significant relationship between depressive symptoms and family stress and conflict among working married women. With regard to the combined analysis, working married women who reported both family stress and family-work conflict exhibited the highest odds of depressive symptoms. [ABSTRACT FROM AUTHOR]

Background This study aimed to investigate perceptual body image and the relationship between perceived body image (PBI) and weight control differentiated according to obesity categories across the adult lifespan by sex among Koreans. Methods We analyzed data on 10 198 adults aged 25 or older from the Korean National Health and Nutrition Examination Survey of a nationally representative sample of non-institutionalized Koreans. Results Significant discordance between PBI and body mass index (BMI) or waist circumference (WC) was found in all age groups in both sexes, and the discordance for obesity grew more severe with age. Linear associations between PBI and BMI or WC were found in normal weight and obese groups in all age groups in both sexes, with relatively greater BMI or WC differences for PBI found in obese men aged ≤64 or ≤44, respectively, and obese women of all ages or aged ≥75, respectively, compared to normal weight. Obese women aged ≥65 (BMI) or ≥75 (WC) and obese men in the 45--54 and 65--74 age groups (BMI and WC) had significant association between PBI and weight control. Conclusions Interventions regarding accurate body size perception should be prioritized for obese women aged ≥65 or ≥75 and for obese men aged 45-54 and 65-74. [ABSTRACT FROM AUTHOR]

Background:Respiratory syncytial virus (RSV) is a significant cause of acute respiratory illness with a clinical spectrum ranging from self-limiting upper respiratory infection to severe lower respiratory infection in elderly persons as well as young children. However, there are limited data on risk factors for life-threatening infections that could guide the appropriate use of antiviral agents in adult patients with RSV. Methods:We conducted a retrospective cohort study from October 2013 to September 2015. Adult patients with RSV who visited the emergency department were enrolled. Primary outcome was life-threatening infection (admission to intensive care unit, need for ventilator care or in-hospital death). Results:A total of 227 patients were analysed. Thirty-four (15%) were classified as having life-threatening infections. By logistic regression, lower respiratory infection, chronic lung disease and bacterial co-infection were independent predictors of life-threatening infections. We developed a simple clinical scoring system using these variables (lower respiratory tract infection = score 4, chronic respiratory disease = score 3, bacterial co-infection = score 3 and fever ≥38 °C = score 2) to predict life-threatening infection. A score of >5 differentiated life-threatening RSV from non-life-threatening RSV with 82% sensitivity (95% CI, 66–93) and 72% specificity (95% CI, 65–78). Conclusions:The use of a clinical scoring system based on lower respiratory infection, chronic respiratory disease, bacterial co-infection and fever appears to be useful for outcome prediction and risk stratification in order to select patients who may need early antiviral therapy. [ABSTRACT FROM PUBLISHER]

Objectives. The effects of a range of types of social integration and patterns of change in social integration over time were examined directly in relation to depressive symptoms in a large sample of the Korean population aged ≥45 years. Methods. Data from the Korean Longitudinal Study of Aging (KLoSA) between 2006 and 2012 were assessed using longitudinal data analysis. We included 10 242 research subjects at baseline (2006) and based the primary analysis on generalised linear mixed models to examine association between social integration and depressive symptom. Results. The odds ratio (OR) for depressive symptoms in individuals at the lowest level of social integration was 1.539-fold higher (95% confidence interval (CI) 1.360-1.742) that that for those at highest level of social integration. Results of subgroup analysis according to gender revealed a similar trend. A five-class linear solution fit the data best; Class 1 (lowest constant social integration level, 10.5% of the sample) was significantly associated with the highest risk of depressive symptoms (OR 1.933, 95% CI 1.706-2.190). Conclusions. The results of the present study provide a scientific basis for the specific association between the level of social integration and changes in social integration pattern with the risk of depressive symptoms in current practice. Therefore, interventions to provide emotional support for older adults via social integration may be important to protect against depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: To evaluate the influence of combined therapy of conventional and herbal medicines on liver function. Methods: This study was a retrospective chart review. A total of 138 patients with abnormal liver transaminase levels at the time of admission were included in this study. We evaluated the influence of combined therapy of conventional and herbal medicines on liver transaminase levels over a period of at least 2 weeks at Kyung Hee University Korean Medical Hospital. Analyses were performed using SPSS version 17.0 for Windows. Paired T-tests were used to examine the significance of differences in AST, ALT, and GGT levels at the time of admission and discharge. Results: We found that combined therapy reduced levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma glutamyl transferase (GGT) to a statistically significant level. Specifically, there were 48, 66, 104 subjects who exhibited abnormal AST, ALT and GGT levels at admission, which was reduced to 13, 37, and 64 subjects after combined therapy, respectively. Some subjects exhibited worsening levels of liver transaminases after combined therapy, so we used the χ² test to analyze the influence of combined therapy with conventional and herbal medicines on liver function according to initial liver transaminase levels. According to this analysis, ALT and GGT levels may be more important than AST levels in estimating the influence of combined therapy on patients with abnormal liver transaminase levels. Conclusions: Based on this retrospective chart review, combined therapy of conventional and herbal medicines would be considered relatively safe. Thus, if patients have abnormal ALT or GGT levels, caution should be taken when suggesting combined therapy with conventional and herbal medicines. [ABSTRACT FROM AUTHOR]

The Poisson process was tested for the sequence of earthquakes that occurred in and around the Korean Peninsula from 1980 through 2014, inclusive. The earthquake origin parameters by Korea Meteorological Administration (KMA) were used. Two statistical tests were applied: the Pearson's Chi-square test for the earthquake frequency and the Kolmogorov-Smirnov test for the inter-event time. The two tests consistently showed the existence of m , the minimum magnitude above which the null hypothesis of the Poisson process could not be rejected. At significance levels of 1, 5, and 10%, the m was smaller than 2.7 for inland earthquakes and 3.1 for all earthquakes. It was concluded that the sequence of Korean earthquakes follows the Poisson process. [ABSTRACT FROM AUTHOR]

