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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]

Background In clinical practice, acupuncture manipulation is highly individualised for each practitioner. Before we establish a standard for acupuncture manipulation, it is important to understand completely the manifestations of acupuncture manipulation in the actual clinic. To examine motion patterns during acupuncture manipulation, we generated a fitted model of practitioners' motion patterns and evaluated their consistencies in acupuncture manipulation. Methods Using a motion sensor, we obtained real-time motion data from eight experienced practitioners while they conducted acupuncture manipulation using their own techniques. We calculated the average amplitude and duration of a sampled motion unit for each practitioner and, after normalisation, we generated a true regression curve of motion patterns for each practitioner using a generalised additive mixed modelling (GAMM). Results We observed significant differences in rotation amplitude and duration in motion samples among practitioners. GAMM showed marked variations in average regression curves of motion patterns among practitioners but there was strong consistency in motion parameters for individual practitioners. The fitted regression model showed that the true regression curve accounted for an average of 50.2% of variance in the motion pattern for each practitioner. Conclusions Our findings suggest that there is great inter-individual variability between practitioners, but remarkable intra-individual consistency within each practitioner. [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]

The American Heart Association's ideal cardiovascular health score is based on 7 cardiovascular health metrics to measure progress toward their Impact Goal of reducing cardiovascular disease by 20 % before 2020. This study applied this construct to assess cardiovascular health in a sample of Asian Americans. Convenience sampling methods were used to enroll self-identified Asian American's over the age of 18 years who were attending community health fairs across the greater Philadelphia and urban areas of New Jersey. The heart health metrics of tobacco use, body mass index, physical activity, diet, blood pressure, and glucose were measured. In the greater sample (N = 541), 82 % were female, the mean age was 65.1 (SD = 15.5) years, 45 % were Vietnamese, 38 % were Chinese and 17 % were Korean. Prevalence of ideal heart health for the metrics of tobacco use (95 %) was high. Only 19.4 % achieved ideal levels of physical activity, 35.1 % for BMI, 28.9 % for glucose and 66 % for blood pressure. Dietary intake was ideal for 20.7 % of the sample. More years since migration and Korean race trended toward having a higher prevalence of poor health in some metrics. Most Asian Americans are not achieving ideal cardiovascular health for several of the metrics evaluated, with those residing in the United States for more than 13 years and Korean Americans being higher-risk groups. Targeted community based intervention approaches to improving and monitoring heart health in Asian American, and Asian American subgroups, are needed. [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]

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]

Purpose: In this study the time point of effects that repeat exposure to simulation-based nursing training has on stress, interest in learning, and problem-solving abilities were identified. Methods: Participants for this study were 75 nursing college students in Seoul. In a preliminary survey data were collected and measured for the general characteristics, stress, interest in learning, and problem-solving abilities of the students. Then, stress was assessed before performance of each of four-rounds of simulation training scenarios. After each simulation round, interest in learning and problem-solving abilities were assessed. Results: With respect to stress, no significant differences were found when comparing the results of the preliminary survey to those of each of the simulation-based training exercises. For the sub-items of interest in learning, interest in nursing knowledge and interest in clinical training significantly increased between the preliminary survey and the 4th survey. Interest in lab training increased significantly at the 1st survey. Problem solving abilities showed a significant increase from the preliminary at each of the survey points. Conclusion: Increasing the exposure of nursing students to simulation-based training enhances their interest in learning and problem-solving abilities. Therefore it is necessary to have education strategies that includes various simulation experiences for students. [ABSTRACT FROM AUTHOR]

We explored the effects of employees' organizational efficacy perceptions on their subsequent behaviour and performance. Study 1 demonstrated the discriminant validity of organizational efficacy and its significant incremental contribution to the prediction of job performance over the variance explained by other efficacy beliefs and organization-directed constructs. Study 2 tested our hypotheses using multilevel analyses of 2-wave longitudinal data collected over a 2-year period from 846 employees of 105 work teams. Organizational efficacy perceptions significantly predicted employees' subsequent helping behaviour and job performance. These relationships were more pronounced when an employee's efficacy perceptions were congruent with those of other team members. Growth curve analysis showed that such perceptual congruence increased over time when the focal employee experienced a high level of support from team leaders. The study contributes to extant efficacy literature by establishing organizational efficacy as a new and meaningful dimension that predicts important employee outcomes. Practitioner points The findings provide practitioners with a demonstration of how employees' organizational efficacy perceptions affect work outcomes and predict their job performance and helping behaviour., The study highlights the importance of perceptual fit in organizational efficacy by showing how organizational efficacy perceptions improve outcomes when team members agree on their perceptions., The findings provide practitioners with insights into the role of team leaders' supportive leadership in promoting perceptual fit among team members. [ABSTRACT FROM AUTHOR]

