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Background: Aims: To investigate the developmental trajectory of the rate and perceptual assessment of oral diadochokinesis (DDK) in typically developing children compared with adults. Also to examine the characteristics of DDK productions in children with speech sound disorders (SSD) and the relationship between DDK production and percentage of consonants correct (PCC). Methods & Procedures: Participants were 316 typically developing children and 90 children with SSD from 3 to 9 years old, as well as 20 adults with normal speech. The mono‐, bi‐ and trisyllabic nonsense strings containing Korean tense consonants and the vowel [a] were used for DDK tasks. The number of iterations per s was measured as the DDK rate for each stimulus. The perceptual assessment of DDK productions was also performed for regularity, accuracy and rate. Outcomes & Results: The DDK rates increased throughout childhood, but the oldest children, 9‐year‐olds in the current study, did not achieve adult‐like rates for all mono‐ and trisyllabic strings. Children with SSD also did not show significant differences from typically developing children when the DDK productions were analysed using only accurate tokens. The PCC of children with SSD showed higher correlations with regularity, accuracy and rate of perceptual ratings than the timed DDK rate. Conclusions & Implications: This study highlighted the fact that the comprehensive evaluation of DDK productions may provide even more useful information about children's oral motor skills. WHAT THIS PAPER ADDS: What is already known on the subject: Rates of DDK reflect the motor skills of the articulatory systems independently of phonological skills; therefore, the tasks are widely used in the diagnostic evaluations of speech disorders in both children and adult populations. However, a substantial number of studies have questioned the validity and usefulness of DDK rates for evaluating speech abilities. Also, the literature suggested that the measure of DDK rate alone does not provide a clear and useful indication of children's oral motor skills. DDK tasks should be analysed in terms of accuracy and consistency as well as rate. What this paper adds to the existing knowledge: The literature reporting normative DDK performance has mainly been based on English speakers. As different consonants have different temporal characteristics, the linguistic and segmental features of DDK tasks can impact the DDK rate. This study established a norm for DDK rate for Korean‐speaking children and investigated the developmental trajectory of DDK performance in typically developing children compared with adults. This study suggested that the comprehensive evaluation of DDK productions may provide even more useful information about children's oral motor skills by examining the characteristics of DDK productions in children with SSD. What are the potential or actual clinical implications of this work?: This study provided normative data of young Korean‐speaking children aged 3–9 years. Normative data in children under 5 years of age are valuable given that the majority of children referred for speech difficulty assessments are between 3 and 5 years of age, but only a few studies have provided the normative data in young children. This study showed that many children could not complete DDK tasks correctly and provided additional support for the notion that other aspects of DDK performance, including accuracy and regularity, may yield more useful diagnostic indications than timed DDK rates alone. [ABSTRACT FROM AUTHOR]

Aim: Breakfast plays an important role in the academic performance and mental health of adolescents. This study explored factors associated with breakfast skipping in high school students in South Korea. Methods: A cross‐sectional survey was completed by 1684 high school students. A logistic regression analysis was conducted to determine the factors associated with skipping breakfast, including sociodemographic factors, mental health problems (such as depression and anxiety), sleep and smartphone use patterns. Results: A total of 29.2% of the adolescents reported skipping breakfast and girls were significantly more likely to skip breakfast than boys (P <.001). The breakfast skipping group spent more time using a smartphone on weekdays [mean (SD) = 186.2 (180.0) min/d] than the breakfast eating group [mean (SD) = 110.2 (111.5) min/d] (P <.001). The Korean scale for smartphone addiction (S‐scale) score was higher in the breakfast skipping group (P =.006). Multivariate logistic regression analysis showed that female gender, poor academic performance (odds ratio (OR), 1.575; 95% CI, 1.166‐2.126, P =.003), depression (OR, 1.023; 95% CI, 1.002‐1.043, P =.031), time spent using a smartphone on weekdays (OR, 1.003; 95% CI, 1.002‐1.004, P <.001), and low parental monitoring of smartphone use were significantly associated with skipping breakfast. Conclusions: Findings indicate that unhealthy lifestyle including smartphone overuse negatively affects breakfast eating in adolescents. School‐based nutritional programs should be designed to assess and overcome various individual factors associated with breakfast skipping. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate a communication skills program based on nonviolent communication targeted on inpatient alcoholics at the alcoholics specialized ward. Design and Methods: The sample for this mixed methods quasi‐experimental study comprised 47 patients who were hospitalized in the alcoholic wards of two psychiatric hospitals in South Korea. Findings: The program effectively improved participants' empathy, anger expression, communication competence, and alcohol abstinence self‐efficacy (p <.001). Practice implications: This program could be implemented in community‐based alcoholic care with the aim of preventing relapse and serve as the basis for developing similar programs for family members. [ABSTRACT FROM AUTHOR]