End-of-life care decision making has become a matter of serious ethical and legal concern in the three Far East Asian Countries of China, Japan, and Korea. Researchers in the three countries collaboratively conducted a comparative descriptive study with respect to physicians’ perspectives concerning end-of-life care decisions. In spite of cultural similarities, each country has its own unique set of social, cultural, and political circumstances. So the content and scope of policies and laws on end-of-life decision reflect the differing views of people based on their social status, moral values, religious beliefs, and economic status. [ABSTRACT FROM PUBLISHER]

Intersectoral collaboration (ISC) is important in the health field because the complexity of determinants of health makes it difficult for one institution to resolve all health issues. Promotion of physical activity can especially benefit from a multi-sectoral approach. Despite so much emphasis on its importance in both primary health and health promotion, ISC has been underachieved in the field. This study aimed to examine the characteristics and level of ISC among physical activity programs in Healthy Cities as compared to non-Healthy Cities. I conducted a postal survey where 24 people from Healthy Cities and 72 people from non-Healthy Cities participated. The survey included questions to measure the level of ISC as well as to determine ISC partners and activities. Among the entire 393 physical activity programs, 336 (85.5%) had some kind of collaboration with one or more partners. The percentage having one or more partners was greater in Healthy Cities than in non-Healthy Cities. However, there were no statistical differences between the two groups in terms of the level of ISC within a municipal organization. Collaboration activities of the other departments were mostly supportive, such as providing a venue, recruiting participants and publicizing, and other kinds of administrative support. To strengthen ISC in Korean Healthy Cities, various actions including providing a legal basis, specific and substantive supports, financial incentives, and organizational recognitions will be helpful as well as the development of partnerships with other departments in urban planning, transport, urban design, and communication. [ABSTRACT FROM AUTHOR]

Background: The number of elderly patients admitted to the intensive care unit is constantly growing. However, a decision regarding intensive care in these populations remains a challenge. Aim: To identify factors that influences the decision of elderly patients and their families about whether to initiate intensive care in case of an acute event. Design/participants: Medical records of patients (>80 years), who were admitted to general wards and referred for intensive care, were retrospectively reviewed. Patients who received intensive care were compared with those not agreeing to the initiation of intensive care. Results: Among the 125 patients, 45 agreed to receiving intensive care. Baseline characteristics at the time of intensive care unit referral were similar between the intensive care and non-intensive care groups. Only one patient had advance directives before the intensive care unit referral. Lower economic status (odds ratio = 0.27, 95% confidence interval = 0.08–0.94) and cognitive impairment (odds ratio = 0.20, 95% confidence interval = 0.07–0.56) were found associated with a lower likelihood of agreeing to intensive care, while a large number of participants involved in the decision-making process were associated with a higher likelihood of intensive care unit use (odds ratio = 1.82, 95% confidence interval = 1.08–3.09). Mean duration of hospital stay was longer for the intensive care group as compared with the non-intensive care group (28.8 days and 19.8 days, respectively, p = 0.03). However, there was no significant difference in the survival rate. Conclusion: The initiation of intensive care in elderly patients was influenced not only by medical conditions but also by the patient’s economic status and the number of family members involved in the decision-making process. [ABSTRACT FROM AUTHOR]

Aim and objective To identify effects of the huddling programme as a strategy for retention of clinical nurses. Background In Korea, new nurses leave hospitals more than experienced nurses for many reasons. Hospitals with a high nurse turnover require larger budgets and longer periods of time to train large numbers of newly recruited nurses until they can perform as well as those who have left. Furthermore, the remaining nurses have an additional workload associated with both the shortage of manpower and the need to train the incoming nurses. This means that reducing nurse turnover intention requires preventive measures that promote empowerment and organisational commitment among nurses in Korea. Design Randomised controlled trial. Methods This research used a pretest-post-test experimental-group-control-group design to investigate the effect of the huddling programme. The participants were 49 clinical nurses working at two general hospitals with more than 500 beds that are located in D city and S city of Korea. The experimental group participated in the huddling programme that comprised a full-day retreat and after-work social networking services during January and February 2013. Self-reported questionnaires were used to assess empowerment, organisational commitment and ego-resilience. The data were analysed by descriptive analysis using the t-test. Results The mean scores for normative commitment and impact of empowerment were higher in the experimental group, but ego-resilience did not differ significantly between the two groups. Conclusion The huddling program positively increased nurses' perception of organisational commitment and empowerment who participated in huddling programme. The huddling programme could be a useful strategy for improving the retention of clinical nurses. Relevance to clinical practice This study is both significant and relevant to nursing science and practice given that it demonstrated the effectiveness of an empowerment programme in increasing organisational commitment and decreasing actual turnover rates of clinical nurses. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify the impact of preprocedural left ventricular ejection fraction and adherence to prescribed medication on major adverse cardiac events in patients with a successful primary percutaneous coronary intervention. Background Although advances in percutaneous coronary intervention for coronary artery disease have considerably reduced poor outcomes such as major adverse cardiac events, many patients still experience adverse outcomes after a percutaneous coronary intervention. Thus, in patients with percutaneous coronary intervention, it is extremely important to identify the predictors for major adverse cardiac events. Design A retrospective and cross-sectional design. Methods Three hundred and nineteen patients who underwent successful primary percutaneous coronary intervention participated in this study. Participants were assessed for major adverse cardiac events after percutaneous coronary intervention for the first year. Preprocedural left ventricular ejection fraction was measured by echocardiogram. Medication adherence was used with the validated Morisky Medication Adherence Scale-8 items at the first year after the successful primary percutaneous coronary intervention. Results Of the 319 patients, 102 had major adverse cardiac events after the successful primary percutaneous coronary intervention. On the basis of Cox regression, after adjusting for patient characteristics, lower baseline left ventricular ejection fraction and medication nonadherence and were statistically significant and independent predictors of major adverse cardiac events. Conclusions Our results show that major adverse cardiac events after successful primary percutaneous coronary intervention are associated with low left ventricular ejection fraction at baseline and medication nonadherence after discharge. Therefore, healthcare providers should consider multidimensional approaches to improve low left ventricular ejection fraction and medication adherence. Relevance to clinical practice The findings suggest that the classification of high-risk patients after percutaneous coronary intervention need to be based on level of preprocedural left ventricular ejection fraction. Follow-up of these patients may include educational interventions to enhance medication adherence, to decrease the prevalence of major adverse cardiac events. [ABSTRACT FROM AUTHOR]