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 Falls are among the most frequent critical health problems for older adults over 65 years of age and often result in consequential injuries. Aim This study developed a guideline covering risk factors and interventions for falls in order to prevent them from occurring in long-term care facilities. Methods This study was grounded in the methodological approach of the Scottish Intercollegiate Guideline Network for establishing evidence-based guidelines: (1) establishment of the target population and scope of the guideline, (2) systematic literature review and critical analysis, (3) determination of the recommendation grade, (4) development of a draft nursing intervention guideline and algorithm, (5) expert evaluation of the draft nursing intervention guideline, and (6) confirmation of the final intervention guideline and completion of the algorithm. Results The resulting evidence-based fall prevention guideline consists of a three-step factor assessment and a three-step intervention approach. Limitations The resulting guideline was based on the literature and clinical experts. Further research is required to test the guideline's feasibility in across long term care facilities. Conclusion This guideline can be used by nurses to screen patients who are at a high risk of falling to provide patient interventions to help prevent falls. Implications for nursing and health policy Considering the high rate of falls at long-term care facilities and the absence of evidence-based guidelines to prevent them, additional studies on falls at long-term care facilities are necessary. Meanwhile, given prior research that indicates the importance of human resources in the application of such guidelines, continuous investigations are needed as to whether the research outcomes are actually conveyed to nurses. [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]

Aims and objectives To evaluate the usefulness of this pathway in managing postoperative emptying failure as a secondary complication of radical hysterectomy. Background Postoperative urological management after radical hysterectomy has not been effective. We designed and prospectively applied a critical pathway for effective postoperative urological management after radical hysterectomy, based on early catheter removal and application of clean intermittent catheterisation. Design Retrospective qualitative study. Materials and methods Retrospective review of results from a database of patients who underwent radical hysterectomy and pelvic lymphadenectomy for the treatment of uterine cervical cancer from 2004-2008 and analysis of questionnaires from ward nurses (Appendix 1) who were directly involved in patient care for measuring the clinical effectiveness. Results Data from a total of 185 patients were analysed. Mean period of the indwelling catheter was 8·3 ( SD 1·1), 13·0 ( SD 1·1) and 13·1 ( SD 3·3) days in the critical pathway ( CP), parallel control ( PC) and historical control ( HC) groups, respectively. Among CP, HC and PC groups, the overall hospital stays were 14·1 ( SD 4·8), 20·2 ( SD 10) and 18·2 ( SD 8·8) days and the periods of time for the indwelling catheters were 8·31 ( SD 1·1), 13·1 ( SD 3·3) and 13·0 ( SD 1·1) days, respectively. Significant differences in the overall hospital stay and the postoperative hospital stay were observed between CP group and the other groups. Analysis of the questionnaires showed that 67% of nurses agreed that the critical pathway was more effective than the previous management pathway system. Conclusions Our results demonstrated that CP is an effective treatment modality for the management of postoperative emptying failure after radical hysterectomy. Relevance to clinical practice Our critical pathway may be applicable to postoperative urological management of radical pelvic surgeries. It may help patients in understanding their hospital course of treatment and encourage patients to participate in their postoperative care. [ABSTRACT FROM AUTHOR]