Aims: To explore the influences of clinical nurses' workplace violence and bystander behaviour on patient safety. Background: Bystanders' role in social violence affects the consequences of said violence; however, few studies have explored the relationship between workplace violence and patient safety among nurses working in clinical settings. Methods: A cross‐sectional survey design was conducted using a structured questionnaire pertaining to workplace violence, bystander behaviour, patient safety culture and nurse‐assessed patient safety outcomes. The questionnaire was administered to 185 bedside nurses at a university hospital in a metropolitan city in Korea. Results: A regression model with department, patient safety culture, workplace bullying, incivility and bystander behaviour explained approximately 34.0% of patient safety. Further, defending bystander behaviour, facilitating bystander behaviour, work‐related bullying and co‐worker incivility influenced the patient safety. Conclusion: Being a facilitating bystander was a threat to patient safety, while being a defending bystander enhanced patient safety. Implications for nursing management: The negative consequences of workplace violence on patient safety may be mitigated by colleagues' reaction to violence; therefore, nursing policymakers should emphasize the role of positive bystanders as an organisational strategy against workplace violence. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate the current state of face‐to‐face bullying and cyberbullying among nurses in the workplace and to identify the effects of nursing organisational culture on face‐to‐face bullying and cyberbullying. Background: It is important to accurately examine the current state of workplace bullying to acknowledge the gravity of the situation faced by nurses and devise prevention strategies. Electronic communication by computer or smartphone is widely used as a prompt and efficient means of facilitating nursing work; however, this leads to the possibility of cyberbullying as well as face‐to‐face bullying among nurses. Design: Descriptive cross‐sectional study. Methods: A total of 226 staff nurses working in one of five upper tertiary hospitals in Korea with a career of 10 years or shorter were surveyed using a self‐reported questionnaire. The collected data were evaluated using various statistical analyses, including hierarchical regression. Our study was applied to the STROBE checklist of items. Results: The mean face‐to‐face bullying score was 1.32 ± 0.53 and the cyberbullying score was 1.14 ± 0.37 (possible range: 1–5); most were work‐related negative experiences. The explanatory power of nursing organisational culture for face‐to‐face bullying was 6.3%, and relation‐oriented culture and hierarchy‐oriented culture were major factors affecting face‐to‐face bullying. The explanatory power of nursing organisational culture for cyberbullying was 4.3%, and relation‐oriented culture was a major factor affecting cyberbullying. Conclusions: Relation‐oriented culture had a significant effect on both face‐to‐face bullying and cyberbullying. Therefore, organisations should strive to foster a relation‐oriented nursing organisational culture in order to prevent and resolve workplace bullying among nurses. Relevance to clinical practice: Cyberbullying should be addressed as an important type of workplace bullying in nursing, which occurs via various information and communication devices. To prevent workplace bullying among nurses, various strategies that promote relation‐oriented nursing organisational cultures should be considered. [ABSTRACT FROM AUTHOR]