Background: In the Korean educational system, academic achievement is one of the crucial factors in assessing a student's academic ability for postsecondary education. Thus, many researchers have been studying ways to improve students' academic achievement. Objective: The purpose of this study was to examine the relationship between students' perceptions of teachers' motivational behavior and students' academic achievement, as well as the mediating effects of students' motivation and self-efficacy on this relation. Methods: Using the Korean Education Longitudinal Study data, we employed structural equation modeling to assess the impacts of different variables (i.e., students' perceptions of their teachers' motivational behavior, self-efficacy, and intrinsic motivation) on the academic achievements of 6227 middle school students'. We further examined whether these relationships differed depending on the school subject, specifically, reading, English, and mathematics. Results: The results indicate that students' self-efficacy and intrinsic motivation mediated the relation between students' perceptions of teachers' motivational behavior and students' academic achievements in all three subjects. Conclusion: This study suggests that students' self-efficacy and intrinsic motivation increase when students perceive their teachers' motivational behaviors positively, which ultimately improves their performance in reading, English, and mathematics. [ABSTRACT FROM AUTHOR]

The present study explored the relationships between fried food consumption and metabolic risk factors and hypertension in Korean adults. The study was based on the fifth Korean National Health and Nutrition Examination Survey between 2010 and 2011. A total of 9221 Korean adults aged ≥19 years were studied. Fried food consumption was assessed using a validated FFQ. Metabolic risk factors such as waist circumference, fasting plasma glucose (FPG), TAG, HDL-cholesterol and systolic and diastolic blood pressure (SBP and DBP) were measured. Hypertension was defined as SBP≥140 mmHg, DBP≥90 mmHg or current use of antihypertensive medication. Adjusted OR for elevated blood pressure significantly increased in men (OR 1·62; 95 % CI 1·11, 2·37; Ptrend=0·0447) and women (OR 2·20; 95 % CI 1·21, 4·00; Ptrend=0·0403) with a greater than twice a week consumption of fried food compared with those who rarely consumed fried food. However, fried food consumption was not associated with other metabolic risk factors (abdominal obesity, high FPG, hypertriacylglycerolaemia, low HDL-cholesterol and the metabolic syndrome). The adjusted OR for hypertension increased by 2·4-fold in women (OR 2·37; 95 % CI 1·19, 4·72; Ptrend=0·0272) with a greater than twice a week fried food consumption compared with those who rarely consumed it. No significant association was found between fried food consumption and hypertension in men. This study suggests that frequent fried food consumption is associated with hypertension in Korean women. Further studies are needed to investigate the effect of different types of fried foods on hypertension. [ABSTRACT FROM AUTHOR]

Aims and objectives To determine the effect of the amount of rice carbohydrates consumed during mealtime on the extent of decrease in postprandial blood pressure in older people with postprandial hypotension. Background The incidence of postprandial hypotension is as high as 74% in older people with hypertension. Design A within-subjects repeated measures design was used. Methods Thirty-nine older people in nursing homes received a full serving and a half-serving of rice on two separate days, in random order blood pressure and heart rate were measured before each meal and every 15 minutes for a total of 120 minutes after each meal. Data were analysed using repeated measures analysis of variance and the paired t-test with a Bonferroni adjustment using IBM spss version 19.0. Results The control and intervention conditions yielded significantly different patterns in systolic blood pressure and diastolic blood pressure. Postprandial hypotension was less frequent under the intervention condition; however, decrease in rice intake did not significantly affect heart rate. Conclusion Reducing the amount of rice intake per meal prevents postprandial blood pressure decreases in the older people. Small and frequent meals with decreased carbohydrate content are recommended to prevent postprandial hypotension and its complications in the older people. Relevance to clinical practice Patients, dieticians and caregivers of older patients should be aware of the importance of diet, especially of decreasing the amount of carbohydrate in a meal. Smaller and more frequent meals are recommended for older people to slow gastric emptying. [ABSTRACT FROM AUTHOR]

Objective Oxytocin circuits are implicated in the regulation of appetite and weight. Variants in the oxytocin receptor (OXTR) gene have been associated with bulimic behaviour. This study aimed to investigate the association between the OXTR gene and eating disorders. Method We genotyped six single nucleotide polymorphisms, rs53576, rs237879, rs2228485, rs13316193, rs2254298 and rs1042778, located within the OXTR gene in Korean patients with eating disorders using the single-base extension method. We studied a total of 262 women, including 69 patients with anorexia nervosa, 90 patients with bulimia nervosa (BN), and 103 healthy women. Results We found a positive association between the G allele of OXTR rs53576 and BN. In the BN group, the G carriers showed a high score on the behavioural inhibition system. Conclusions These findings suggest the involvement of the oxytocinergic system in the mechanism that underlies BN. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Aims and objectives This study aims to identify the effects of type D personality on symptom control and quality of life and to explore factors influencing quality of life among asthma patients in Korea. Background Psychological factors such as depression and stress are well known to be related to medical outcomes and quality of life in asthma patients. People with type D personality are vulnerable to stress, show poor prognosis in disease and experience low quality of life. Design A descriptive cross-sectional design was used. Methods A total of 144 patients with asthma participated in this study. Data were collected through face-to-face interviews using structured questionnaires: the Type D Personality Scale-14, Asthma Control Test and Asthma-Specific Quality of Life. Results About 33% of participants were classified into the type D personality group. The type D personality group showed statistically significantly lower symptom control and asthma-specific quality of life compared to the non-type D personality group. Based on forward stepwise multiple regression, the most significant factor of quality of life was symptom control, followed by type D personality, hospitalisation within the previous one year, and lifetime hospitalisation experiences. Conclusions The prevalence of type D personality in asthma patients was high, and type D personality was significantly associated with poor symptom control and low quality of life. Psychosocial interventions might be beneficial to improve symptom control and quality of life in asthma patients with type D personality. Relevance to clinical practice Nurses should be aware of the high prevalence of type D personality and the effects on symptom control and quality of life in asthma patients. Nurses should also provide personality-specific interventions to improve quality of life in such patients. [ABSTRACT FROM AUTHOR]