Background It has been known that ADH1B*2 allele has a protective effect against the development of alcohol dependence. However, the protection mechanism is still unknown. We investigated whether ADH1B gene polymorphism affects ethanol (EtOH) metabolism. Methods In a parent study, we conducted a randomized crossover trials on 24 healthy male subjects who were selected by genotyping: 12 with ALDH2*1/*1 (active form) and 12 with ALDH2*1/*2 (inactive form). In the present study, the 24 subjects were reclassified into 2 groups of 11 with ADH1B*1/*2 and 13 with ADH1B*2/*2 according to the ADH1B genotypes. Each subject was administered 1 of 3 doses of EtOH (0.25, 0.5, 0.75 g/kg) or a placebo in 4 trials. After the administration of alcohol, blood EtOH and acetaldehyde concentrations were measured 9 times over 4 hours. Results In the case of EtOH, the area under the concentration-time curve from 0 to 4 hours ( AUC0-4) and the peak blood concentration of EtOH ( Cmax) in subjects with ADH1B*2/*2 were significantly higher than those in subjects with ADH1B*1/*2 at all 3 dosages before stratifying by ALDH2 genotype. However, after stratifying by ALDH2 genotype, a statistically significant difference between ADH1B*2/*2 and ADH1B*1/*2 was found only at the 0.5 g/kg dosage regardless of ALDH2 genotype. In the case of acetaldehyde, the AUC0-4 and Cmax of acetaldehyde of ADH1B*2/*2 after administration of 0.25 g/kg alcohol and the AUC0-4 of acetaldehyde of ADH1B*2/*2 at 0.5 g/kg were significantly higher than corresponding values of ADH1B*1/*2 only in the group of ALDH2*1/*2. Conclusions Our findings indicate that the blood EtOH concentrations of ADH1B*2/*2 group are higher than those of ADH1B*1/*2 group regardless of ALDH2 genotype, and the blood acetaldehyde concentrations of ADH1B*2/*2 are also higher than those of ADH1B*1/*2 only in the ALDH2*1/*2 group. To our knowledge, this is the first report to demonstrate the association of ADH1B*2 allele with blood EtOH and acetaldehyde levels in humans, and these results suggest that higher blood EtOH and acetaldehyde concentrations in ADH1B*2/*2 may constitute the mechanism of protection against alcoholism by ADH1B*2/*2. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate cardiac self-efficacy and its predictors among patients with coronary artery diseases. Background Patients with coronary artery diseases must perform the health behaviour to prevent recurrent cardiac events. It has been already well known that self-efficacy is a vital factor in both initiating and maintaining health behaviours. Design Descriptive correlational and cross-sectional survey design. Methods Subjects were interviewed using structured study questionnaires. The data collected were statistically analysed by descriptive statistics and inferential statistics including the t-test, anova, Tukey's test, Pearson's correlation and hierarchical multiple regression analysis to determine the predictors of cardiac self-efficacy. Results A convenience sample of 214 patients with coronary artery diseases was included. The mean age of subjects was 60·71 ± 10·07 years, and three-fourths were men. The overall model significantly explained 15·8% of variance in cardiac self-efficacy. Among predictors, occupation, diagnosis, body mass index, experience of receiving patient education and awareness of risk factors had statistically significant influences on cardiac self-efficacy. Conclusions Rather than disease knowledge, factors related to subject's perception were more likely to associate with cardiac self-efficacy. These findings might provide a theoretical basis to develop nursing interventions for enhancing cardiac self-efficacy of patients with coronary artery diseases. Relevance to clinical practice Clinical nurses taking care of patients with coronary artery diseases should consider the patients' perception on their coronary artery diseases including experience of receiving patient education, and awareness of risk factors in encouraging the cardiac self-efficacy to promote the health behaviours for the secondary prevention of coronary artery diseases. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the relationship between the perception on parenting practices and attention deficit hyperactivity disorder ( ADHD) symptoms in school-age children. Background Psychosocial attention deficit hyperactivity disorder intervention approaches emphasise environmental risk factors at the individual, family and community level. Parenting variables are strongly related to attention deficit hyperactivity disorder symptom severity. Design A cross-sectional questionnaire survey. Methods The participants were 747 children and their parents in two elementary schools. The instruments used were Korean Conners Abbreviated Parent Questionnaire and Korean version Maternal Behavior Research Instrument (measuring four dimensions of parenting practices: affection, autonomy, rejection, control). Descriptive and logistic regression analyses were performed. Results The rejective parenting practice was statistically significant in logistic regression controlling gender and age of children, family structure, maternal education level and socio-economic status. The rejection parenting is associated with attention deficit hyperactivity disorder symptoms in children ( OR = 1·356). Conclusions These results suggest the importance of specific parenting educational programmes for parents to prevent and decrease attention deficit hyperactivity disorder symptoms. It would be more effective rather than focusing only on the child's attention deficit hyperactivity disorder symptoms, developing educational programmes for parents to prevent rejection parenting practice and improve parenting skills in the family system. Relevance to clinical practice When developing a treatment programme for children with attention deficit hyperactivity disorder, healthcare providers should consider not only the child's attention deficit hyperactivity disorder symptoms, but also the parenting practices. Comprehensive interventions designed to prevent rejection and improve parenting skills may be helpful in mitigating attention deficit hyperactivity disorder symptoms. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to investigate whether a patient’s preference for a doctor’s face is associated with better assessments of relational empathy in the patient–doctor relationship after the first clinical consultation.Methods A total of 110 patients enrolled in a traditional Korean medical clinic participated in the study. Patients’ preference for doctors’ faces was assessed by a two alternative forced choice (2AFC)task, with 60 different pairs of six different Asian male doctors’ faces. One of the six doctors then carried out the initial clinical consultation for these patients. The patient–doctor relationship was assessed using the Consultation and Relational Empathy (CARE) measure.Results The data of all patients’ simulated preferences for a doctor’s face and their assessment values of a doctor’s relational empathy was compared, and no significant correlation was found between both values (r=−0.024, p>0.809).Conclusions These findings suggest that the perceived empathy in the patient–doctor relationships not influenced by the patient’s preference for a certain doctor’s face. The first impression of a doctor is often determined by his appearance and look. However, whether or not the patient particularly prefers a doctor’s face does not seemto matter in developing a good patient–doctor relationship. [ABSTRACT FROM AUTHOR]