Introduction: In South Korea, approximately 40% of older adults are reported to have low health literacy. The purpose of this study was to evaluate the relationship between health literacy and patient participation among Korean older adults with heart failure. Method: This cross-sectional descriptive study involved 145 Korean patients at one prominent medical center in South Korea. The Korean Health Literacy Scale short form and the 13-item Perceived Involvement in Care Scale were administered between June and September, 2016. Results: Among participants (mean age = 71.30 years; 26.9% female), approximately 30% had poor health literacy. A significant correlation was observed between health literacy and participation scores (r = .538, p < .01). Health literacy was the most important predictor of patient participation (β = .488, p < .001). Discussion: The results imply that effective knowledge acquisition may encourage greater patient participation. By identifying health literacy in Korean older adults, we can provide more culturally congruent health care by improving participation between providers and patients. [ABSTRACT FROM AUTHOR]

Purpose: To determine effects of job-seeking stress on perimenstrual symptoms of female college students with health and non-health related majors and mediating effects of stress coping styles. Methods: Data were collected from 189 female college students who were juniors or seniors. This study was conducted using questionnaires on job-seeking stress, perimenstrual symptoms, and stress coping styles. Data analysis included descriptive statistics, Pearson correlation analysis, and multiple regression analysis using SPSS, version 23.0. Mediation analysis was performed according to the Baron and Kenny method and Sobel test. Results: Job-seeking stress was significantly and positively correlated with perimenstrual symptoms in non-health college students. Passive stress coping styles demonstrated a complete mediating effect on the relationship between job-seeking stress and perimenstrual symptoms of those with non-health related majors (β=0.31, p=.002). Such effect was significant (Sobel test; Z=2.06, p=.039). Conclusion: Effects of job-seeking stress on perimenstrual symptoms were mediated by passive stress coping styles of non-health related major students. Based on findings of this study, effective stress cope strategies should be developed considering characteristics of majors to manage perimenstrual symptoms of female college students with high job-seeking stress. [ABSTRACT FROM AUTHOR]

Gestational vitamin D insufficiency is related with increased risks of various diseases and poor health outcomes later in life. Telomere length at birth or early in life is known to be a predictor of individual health. Both vitamin D and telomere length are related with various health conditions, and vitamin D concentrations are associated with leukocyte telomere lengths in women. We investigated the association between maternal vitamin D concentrations and newborn leukocyte telomere lengths. This cross-sectional study included 106 healthy pregnant women without adverse obstetric outcomes and their offspring. We examined the maternal age, weight before pregnancy, health behaviours, and nutritional intakes, along with each newborn's sex and birthweight, and we measured maternal height, telomere length, total white blood cell count, and glycosylated haemoglobin as covariates. Pearson's correlation coefficients were calculated to evaluate the relationship between the baseline variables and newborn leukocyte telomere lengths. To confirm that there was an independent association between newborn leukocyte telomere lengths and maternal vitamin D concentrations, we performed a stepwise multiple linear regression analysis. Newborn leukocyte telomere lengths correlated positively with maternal leukocyte telomere lengths ( r = .76, p < .01), maternal 25-hydroxyvitamin D concentrations ( r = .72, p < .01), maternal energy intakes ( r = .22, p = .03), and newborn body weights ( r = .51, p < .01). In the multivariate model, newborn leukocyte telomere lengths were associated with maternal vitamin D concentrations (β = .33, p < .01). These findings suggest that the maternal vitamin D concentration during pregnancy may be a significant determinant of the offspring's telomere length. [ABSTRACT FROM AUTHOR]