The frequency of dining out has rapidly increased; however, the independent associations between dining out, metabolic syndrome risk factors and nutritional status have not been well characterised. The aim of the present study was to investigate the associations between dining out, nutritional intakes and metabolic syndrome risk factors among Korean adults, using data from the 2011 Korean National Health and Nutrition Examination Survey. Frequency of dining out was significantly associated with intake of nutrients such as energy, water, protein, fat, carbohydrate, Ca, Na, vitamin A and carotene. Especially, the result revealed that Korean adults had insufficient Ca intake compared with the Korean reference intake (700 mg). As the frequency of dining out increased, so did energy intake. In addition, individuals who dined out seven or more times per week experienced a 64 % higher likelihood of blood pressure abnormalities, an 88 % higher likelihood of waist circumference abnormalities, and a 32 % higher likelihood of low HDL-cholesterol levels than those who dined out less than once per week. BMI was not associated with the frequency of dining out. Our findings suggest that strategies to modify dining-out behaviour could reduce metabolic syndrome risk factors via improved nutrition. [ABSTRACT FROM PUBLISHER]

Background Alcohol exposure has been shown to cause devastating effects on neurobehavioral development in numerous animal and human studies. The alteration of DNA methylation levels in gene-specific promoter regions has been investigated in some studies of human alcoholics. This study was aimed to investigate whether social alcohol consumption during periconceptional period is associated with epigenetic alteration and its generational transmission in the blood cells. Methods We investigated patterns of alcohol intake in a prospective cohort of 355 pairs of pregnant women and their spouses who reported alcohol intake during the periconceptional period. A subpopulation of 164 families was established for the epigenetic study based on the availability of peripheral blood and cord blood DNA. The relative methylation changes of dopamine transporter ( DAT) , serotonin transporter ( SERT), and methyl CpG binding protein 2 ( Me CP2) gene promoters were analyzed using methylation-specific endonuclease digestion followed by quantitative real-time polymerase chain reaction. Results The relative methylation level of the DAT gene promoter was decreased in the group of mothers reporting above moderate drinking ( p = 0.029) and binge drinking ( p = 0.037) during pregnancy. The relative methylation level of the DAT promoter was decreased in the group of fathers reporting heavy binge drinking ( p = 0.003). The relative methylation levels of the SERT gene promoter were decreased in the group of newborns of light drinking mothers before pregnancy ( p = 0.012) and during pregnancy ( p = 0.003). The methylation level in the Me CP2 promoter region of babies whose mothers reported above moderate drinking during pregnancy was increased ( p = 0.02). In addition, methylation pattern in the DAT promoter region of babies whose fathers reported heavy binge drinking was decreased ( p = 0.049). Conclusions These findings suggest that periconceptional alcohol intake may cause epigenetic changes in specific locus of parental and newborn genomes as follows: Alcohol consumption decreases the methylation level of the DAT promoter region of the parent themselves, maternal alcohol drinking during the periconceptional period decreases the methylation level of the SERT promoter region of newborns, and maternal alcohol consumption increases the methylation level of the Me CP2 promoter region of newborns. [ABSTRACT FROM AUTHOR]

Background: Brain frontostriatal circuits have been implicated in the pathophysiology of attention-deficit/hyperactivity disorder (ADHD). However, effects of methylphenidate on circuit-level functional connectivity are as yet unclear. The aim of the present study was to comprehensively investigate the functional connectivity of major striatal subregions in children with ADHD, including subanalyses directed at mapping cognitive and treatment response characteristics. Methods: Using a comprehensive seeding strategy, we examined resting-state functional connectivity of dorsal and ventral subdivisions of the caudate nucleus and putamen in children and adolescents with ADHD and in age- and sex-matched healthy controls. Results: We enrolled 83 patients with ADHD and 22 controls in our study. Patients showed significantly reduced dorsal caudate functional connectivity with the superior and middle prefrontal cortices as well as reduced dorsal putamen connectivity with the parahippocampal cortex. These connectivity measures were correlated in opposite directions in patients and controls with attentional performance, as assessed using the Continuous Performance Test. Patients showing a good response to methylphenidate had significantly reduced ventral caudate/nucleus accumbens connectivity with the inferior frontal cortices compared with poor responders. Limitations: Possible confounding effects of age-related functional connectivity change were not excluded owing to the wide age range of participants. Conclusion: We observed a region-specific effect of methylphenidate on resting-state functional connectivity, suggesting the pretreatment level of ventral frontostriatal functional connectivity as a possible methylphenidate response biomarker of ADHD. [ABSTRACT FROM AUTHOR]

This study examines ethnic and gender differences in exposure to discrimination and its association with depressive symptoms among five immigrant groups. Data were derived from a cross-sectional survey of 900 adult immigrants (50.8 % men, 49.2 % women) sampled from five ethnic immigrant communities in Toronto between April and September 2001. Men reported higher levels of discrimination than women. Ethiopians had the highest perception of discrimination followed by Korean, Iranian, Vietnamese, and Irish immigrants. With regard to discrimination-related depressive symptoms, Iranian and Korean men showed a greater risk than their Irish counterparts. Among women, Vietnamese and Irish seemed to be more vulnerable to discrimination than other ethnic groups. Despite experiencing the highest level of discrimination, Ethiopian men and women showed no association between discrimination and depressive symptoms. The exposure and psychological response to discrimination vary significantly across ethnicities and gender. [ABSTRACT FROM AUTHOR]