This study followed 106 international adoptees over an 18-month period. Mothers completed the Ages and Stages Questionnaire (ASQ) at 6, 12, and 24 months post-adoption, assessing their children's development in multiple domains. Results revealed that the sample overall demonstrated linear improvement over time in most domains, but children with initially low scores remained significantly lower than others at the 18-month follow-up. ASQ scores were unrelated to age at adoption, but significant differences by birth country emerged. Across most domains, children from Eastern Europe had generally lower scores than children from other birth regions. [ABSTRACT FROM AUTHOR]

Oral Diseases (2012) 18, 613-620 Objective: The aim of this study was to investigate salivary markers related with burning mouth syndrome (BMS). Materials and Methods: Thirty female patients with BMS and twenty female control subjects were included. Unstimulated (UWS) and stimulated whole saliva samples (SWS) were collected, and their flow rates were determined. Salivary levels of cortisol, 17β-estradiol, progesterone, dehydroepiandrosterone (DHEA), and enzymatic activity of α-amylase were determined. Salivary transferrin level was measured to determine the level of blood contamination in saliva samples. Results: The levels of all analytes in UWS were significantly correlated with those of SWS. The levels of 17β-estradiol, progesterone, and DHEA in UWS were significantly correlated with age. Age-matched comparisons revealed that the patient group had significantly higher levels of cortisol in UWS and of 17β-estradiol in SWS. When the patients were divided into older (≥60 years) and younger (<60 years) groups, the older group showed a significantly lower level of progesterone in UWS. There were no significant relationships between treatment efficacy and levels of salivary analytes. Conclusions: In conclusion, patients with BMS showed significantly higher levels of cortisol in UWS and of 17β-estradiol in SWS compared with controls. [ABSTRACT FROM AUTHOR]