Purpose To examine the relationship between evidence-based practice (EBP) adoption and social capital in nurses and to determine how social capital affected EBP adoption in South Korea. Design A cross-sectional, correlational design was used. Methods In total, 432 registered nurses from two university-affiliated teaching hospitals in South Korea completed the questionnaire, which included demographic items, the Developing Evidence-Based Practice Questionnaire, and the Social Capital Outcomes for Nurses scale. Data were analyzed using hierarchical regression to identify the predictors of EBP adoption. Findings Nurses with higher social capital scores reported fewer perceived barriers to finding and reviewing evidence, and changing practice. Higher social capital scores were associated with higher levels of perceived facilitators of EBP adoption and skills appraisal in finding and reviewing evidence. Social capital was a significant predictor of EBP adoption. Conclusions Nurses with greater opportunities to exchange and communicate their ideas freely are more likely to accept new evidence through diverse channels and trust-based relationships between nurses, which allows healthcare organizations to promote innovations such as EBP adoption. Therefore, social capital in nurses could serve as a driving force for EBP adoption and should provide a healthy foundation for changes in patient care practices. Clinical Relevance Nurses with higher social capital are tending to adopt EBP willingly. High trust enables nurses to facilitate and support change in practice. Therefore, to improve EBP adoption in patient care, it needs to be monitored that relationships between nurses are carefully structured and that they foster mutual interaction. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to investigate the relationships among leisure competence, level of leisure activity, and life satisfaction in low-income older adults in rural South Korea. A sample of 137 older adults answered the study questionnaire, and significant differences in leisure competence were noted depending on age, religion, and perceived health status as well as level of leisure activity based on perceived health status and type of leisure activities. There were also notable differences in life satisfaction regarding religion and perceived health status, and a correlation among leisure competence, level of leisure activity, and life satisfaction; the influencing power of leisure competence and level of leisure activity on life satisfaction was 47%. The findings suggest that enhancement of older adults' leisure competence may increase participation in leisure activities. [ABSTRACT FROM AUTHOR]

The current cross-sectional study described the prevalence of malnutrition risk and identified its associated factors in home-dwelling Korean older adult women. Nutritional status was assessed by the Nutrition Screening Initiative. Multinomial logistic regression analysis determined predictors of nutritional risk. Of 168 participants (mean age = 76.34 years, SD = 6.51 years), approximately 69.6% were classified as being at moderate/high risk for malnutrition. Results showed that higher levels of physical (odds ratio [OR] = 0.34, 95% confidence interval [CI] [0.12, 0.92]) and emotional (OR = 0.31, 95% CI [0.13, 0.74]) function were associated with decreased risk of malnutrition. In addition, higher levels of bodily pain were associated with increased risk of malnutrition (OR = 2.75, 95% CI [1.35, 5.59]). The findings emphasize the importance of nutritional assessment with comprehensive geriatric assessment. Future longitudinal studies including various sociodemographic backgrounds should examine the effects of self-reported health status on malnutrition risk in older adults. [ABSTRACT FROM AUTHOR]

Background Suboptimal nutrition accompanied by chronic low-grade increases in circulating cytokine levels is more common in elderly people. We explored the improvement in nutritional status, especially in the level of insulin-like growth factor-1 ( IGF-1) and its relationship with changes in circulating cytokine levels, after providing extra protein and energy content to community-dwelling older adults at risk of undernutrition. Methods Sixty nondiabetic subjects, aged ≥65 years and living independently in a community for elderly people, with a serum pre-albumin level ≤30 mg dL−1 and a body mass index <25 kg m−2, were recruited. The subjects were followed for a 2-week pre-intervention period, during which they maintained routine dietary habits. This was followed by an intervention period, during which they received oral nutritional supplementation for 2 weeks. Results Following 2 weeks of intervention, there were significant increases in total lymphocyte count ( TLC) and insulin-like growth factor ( IGF)-1, pre-albumin and transferrin compared to baseline. Body weight and mid-arm circumference significantly increased without alteration of tricep skinfold thickness at the end of the intervention. There was a significant reduction in interleukin ( IL)-6 levels and a trend toward a decrease in the tumor necrosis factor ( TNF)-α levels. At baseline, age was negatively correlated with IGF-1 levels and positively correlated with IL-6 and TNF-α levels. The change (▵, from baseline) in IGF-1 level was positively correlated with age and negatively correlated with ▵ IL-6 and ▵ TNF-α. Conclusions A 2-week intervention with oral nutritional supplementation improved nutritional status and decreased circulating cytokine levels. Specifically, ▵ IGF-1 was negatively correlated with changes in pro-inflammatory cytokine levels in community-dwelling elderly people at risk of undernutrition. (Clinicaltrials.gov: NCT02656186). [ABSTRACT FROM AUTHOR]