Introduction Although a plethora of studies have delineated the relationship between childhood trauma and onset, symptom severity, and course of depression and anxiety disorders, there has been little evidence that childhood trauma may lead to interpersonal problems among adult patients with depression and anxiety disorders. Given the lack of prior research in this area, we aimed to investigate characteristics of interpersonal problems in adult patients who had suffered various types of abuse and neglect in childhood. Methods A total of 325 outpatients diagnosed with depression and anxiety disorders completed questionnaires on socio-demographic variables, different forms of childhood trauma, and current interpersonal problems. The Childhood Trauma Questionnaire (CTQ) was used to measure five different forms of childhood trauma (emotional abuse, emotional neglect, physical abuse, physical neglect, and sexual abuse) and the short form of the KoreanInventory of Interpersonal Problems Circumplex Scale (KIIP-SC) was used to assess current interpersonal problems. We dichotomized patients into two groups (abused and non-abused groups) based on CTQ score and investigated the relationship of five different types of childhood trauma and interpersonal problems in adult patients with depression and anxiety disorders using multiple regression analysis. Result Different types of childhood abuse and neglect appeared to have a significant influence on distinct symptom dimensions such as depression, state-trait anxiety, and anxiety sensitivity. In the final regression model, emotional abuse, emotional neglect, and sexual abuse during childhood were significantly associated with general interpersonal distress and several specific areas of interpersonal problems in adulthood. No association was found between childhood physical neglect and current general interpersonal distress. Conclusion Childhood emotional trauma has more influence on interpersonal problems in adult patients with depression and anxiety disorders than childhood physical trauma. A history of childhood physical abuse is related to dominant interpersonal patterns rather than submissive interpersonal patterns in adulthood. These findings provide preliminary evidence that childhood trauma might substantially contribute to interpersonal problems in adulthood. [ABSTRACT FROM AUTHOR]

This study investigated how mothers’ working status directly and indirectly influences their infants’ development. The participants were 1,818 mothers with children aged 11 months to 18 months from the Panel Study on Korean Children. We categorized mothers into four groups according to their working status: consistent working, transition to working, transition to nonworking, and consistent nonworking. We found two competing mediating mechanisms through which mothers’ working status influences infant development. First, mothers’ consistent working and transition to working status had a positive influence on their mental health in terms of low depressive symptoms and high self-esteem, which in turn positively contributed to positive parenting style. Second, mothers’ consistent working and transition to working status had direct adverse effects on their parenting style. Positive parenting style contributed to infant development. We also found that mothers’ transition to working directly enhanced infant development. [ABSTRACT FROM PUBLISHER]

Background. The benefits of proton beam craniospinal irradiation (PrBCSI) in children have been extensively reported in dosimetric studies. However, there is limited clinical evidence supporting the use of PrBCSI. We compared the acute toxicity of PrBCSI relative to that of conventional photon beam CSI (PhBCSI) in children with brain tumours. Material and methods. We prospectively evaluated the haematological and gastrointestinal toxicities in 30 patients who underwent PrBCSI between April 2008 and December 2012. As a reference group, we retrospectively evaluated the medical records of 13 patients who underwent PhBCSI between April 2003 and April 2012. The median follow-up time from starting CSI was 22 months (range 2-118 months). The mean irradiation dose was 32.1 Gy (range 23.4-39.6 Gy) and 29.4 CGE (cobalt grey equivalents; range 19.8-39.6), in the PrBCSI and PhBCSI groups, respectively (p = 0.236). Results. There was no craniospinal fluid space relapse after curative therapy in either group of patients. Thrombocytopenia was less severe in the PrBCSI group than in the PhBCSI group (p = 0.012). The recovery rates of leukocyte and platelet counts measured one month after treatment were significantly greater in the PrBCSI group than in the PhBCSI group (p = 0.003 and p = 0.010, respectively). Diarrhoea was reported by 23% of patients in the PhBCSI group versus none in the PrBCSI group (p = 0.023). Conclusions. The incidence rates of thrombocytopenia and diarrhoea were lower in the PrBCSI group than in the PhBCSI group. One month after completing treatment, the recovery from leukopenia and thrombocytopenia was better in patients treated with PrBCSI than in those treated with PhBCSI. [ABSTRACT FROM AUTHOR]

Objectives: To identify prognosis-associated methylation markers of uterine cervical squamous cell carcinoma (SCC) and to verify potential clinical correlations. Methods: A genome-wide methylation array was performed using tissue samples of stage Ib1 (n = 9) and IIa (n = 5) tumors. Methylation levels were quantitatively evaluated by pyrosequencing for 54 tissue samples from SCC patients and 22 samples from normal controls. Clinicopathologic findings were obtained from medical records. Correlation or t test statistics were used to analyze the relationships between methylation levels and clinical features. Survival data were estimated using the Kaplan-Meier method and compared to the log-rank test. Results: The methylation array identified 32 genes with distinct differences (p < 0.01) between stage Ib1 and IIa disease, and VIM was selected for further evaluation. Pyrosequencing analysis revealed that 40.7% of carcinoma samples had a higher methylation level in the VIM gene compared to the normal controls. VIM methylation status, low FIGO stage, and lack of parametrial involvement were significantly associated with longer disease-free survival (p = 0.036, p = 0.028, and p = 0.001, respectively). Conclusions: We profiled 32 genes that might be associated with prognosis in cervical cancer. We further revealed that the VIM gene is frequently methylated in cervical SCC and that its methylation might predict a favorable prognosis. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Aims and objectives To compare the effects of two pain management methods, intravenous patient-controlled analgesia and conventional intravenous injection, in terms of pain level, adverse reactions experienced, nursing care time spent for pain management, satisfaction with pain management and total cost of pain management for patients who underwent total abdominal hysterectomy. Background Patient-controlled intravenous analgesia has been used most commonly for management of postoperative pain. Although it can be very effective in management of postoperative pain, patients still complained of many adverse reactions. Design A quasi-experimental study design was used. Methods Seventy female participants were recruited for each group and were randomly assigned to one of the pain management methods. Data regarding pain level, adverse reactions experienced and level of satisfaction with pain management methods during a 48-hour postoperative period were collected. Calculation of cost for each pain management method was based on the cost of the device, drugs for both analgesics and antiemetics, and time spent by nurses for both pain management methods. Frequencies, percentages and means of the data were calculated, and chi-squared test and t-test were performed for homogeneity. Results Mean postoperative pain levels at 2, 6 and 12 hour were significantly lower in patients who used patient-controlled analgesic compared with patients who received intravenous injection; however, after that, there was no significant difference between the two methods. The cost for pain management was much higher for patients who used patient-controlled analgesic; however, satisfaction level with pain control was lower than that for patients who received intravenous injection. Conclusions For patients who underwent total hysterectomy, patient-controlled analgesia was not cost-effective for management of postoperative pain for 48 hour, compared with conventional intravenous injection. Relevance to clinical practice For nurses caring for patients with pain, adaptation of diverse methods of pain management that will increase patients' satisfaction with pain management as well as lower the cost and occurrence of adverse reactions should be considered. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to examine the performance of the Global Trigger Tool and to investigate characteristics associated with the occurrence of adverse events ( AEs). Study design Retrospective medical record review. Setting A tertiary teaching hospital, Korea. Method We employed two-stage review of a random sample of 630 charts for patients discharged between January and June 2011. Two quality improvement specialists reviewed the presence of AEs using 53 triggers developed by the Institute for Healthcare Improvement. Two physicians reviewed and validated the findings of adverse events. Positive predictive values for individual triggers were calculated. Logistic regression analysis was performed to determine factors associated with AEs. Results Of 629 patients, 45 (7%) experienced at least one AE during their hospitalization. Among the observed AEs, 61% were preventable. The frequent types of AEs were 'procedure-related' and 'medication-related'. Six triggers had positive predictive values of greater than 50.0%: 'health care-associated infection', 'any procedure complication', 'medication: other', 'return to surgery', 'occurrence of any operative complication' and 'intubation/reintubation'. Significant factors associated with the occurrence of AEs were length of stay ( OR 1.13; 95% CI 1.07 to 1.20) and the number of triggers ( OR 1.49; 95% CI 1.11 to 1.98). Conclusion The Global Trigger Tool was useful for the detection of adverse events in a Korean hospital setting. Triggers with high positive predictive values should have priority for incorporation into routine screening systems. Furthermore, patients who stay longer in the hospital need to be closely monitored using triggers to improve patient safety. [ABSTRACT FROM AUTHOR]