The study was conducted to examine the relative effectiveness of cognitive behavior therapy with a cultural tailoring intervention compared to brief medication management. The study used a two-arm randomized controlled trial in which participant assignment was stratified by gender. The intervention condition received eight weekly 40-min individualized counseling sessions of culturally tailored cognitive behavior therapy, while the control condition received eight weekly 10-min individualized counseling sessions of medication management. Both conditions received nicotine patches for 8 weeks. Data were collected at baseline and at four follow-up points (one and 4 weeks, and three and 6 months post-quit). Treatment outcomes were presented as an intention-to-treat analysis. Thirty Korean immigrants participated in the study. At 6-month follow-up, 57.1% of participants in the intervention and 18.8% of participants in the control had 7-day point prevalence abstinence (odds ratio = 5.8, 95% confidence interval = 1.12-26.04, P = 0.04). Participants' self-reported abstinence was biochemically verified with exhaled carbon monoxide and salivary cotinine levels. A combination of the culturally tailored cognitive behavior therapy and nicotine replacement therapy had a better treatment outcome compared to brief medication management. The promising result suggests a need to further test the intervention in larger samples and longer follow-up assessments before it can be adapted in clinical settings. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the current practice of the involvement in decision making from the perspectives of terminal cancer patients, and to explore its possible associations with quality of life and quality of death in Korea.Methods: A multi-center, cross-sectional survey was performed on 93 terminal cancer patients. The questionnaire solicited their opinions regarding participation in treatment decision making, as well as quality of life (European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire for Palliative Care) and quality of death (Good Death Inventory-Patient Version).Results: A total of 78.5% of the patients had awareness of their terminal status, while 21.5% did not; 42.4% stated that they knew their condition and shared the decision-making responsibility with the medical staff and their family, while 21.7% made decisions on their own, and 35.9% left the decision-making responsibility to others. Patients who were aware of their illness and who actively participated in the decision making did not score higher than others on outcome measures of quality of life and quality of death. Moreover, the former even showed lower scores in some domains, including the ‘physical and psychological comfort’ (4.99 versus 5.61, p = 0.03), ‘environmental comfort’ (5.51 versus 6.04, p = 0.08), and ‘emotional functioning’ (55.70 versus 71.01, p = 0.06).Conclusion: in Korea, patient autonomy is not a universally accepted value from the perspectives of terminal cancer patients, nor is patient involvement in decision making always conducive to high quality of life or quality of death. The level of information and the pace at which it is provided should be tailored to each individual’s ability, preference, need, and culture. [ABSTRACT FROM PUBLISHER]

Background: The present study was conducted to examine the reliability and validity of the 'Korean Standard Pattern Identification for Stroke (K-SPI-Stroke)', which was developed and evaluated within the context of traditional Korean medicine (TKM). Methods: Between September 2006 and December 2010, 2,905 patients from 11 Korean medical hospitals were asked to complete the K-SPI-Stroke questionnaire as a part of project' Fundamental study for the standardization and objectification of pattern identification in traditional Korean medicine for stroke (SOPI-Stroke). Each patient was independently diagnosed by two TKM physicians from the same site according to one of four patterns, as suggested by the Korea Institute of Oriental Medicine: 1) a Qi deficiency pattern, 2) a Dampness-phlegm pattern, 3) a Yin deficiency pattern, or 4) a Fire-heat pattern. We estimated the internal consistency using Cronbach's α coefficient, the discriminant validity using the means score of patterns, and the predictive validity using the classification accuracy of the K-SPI-Stroke questionnaire. Results: The K-SPI-Stroke questionnaire had satisfactory internal consistency (α = 0.700) and validity, with significant differences in the mean of scores among the four patterns. The overall classification accuracy of this questionnaire was 65.2 %. Conclusion: These results suggest that the K-SPI-Stroke questionnaire is a reliable and valid instrument for estimating the severity of the four patterns. [ABSTRACT FROM AUTHOR]

A pre-post test, two-group study was conducted to examine the effects of a culturally competent targeted intervention titled GO EARLY Save Your Life on the breast cancer and early screening-related knowledge and beliefs and mammography use among 180 Korean American (KA) women aged 40 years or older who had not had mammograms within the past 12 months. The intervention group received an interactive education session focused on breast cancer, early screening guidelines, and beliefs (breast cancer-related and Korean cultural beliefs). The control group received no education. There was no statistically significant intervention effect on mammography use between the intervention (34%) and control groups (23%) at 24 weeks post baseline. The rates of mammography use for both groups significantly increased from 16 to 24 weeks post baseline. The education was effective in increasing breast cancer/early screening-related knowledge and modifying beliefs (decreasing barriers, fear, seriousness, and fatalism, and increasing preventive health orientation). [ABSTRACT FROM AUTHOR]