The purpose of this study was to test the effects of healthy life practice (HLP) education on reported health behaviors, including health promotion, disease prevention, and safety among fourth-grade elementary school students. A quasi-experimental, pretest/posttest design was used. The 101 recruited participants from two schools were assigned to the intervention group (n = 51) that received 10 health education sessions and the control group (n = 50) that did not receive the intervention. Significant differences in health behaviors were observed between the two groups (t = 2.563, p = .012), specifically for disease prevention (t = 2.178, p = .032) and safety (t = 2.711, p = .008). However, no significant between-group differences were observed in health promotion (t = .270, p = .788). Educational interventions aimed at changing HLP-related health behaviors may be effective for elementary schoolchildren. [ABSTRACT FROM AUTHOR]

Intubated patients are at risk of oral health problems. Although a variety of oral care regimens for intubated patients have been studied, there is a lack of research on the effects of combination oral care that includes tooth brushing, chlorhexidine and cold water. This open-labelled, randomized, controlled trial aimed to evaluate the effects of combination oral care on oral health status. Participants aged 20 years and older were recruited on the first day after intubation through convenience sampling in a medical intensive care unit. Random assignment was performed using an internet randomization service. The primary outcome was oral health status. Data were collected during May and June 2013. Participants were randomized to one of two groups (23 intervention and 21 control). The final analysis included 18 patients with combination oral care and 17 in the control group. The intervention group had better oral health (effect size = 1.56), less dry mouth and higher salivary pH than the control group. Any additional burden of providing combination oral care to patients who are mechanically ventilated is worthwhile in terms of clinical outcomes. [ABSTRACT FROM AUTHOR]

This study aimed to examine the effect of progressive muscle relaxation therapy (PMRT) on cortisol level, the Stress Arousal Checklist (SACL) score, blood pressure, and heart rate in colorectal cancer patients undergoing laparoscopic surgery. Forty-six patients were divided into control and experimental groups. Cortisol levels, blood pressure, and heart rate were measured before surgery and between 8:00 and 11:00 a.m. on the first, third, and fifth days after surgery. SACL score was measured before surgery and on the fifth day after surgery at the same time points. PMRT was performed twice a day for 5 days. Analyses of covariance with advanced covariate levels and t tests showed that PMRT helps colorectal cancer patients achieve a lower stress response and provides an important basis for stress control. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the effects of an integrated stress management program (ISMP) on college life stress, stress coping, psychological distress, and cortisol among male college students. Design and Methods: Out of 137 initially enrolled students, 99 participants were identified as distressed subjects and randomly assigned to either the ISMP or control group. Ultimately, 84 participants (43: experimental, 41: control) completed pretest‐posttest. The experimental group received eight 2‐hr sessions over 4 weeks. Findings: Stress and psychological distress decreased significantly, whereas stress coping and cortisol did not improve significantly. Practice Implications: Further studies with longer follow‐up periods and physiological interventions are required. [ABSTRACT FROM AUTHOR]

This randomized, double-blind, placebo-controlled trial examined whether the administration of ganglioside, an active ingredient of deer bone extract, can improve working memory performance by increasing gray matter volume and functional connectivity in the default mode network (DMN) in individuals with subjective cognitive impairment. Seventy-five individuals with subjective cognitive impairment were chosen to receive either ganglioside (330g/day or 660g/day) or a placebo for 8 weeks. Changes in working memory performance with treatment of either ganglioside or placebo were assessed as cognitive outcome measures. Using voxel-based morphometry and functional connectivity analyses, changes in gray matter volume and functional connectivity in the DMN were also assessed as brain outcome measures. Improvement in working memory performance was greater in the ganglioside group than in the placebo group. The ganglioside group, relative to the placebo group, showed greater increases in gray matter volume and functional connectivity in the DMN. A significant relationship between increased functional connectivity of the precuneus and improved working memory performance was observed in the ganglioside group. The current findings suggest that ganglioside has cognitive-enhancing effects in individuals with subjective cognitive impairment. Ganglioside-induced increases in gray matter volume and functional connectivity in the DMN may partly be responsible for the potential nootropic effects of ganglioside. The clinical trial was registered with ClinicalTrials.gov (identifier: NCT02379481). [ABSTRACT FROM AUTHOR]