This study examines whether elderly Koreans recognize a scenario of intimate partner violence as such and whether they would seek help in the given situation of elder mistreatment (EM). Two cohorts of Korean elders (one immigrant and one Korea-based), each numbering 124 participants, were recruited using a quota sampling strategy. The study used a mixed method approach, employing a hypothetical scenario, and patriarchy theory informed the study. Findings revealed low perception of the vignette as EM and low help-seeking intention in both cohorts. Among the immigrant cohort, intention to seek help was greater among respondents who were female, demonstrated lower adherence to traditional values, and perceived the vignette as EM. Among the Korea-based cohort, the only significant factor was recognition of the scenario as EM. Development of culturally competent and geographically specific practice and intervention is urgently needed, particularly among elders who have greater adherence to traditional cultural values. [ABSTRACT FROM AUTHOR]

Aim The aim of this exploratory study was to analyse prevalence of extraction sockets showing erratic healing and evaluate factors potentially impeding healing. Methods Erratic healing was defined as extraction sites showing clinical observations of fibrous scar tissue occupying the extraction site rather than bone following 12 or more weeks of healing. Computerized tomography was used to evaluate characteristics and calculate Hounsfield unit scores for sites showing erratic healing. Results A total of 1226 dental records from Seoul National University Dental Hospital archives including patients subject to extractions prior to implant placement were evaluated. Seventy subjects (5.71%) and 97 sites (4.24%) exhibited erratic extraction socket healing. Maxillary incisor/canine sites showed the lowest (0.47%), whereas mandibular molar sites the highest (5.41%) occurrence. In the multivariable analysis, erratic healing was more likely to occur in subjects <60 years old ( OR = 2.23, 95%CI = 1.26-3.94), subjects with hypertension ( OR = 2.37, 95%CI = 1.24-4.55), in molar sites ( OR = 4.91, 95% CI = 1.41-17.07), and following single tooth extractions ( OR = 2.98, 95% CI = 1.36-6.53). Computerized tomography showed the highest incidence of bone loss for the buccal wall (49.3%). Conclusion Erratic extraction socket healing appears a not uncommon sequel and local factors seem to be major contributors to its occurrence. [ABSTRACT FROM AUTHOR]

Purpose: In order to provide a systematic and standardized treatment course for MVD patients, a critical pathway (CP) program was developed and the results of its long term application were analyzed. Methods: This was a methodological study. The CP was established and applied to 75 (step I) and 1,216 (step II). Another group of 56 with similar features was used as a control group. Results: The application of CP turned out to be useful in many regards: the rate of hearing loss was reduced from 1.8% to 0% (step I) and 0.5% (step II), and low cranial nerve palsy was reduced from 1.8% to 1.3% and 0.7%, respectively. The length of hospitalization decreased by 2.56 days (25.2%) for step I and 3.05 days (30.0%) for step II. Days of ICU stay were reduced by 7.9% and 1.8%. The total cost per patient was reduced by 14.8% (step I). The cost per day was increased by 13.7% and 52.4%. An increase in the patient satisfaction index was noted, as shown in the ICU information guide (p=.002). Conclusion: The development and application of CP was found to improve the quality of medical treatment and the efficacy of hospital management in MVD patients. Well organized and efficient system and multidisciplinary teamwork are the key component of the successful application of CP. [ABSTRACT FROM AUTHOR]

Asian Americans experience diabetes at a higher rate than non-Hispanic whites. Diabetes prevention programs using lifestyle interventions have been shown to produce beneficial results, yet there have been no culturally-tailored programs for diabetes prevention in the Korean community. We explore the impact and feasibility of a pilot Community Health Worker (CHW) intervention to improve health behaviors and promote diabetes prevention among Korean Americans using a randomized controlled trial. Between 2011 and 2012, a total of 48 Korean Americans at risk for diabetes living in New York City (NYC) participated in the intervention. Participants were allocated to treatment or control groups. A community-based participatory research approach guided development of the intervention, which consisted of 6 workshops held by CHWs on diabetes prevention, nutrition, physical activity, diabetes complications, stress and family support, and access to health care. Changes over 6 months were examined for clinical measurements (weight, BMI, waist circumference, blood pressure, glucose, and cholesterol); health behaviors (physical activity, nutrition, food behaviors, diabetes knowledge, self-efficacy, and mental health); and health access (insurance and self-reported health). In this small pilot study, changes were seen in weight, waist circumference, diastolic blood pressure, physical activity nutrition, diabetes knowledge, and mental health. Qualitative findings provide additional contextual information that inform ways in which CHWs may influence health outcomes. These findings demonstrate that a diabetes prevention program can be successful among a Korean American population in NYC, and important insight is provided for ways that programs can be tailored to meet the needs of vulnerable populations. [ABSTRACT FROM AUTHOR]