Integrating the perspectives of psychological contract and sex differences, this study examines how organizational decision to reduce labour costs influences employees' perceived psychological contract breach and their commitment to their organizations. Using two experiments, we found three-way interaction effects among the decision to reduce labour costs, employee sex, and the managerial control over the decision. The decision of labour costs reduction leads to stronger feelings of psychological contract breach for females when the decision is in low than in high levels of managerial control, but the same decision leads to stronger psychological contract breach for males when the decision is in high than in low levels of managerial control. Furthermore, the indirect effect of labour costs reduction on employees' organizational commitment through psychological contract breach is also contingent upon the interaction between employee sex and managerial control. Our findings expand the literature of psychological contract and shed light on timely practical issues of management's decisions regarding labour costs reduction. Practitioner points Labour costs reductions in economic downturns lead to different responses from employees, and managers are advised to plan their actions bearing in mind such differences., Management in crisis or difficulties calls for more delicate considerations of employees' psychological feelings towards the organization., Nuanced empirical evidence informs us about the different needs and responses of a diverse group of employees and how their responses contradict. [ABSTRACT FROM AUTHOR]

Aims and objectives This study was conducted to develop a family relocation stress scale by modifying the Son's Relocation Stress Syndrome Scale, to examine its clinical validity and reliability and to confirm its suitability for measuring family relocation stress. Background The transfer of ICU patients to general wards is a significant anxiety-producing event for family members. However, no relocation stress scale has been developed specifically for families. Design A nonexperimental, correlation design was adopted. Methods The study subjects were 95 family members of 95 ICU patients at a university hospital located in Incheon, South Korea. Face and construct validities of the devised family relocation stress scale were examined. Construct validity was examined using factor analysis and by using a nomological validity test. Reliability was also examined. Results Face and content validity of the scale were verified by confirming that its items adequately measured family relocation stress. Factor analysis yielded four components, and the total variance explained by these four components was 63·0%, which is acceptable. Nomological validity was well supported by significant relationships between relocation stress and degree of preparation for relocation, patient self-care ability, family burden and satisfaction with the relocation process. The devised scale was also found to have good reliability. Conclusions The family relocation stress scale devised in this study was found to have good validity and reliability, and thus, is believed to offer a means of assessing family relocation stress. Relevance to clinical practice The findings of this study provide a reliable and valid assessment tool when nurses prepare families for patient transfer from an ICU to a ward setting, and may also provide useful information to those developing an intervention programme for family relocation stress management. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression are associated with recurrent cardiac events after percutaneous coronary interventions (PCIs). However, few investigators have evaluated the impact of depression and anxiety on recurrent cardiac events in Korea. Objective: The aim of this study was to examine the relationship among depression, anxiety, and recurrent cardiac events in Korean patients with coronary artery disease (CAD) after PCI. Methods: A prospective longitudinal study was undertaken with a sample of 133 CAD patients with PCI. Data were collected between August 2009 and September 2010, and patients were followed after discharge through 2011 with self-report questionnaires on anxiety and depression using the Hospital Anxiety and Depression Scale and with patient medical records on sociodemographic and clinical characteristics. Recurrent cardiac events were collected for 12 months after discharge and were assessed by patient interviews and medical records. Results: There were 18 recurrent cardiac events (13.5%) among the 133 participants. After adjustment for sociodemographic and clinical characteristics, a hierarchical Cox proportional hazards regression model found that a moderate or severe level of anxiety (hazard ratio, 6.21; 95%confidence interval, 1.64Y23.54) and amoderate or severe level of depression (hazard ratio, 4.32; 95% confidence interval, 1.35Y13.88) were independent predictors of recurrent cardiac events. Conclusions: Patients with CAD who have a high level of anxiety and depression are at increased risk for recurrent cardiac events after PCI. Screening should be focused on patients who experience anxious and depressive feelings in addition to traditional risk factors. Furthermore, psychoeducational support interventions to reduce anxiety and depression after PCI may improve health outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the effects of Wheel of Wellness counseling on wellness lifestyle, depression, and health-related quality of life in community dwelling elderly people. Methods: A parallel, randomized controlled, open label, trial was conducted. Ninety-three elderly people in a senior welfare center were randomly assigned to two groups: 1) A Wheel of Wellness counseling intervention group (n=49) and 2) a no-treatment control group (n=44). Wheel of Wellness counseling consisted of structured, individual counseling based on the Wheel of Wellness model and provided once a week for four weeks. Wellness lifestyle, depression, and health-related quality of life were assessed pre-and post-test in both groups. Results: Data from 89 participants were analyzed. For participants in the experimental group, there was a significant improvement on all of the wellness-lifestyle subtasks except realistic beliefs. Perceived wellness and depression significantly improved after the in the experimental group (n=43) compared to the control group (n=46) from pre- to post-test in the areas of sense of control (p =.033), nutrition (p =.017), exercise (p =.039), self-care (p <.001), stress management (p =.017), work (p =.011), perceived wellness (p =.019), and depression (p =.031). One participant in the intervention group discontinued the intervention due to hospitalization and three in the control group discontinued the sessions. Conclusions: Wheel of Wellness counseling was beneficial in enhancing wellness for the community-dwelling elderly people. Research into long-term effects of the intervention and health outcomes is recommended. [ABSTRACT FROM AUTHOR]

The article presents a study on the mechanical differences in lumbopelvic-hip movement of asymptomatic professional golfers with and without limited hip rotation during the golf swing. Topics covered include muscle imbalance, lumbopelvic kinematics, and the right and left axial rotation. Also mentioned is limited hip joint mobility as a key biomechanical marker of low back pain (LBP) in golfers.

Purpose The purposes were to examine Korean school health teachers' knowledge and attitudes toward human papillomavirus ( HPV) and HPV vaccination, identify factors associated with their intention to recommend the HPV vaccine, and characterize school health teachers' communication with students or parents regarding the HPV vaccine. Design and Methods The online survey involved 119 school health teachers in Korea. Results Factors associated with an intention to recommend the HPV vaccine were perceived benefits, desiring more education regarding HPV and the HPV vaccine, and age of school health teachers. Practice Implications Findings suggest a need for more education to promote a greater understanding of HPV and HPV vaccination among Korean school health teachers. [ABSTRACT FROM AUTHOR]

Aims and objectives. This study was to evaluate the effects of a patient-tailored self-management intervention on (1) blood pressure control and (2) self-care behaviour, exercise self-efficacy and medication adherence among Korean older hypertensive patients in a nursing home. Background. Little is known about whether a patient-tailored self-management for nursing home residents with hypertension is likely to advance the care of this growing population worldwide. Design. A non-equivalent comparison group design. Methods. Forty-seven patients (23 and 24 in the intervention and comparison groups, respectively) participated in the study. No one withdrew during the eight-week study period. Hypertensive patients in the intervention group received health education and tailored individual counselling for eight weeks to enhance the self-management. Results. The mean age of patients was 77·4 years. Patients were on hypertensive medications for 11·8 years; only 36 of them took medications without assistance. The baseline comparisons of the patients with and without 8-week intervention did not differ for clinical and demographic variables and outcome measures. Blood pressure decreased when comparing the baseline to eight weeks later from baseline; moreover, blood pressure was significantly reduced only in patients who received the intervention. Self-care behaviour and exercise self-efficacy significantly increased over time only in those who were in the intervention group. However, no significant difference was observed in medication adherence between the two groups. Conclusions. Patient-tailored self-management intervention was a practical approach for decreasing blood pressure and increasing self-care behaviour in older hypertensive patients in a nursing home. Further studies are needed to validate these findings using a larger sample with long-term follow-up. Relevance to clinical practice. A patient-tailored intervention is feasible not only to empower nursing home residents with hypertension for their care, but also to offer a qualified training and guidelines to nursing home staffs, expanding their professional competence in clinical practice. [ABSTRACT FROM AUTHOR]