Summary: Higher serum uric acid (UA) was associated with higher bone mass, lower bone turnover, and lower prevalence of vertebral fracture in postmenopausal women. Furthermore, UA suppressed osteoclastogenesis and decreased production of reactive oxygen species in osteoclast precursors, indicating UA may have beneficial effects on bone metabolism as an antioxidant. Introduction: UA is known to play a physiological role as an antioxidant, and oxidative stress has detrimental effects on bone metabolism. In the present study, we investigated the association of serum UA level with the osteoporosis-related phenotypes and its direct effect on bone-resorbing osteoclasts using in vitro systems. Methods: This is a large cross-sectional study, including 7,502 healthy postmenopausal women. Bone mineral density (BMD) and serum UA concentrations were obtained from all subjects. Data on bone turnover markers and lateral thoracolumbar radiographs were available for 1,023 and 6,918 subjects, respectively. An in vitro study investigated osteoclastogenesis and reactive oxygen species (ROS) levels according to UA treatment. Results: After adjusting for multiple confounders, serum UA levels were positively associated with BMD at all sites (all p < 0.001). Compared with the participants in the highest UA quartile, the odds for osteoporosis were 40 % higher in those in the lowest quartile. The serum UA levels were inversely related to both serum C-terminal telopeptide of type I collagen and osteocalcin levels ( p < 0.001 and p = 0.004, respectively). Consistently, subjects with vertebral fracture had lower serum UA levels, compared with those without it ( p = 0.009). An in vitro study showed that UA decreased osteoclastogenesis in a dose-dependent manner and reduced the production of ROS in osteoclast precursors. Conclusion: These results provide epidemiological and experimental evidence that serum UA may have a beneficial effect on bone metabolism as an antioxidant in postmenopausal women. [ABSTRACT FROM AUTHOR]

Conclusion: Factors that affected prognosis were T stage and extracapsular spread in patients that underwent primary surgery with postoperative radiotherapy for pN2 head and neck carcinoma. Objectives: The purpose of this study was to examine treatment outcomes and define prognostic factors for pN2 head and neck carcinoma. Methods: A total of 209 patients underwent surgery with postoperative radiotherapy between 1994 and 2011. Primary tumor sites were the oropharynx ( n = 70), hypopharynx ( n = 48), larynx ( n = 47), and oral cavity ( n = 44). There were 21, 83, 60, and 45 patients with stage T1 to T4 cancers, respectively. The N stages were 20 N2a, 129 N2b, and 60 N2c. Results: The recurrence rate was 40% (83/209) over a mean observation period of 39 months. The 5-year disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS) rates in our cohort were 44%, 60%, and 56%, respectively. The presence of advanced T stage or extracapsular spread had a significant adverse effect on 5-year DFS, DSS, and OS rates according to Kaplan-Meier survival curves. Multivariate Cox regression analysis confirmed the significant association between 5-year DSS rate and advanced T stage (hazard ratio (HR), 2.20; 95% confidence interval (CI), 1.26-3.82; p = 0.005) and extracapsular spread (HR, 2.29; 95% CI, 1.24-4.21; p = 0.008). [ABSTRACT FROM AUTHOR]

AF Termination Sites During RA CFAE Ablation Background The role of right atrial (RA) ablation guided by complex fractionated atrial electrograms (CFAE) in atrial fibrillation (AF) has been debated. This study evaluated the spatial distribution of RA CFAE, the critical sites, and the predictors of successful termination of longstanding persistent AF during RA ablation. Methods A total of 97 patients with persistent AF who received automated detection of CFAE mapping and ablation at the RA for sustained AF after pulmonary vein isolation and left atrial (LA) CFAE-guided ablation were analyzed. The AF termination patterns and CFAE areas were analyzed. Results Forty-eight (49%) patients successfully converted to atrial tachycardia (AT) or sinus rhythm (SR) during CFAE-guided ablation at the RA. Of these, 7 (15%) patients converted directly to SR, and 41 (85%) converted via AT. The crista terminalis (CT) was the most common site for AT conversion during RA CFAE ablation, followed by the RA appendage and RA septum. Patients with larger RA volumes (>145 mm3) had lower rates of SR or AT conversion during RA CFAE ablation. Patients with AF termination during RA CFAE ablation had less late recurrence than those without AF termination (P = 0.003). Conclusion A half of patients with persistent AF refractory to LA ablation successfully converted to AT or SR during automated CFAE-guided ablation at the RA. The most common critical sites for AF termination were the CT and RA appendage and septum. Patients with AF termination during procedure whether LA CFAE only or after RA CFAE ablation had better outcome with less late recurrence of atrial tachyarrhythmia compared to those without AF termination. [ABSTRACT FROM AUTHOR]

By combining stakeholder theory and activity theory, this study examines the dynamic relationships among wealth, volunteering, and self-esteem of older adults. This study uses latent growth curve modeling (LGCM) to capture the longitudinal patterns of self-esteem across four waves of data from the Americans’ Changing Lives (ACL) Study. As time-varying variables, the longitudinal trajectories of volunteering hours and self-esteem are analyzed. As time-invariant independent variables, the authors consider two types of wealth measurements: homeownership and the amount of total liquid assets at Wave 1. The authors find that the intercept of volunteering hours is positively associated with the intercept of self-esteem. This study also finds that volunteering hours partially mediates the relationship between wealth and self-esteem. This study sheds lights on dynamic mechanisms of wealth, volunteering, and self-esteem among older adults. [ABSTRACT FROM PUBLISHER]

Backgroud Procurement of tumor tissue is mandatory for a mutation analysis in patients with non-small cell lung cancer. The purpose of this study was to evaluate the usefulness of bronchoscopic biopsy and endobronchial ultrasound-guided transbronchial needle aspiration ( EBUS-TBNA) biopsy for detecting epidermal growth factor receptor ( EGFR) and KRAS mutations in routine practice. Methods Tumor DNA was extracted from formalin-fixed paraffin-embedded tissues, and amplifications of exons 18-21 of EGFR and codons 12, 13 and 61 of KRAS were performed using polymerase chain reaction ( PCR). PCR products were subjected to direct sequencing in both directions. Results Of 211 consecutive specimens, 201 (95.3%) were available for EGFR mutation analysis, and 196 (92.9%) were adequate for KRAS mutation analysis. EGFR and KRAS mutations were detected in 14.9% and 5.4%, respectively. A median of 16 days was spent from biopsy to the final report for either EGFR or KRAS mutation status. The detection rates for both mutations were similar between bronchoscopic biopsy and EBUS-TBNA (P > 0.05). Female gender (53.3%), never smoker (63.3%), and adenocarcinoma (96.7%) were predominant in patients with EGFR mutations. Among patients with adenocarcinoma (n = 104), the frequencies of EGFR and KRAS mutations were 27.9% and 10.6%, respectively. Conclusions Small tissue samples obtained by bronchoscopic biopsy and EBUS-TBNA are sufficient for detecting EGFR and KRAS mutations in routine practice. Therefore, concurrent mutational analyses of small tissue samples should be considered at the time of initial diagnosis. [ABSTRACT FROM AUTHOR]

Conclusion: As the occult nodal metastasis ratio is low and there is no statistical benefit of elective neck dissection, elective neck dissection is not always necessary during salvage surgery. However, in patients with N positive at initial treatment and cases developing a recurrence within 1 year, elective neck dissection should be considered during salvage surgery. Objectives: The aim of this study was to evaluate the role of ipsilateral or contralateral elective neck dissection during salvage surgery in head and neck squamous cell carcinoma. Methods: A total of 154 node negative and previously undissected heminecks were electively dissected or observed. We estimated the occult metastasis rate in the electively dissected group and compared the regional control rate and disease-specific survival rate between the elective neck dissection group and the observation group. Results: Six of 80 electively dissected heminecks (7.5%) had occult nodal metastasis. When comparing the regional control rate and disease-specific survival rate between the elective neck dissection group and the observation group, there was no statistically significant difference between groups. However, N-positive cases at initial treatment and recurrent cases that developed within 1 year had a significant advantage for elective neck dissection during salvage surgery. [ABSTRACT FROM AUTHOR]

Purpose Brain metastasis has a poor prognosis in patients with advanced non-small cell lung cancer ( NSCLC). In this study, we evaluated the prognosis of NSCLC patients with brain metastases. Methods We analyzed a total of 313 NSCLC patients with brain metastasis. We compared the prognoses between a group of less than four (group A) and a group of more than four or equal to four (≥4) (group B) brain metastases. Results The median survival time was 334 days (group A, 164 patients, 52.4%) and 234 days (group B, 149 patients, 47.6%). Univariate analysis showed that the number of metastases, age at diagnosis of brain metastasis, smoking history, histologic type, and former stage of primary lung cancer before brain metastasis, had a significant influence. In addition, treatment for primary lung cancer lesions and brain metastasis also affected the overall survival (p < .0001). However, there was no difference in the overall survival between the two groups in the multivariate analysis. Conclusion Our results show that the number of brain metastases, classified by group A (<4) or group B (≥4) did not influence the overall survival of NSCLC patients. However, the overall survival in group A was better than in group B when analyzed, except for local brain treatment modalities in sub-group analysis, suggesting that non-optimized local treatment strategies might cause an unexpected prognosis result in this retrospective study. We suggest that more prospective studies might be needed for the optimal standard treatment for brain metastasis. [ABSTRACT FROM AUTHOR]

Aims: Reducing craving is a key to success in the treatment of alcohol dependence. The emotion circuit may be involved in pathological craving for alcohol. In this study, we investigated neural correlates of emotional involvement in craving in alcohol dependence. Methods: The study included 17 detoxified alcoholic patients and 25 social drinkers. We used functional magnetic resonance imaging to examine brain activation (blood oxygen level-dependent signals) while participants reported craving and emotion in response to visually presented, alcohol-related stimuli and emotional stimuli. Results: In the craving-rating paradigm, negative emotional stimuli as well as alcohol cues activated craving-related brain regions in alcoholic patients. Activations of the inferior parietal lobule and dorsolateral prefrontal cortex by negative emotional stimuli were negatively correlated with craving; meanwhile limbic activation was positively correlated with craving. For the emotion paradigm, greater limbic activation was evident by alcohol-related stimuli in the alcohol-dependent group. Conclusions: Our findings constitute neural evidence for emotional involvement in pathological craving for alcohol, underscoring the importance of emotion management in abstinent alcoholic patients for relapse prevention. [ABSTRACT FROM AUTHOR]

Conclusion: Intratympanic steroid therapy (IT-S) was as effective as systemic steroid therapy (SST) or combined therapy (CT) and could be considered a first-line therapeutic modality for idiopathic sudden sensorineural hearing loss (SSNHL). Due to its known safety and efficacy, IT-S will be particularly suitable for patients with SSNHL who have chronic diseases such as diabetes mellitus, hypertension, or chronic renal failure. Objectives: Systemic high dose steroid therapy is the main therapeutic modality for SSNHL. Comparable therapeutic efficacies for IT-S and CT with SST and IT-S for SSNHL have been reported recently. We compared the efficacy of IT-S, SST, and CT for treating SSNHL. Methods: A retrospective, multicenter study investigating the therapeutic efficacy of SST, IT-S, and CT for SSNHL was designed and involved 735 patients with idiopathic SSNHL who were diagnosed and treated at seven tertiary referral medical centers of the Catholic University of Korea between 2007 and 2011. Patients were divided into three groups according to the treatment methods they received: IT-S group, SST group, and CT group (SS plus IT-S). Hearing was evaluated by pure tone audiogram performed before initial treatment and at 4 weeks following the final treatment. More than a 10 dB HL decrease in average air conduction threshold of hearing at 500, 1000, 2000, and 3000 Hz was defined as improved hearing. Results: Among 735 patients with SSNHL, 94 were included in the IT-S group, 444 in the SST, and 197 in the CT group. Age, gender, interval from disease onset to start of treatment, and initial hearing level were not different among the three groups. Patients who had concomitant medical disorders such as diabetes mellitus, hypertension, or chronic renal failure were more frequently treated with IT-S. No difference in the level of hearing gain or ratio of hearing improvement was observed among the three groups (p = 0.147 and p = 0.067, respectively). [ABSTRACT FROM AUTHOR]