Aims and objectives. To identify cancer-related symptom clusters, to explore their inter-relationships and to examine the effects of single symptoms and the synergistic effects of symptom clusters on functional performance using path analysis by structural equation modelling in patients with various types of cancer. Background. Recent studies suggest that cancer patients frequently experience three or more concurrent related symptoms and that this clustering of symptoms is likely to have negative synergistic impacts on outcomes, because of the complicated dynamics of clusters. Design. A cross-sectional design. Methods. One hundred and ten patients with various types of cancer were recruited as in- and out-patients at a University Hospital in Incheon, South Korea. Data collection was performed using a questionnaire and by direct interview. Pain, insomnia, fatigue, depression and functional performance were measured. Results. The developed model was composed of antecedents, symptom clusters and outcomes. Of the symptoms often encountered as clusters in cancer patients, insomnia, depression and fatigue were found to have significant single (direct) effects on functional performance. Seven symptom clusters were identified between pain and functional performance, three between insomnia and functional performance and one between depression and functional performance. These single symptoms and symptom clusters were found to have significant synergistic effects on functional performance and to explain 24% of functional performance variance. Conclusions. Multiple cancer-related symptom clusters may occur and the dynamics within symptom clusters is complicated. Our findings provide sound evidence regarding the importance of assessing and managing clusters of symptoms simultaneously rather than focusing on single symptoms. Relevance to clinical practice. A comprehensive understanding of symptom clusters in cancer patients would help establish valid diagnostic symptom cluster entities and aid the development of subjective/objective phenotypic criteria for symptom cluster based diagnoses and of nursing care protocols for managing symptom clusters. [ABSTRACT FROM AUTHOR]

Background: In lateral meniscus allograft transplantation (MAT) using the keyhole method, precise trough drilling is critical for ensuring the graft is placed at the correct anatomic position to minimize the risk of extrusion. However, no study has focused on the effect of bony trough axial obliquity on graft extrusion. Our purpose was to investigate whether bony trough axial obliquity and bony trough position correlate with graft extrusion in lateral MAT using the keyhole method. Hypothesis: We hypothesized that drilling the tibial bony trough at a greater axial angle would increase the risk of graft extrusion. Study Design: Case series; Level of evidence, 4. Methods: The study involved 49 patients who underwent lateral MAT between 2009 and 2010 following total or subtotal meniscectomy. The mean patient age at the time of surgery was 34 years (range, 19-52 years). Graft extrusion and bony trough parameters (absolute and relative distance at the anterior, center, and posterior cuttings of the bony trough, and axial trough angle [ATA]) were assessed using conventional magnetic resonance imaging (MRI) performed on postoperative day 2. The correlation between graft extrusion and MRI trough parameters was analyzed, and multiple linear regression analysis was performed to identify predictors of graft extrusion. Results: Of the 7 MRI measurement parameters, the ATA (r = .355, P = .012), absolute anterior distance (r = .301, P = .031), and relative anterior distance (r = .307, P = .032) were found to positively correlate with absolute extrusion. The ATA (r = .296, P = .037) and relative anterior distance (r = .296, P = .039) were also found to correlate with relative extrusion. The ATA was found to be a predictor of absolute extrusion (β = .36, P = .012) and relative extrusion (β = .33, P = .019). Conclusion: The risk of graft extrusion increases as the axial plane trough angle increases. The angle can be reduced by ensuring that the bony trough starting point is not created in too lateral a position. [ABSTRACT FROM AUTHOR]