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We aimed to derive data that can serve as the basis for designing customized therapeutic farming programs (TFPs) for different life stages by collecting information regarding the mental health status and perceptions of therapeutic farming (TF). We created a survey encompassing individual mental health conditions, general perceptions and participation, demand, and policy requirements regarding TF. By targeting children, adolescents, adults, and older adults in the metropolitan area of South Korea, we collected 505 surveys online and face-to-face. Children and adolescents had worse mental health management than adults and older adults. More than half of the respondents reported experiencing stress and depressive symptoms. Regarding perceptions of TF, compared with other age groups, older adults were more likely to believe in the mental health benefits of plants. Additionally, those with relatively lower stress, depression, and anxiety levels agreed on these benefits. The primary purposes and expected activities regarding TFP participation differed by age group. However, pets and small farm animals were the most preferred animals for TF across all age groups. When promoting TF, children and adolescents prioritized improved introduction and promotion, whereas adults and older adults prioritized improved accessibility. These data can help develop customized TFPs for different life stages as well as the general public.

This study measured and compared the psychophysiological and psychological differences in the responses of men and women to olfactory stimuli from herbal plants. A total of 30 adult participants (mean age, 27.4 years; SD, ±8.97 years; 15 men and 15 women) were included and five different herbs were used: lavender, rosemary, sage, apple mint, and pelargonium. During olfactory activity, participants smelled each herb for 90 seconds while relying solely on their sense of smell and electroencephalography was used to measure brain wave changes. Subsequently, participants’ emotional states were assessed using the semantic differential method (SDM). The results indicated significant differences in the relative alpha, relative slow alpha, and relative low alpha frequencies in the prefrontal lobe (Fp1 and Fp2) for both genders (P < 0.05). Significant gender differences were observed in the relative beta, relative middle beta, ratio of sensorimotor rhythms-mid beta to theta frequencies in the occipital lobe (O1 and O2) (P < 0.05). The SDM results showed significant natural emotional responses in both genders after olfactory stimulation with herbal plants. Furthermore, compared with men, women exhibited more natural emotions to sage, apple mint, and pelargonium olfactory stimulation. These findings affirm the calming effects of olfactory stimulation with herbal plants for both genders, thus underscoring gender differences in preferences and psychological responses.

The underlying therapeutic mechanisms of care farming activities have not been addressed using psychophysiological data. We aimed to understand frontal cortex activation in adults during care farming activities and to explore the psychophysiological effects. Using a randomized crossover study method, 20 adults (average age, 31.3 ± 9.8 years) participated in 10 care farming activities, (four gardening activities, three animal-mediated activities, and three off-farming activities) for 3 minutes each at an actual care farm. Electroencephalography (EEG) was performed during the activity, and emotional states were assessed using subjective emotional questionnaires after each activity. The EEG results revealed that alpha activity increased during gardening activities, such as organizing garden plots and planting plants. Spectral edge frequency 50, which predicts the degree of arousal, increased during interaction with dogs. The results of the subjective emotional questionnaire revealed that participants experienced positive emotions, such as vigor, comfort, naturalness, and relaxation, when participating in care farming activities compared with those while resting. Therefore, this study suggests that care farming activities can induce changes in the frontal cortex activation and positive emotional states in participants. This study elucidates the use of such activities to address mental health-related issues.

Visual stimuli from green plants have positive effects on mental health. This study aimed to compare human responses to varying plant types [live, artificial, two-dimensional (2D), and three-dimensional (3D) plant models] as visual stimuli. Thirty adults (age, 29.9 ± 11.5 years) viewed each plant form while an electroencephalography (EEG) measured their brain activity. Psychological responses were assessed using the semantic differential method (SDM). No significant differences were observed among visual stimuli; however, brain activity differences varied between male and female participants. Males who observed live and artificial plants had a higher relative alpha (RA) spectrum (RAS) and relative fast alpha (RFA) spectrum frequencies at Fp1 and Fp2 (P < 0.05 and P < 0.01 vs. P < 0.05 and P < 0.01, respectively), indicating greater emotional stability. Similarly, male participants who viewed 2D models had higher RA and RFA frequencies at Fp1 (P < 0.01, P < 0.01) and Fp2 (P < 0.05, P < 0.01). Male participants who observed 3D models exhibited higher RA, RSA, and RFA frequencies at Fp1 (P < 0.01). Live and artificial plants were deemed the most calming (P < 0.01). Both sexes found live plants to be the most pleasant (males: P < 0.01; females: P < 0.05) and natural (males: P < 0.001; females: P < 0.01). Overall, alpha wave differences were not significant among plant types, and live plants elicited a trend toward emotional stability. These findings suggest that 3D plant models can be as effective as real plants in psychophysiological applications, indicating their potential benefits for enhancing mental health in urban environments.

This study aimed to investigate the psychophysiological effects of horticultural activities on the prefrontal cortex (PFC) to understand how horticultural activities can influence mental health and cognitive function. This study involved 39 adults with an average age of 54.6 years (±12.5 years) and was conducted in a laboratory setting at Konkuk University. The impact of five different types of horticultural activities—sowing, transplanting, planting, harvesting, and packaging—on PFC oxyhemoglobin (oxy-HB) concentrations was assessed. Functional near-infrared spectroscopy (fNIRS) was used to measure oxy-HB levels in the PFC while participants engaged in each activity for 90 seconds. The results indicated that the overall PFC oxy-HB concentration was at its lowest during planting and at its highest during sowing (P < 0.001). In the right PFC, oxy-HB was also at its lowest during planting and at its highest during sowing (P < 0.01). In the left PFC, the lowest oxy-HB concentrations were observed during both planting and harvesting, whereas the highest oxy-HB concentrations were observed during transplanting and sowing (P < 0.001). Additionally, sex-based differences were noted, with females showing significantly lower oxy-HB concentrations during sowing (P < 0.05) and transplanting (P < 0.01) than those of males. These findings suggested that psychophysiological responses, as indicated by oxy-HB concentrations, vary depending on the type of horticultural activity and by sex.

Green care activities are associated with lower intensity and a lower risk of injury than agricultural activities aimed at producing agricultural and livestock products; however, the risk of health problems cannot be completely ruled out. To implement green care interventions to improve physical health, it is essential to identify the green care activity levels and biomechanical characteristics of the movements that are appropriate for each subject’s physical functions and goals. Thus, this study was conducted to determine the muscle activation of the upper and lower limbs during 19 green care farming activities. We used electromyography signals, which are biomedical signals that measure the action potentials generated in the muscles and nervous system when the muscles contract, to evaluate the muscle activation. Twenty adults (aged 29.9 ± 9.6 years) participated in this study. Participants performed 19 green care farming activities, including horticultural activity, animal-mediated, and off-farming activities. The participants performed each activity three times. The electromyography data were assessed using surface electromyography during activities to measure muscle activation. As a result, 16 upper and lower limb muscles were activated during the green care farming activities, which showed significantly different muscle activation by care farming activity. As a result of the comparison of muscle activity according to each muscle, many of the muscles of the upper and lower limbs were most activated during organizing a garden plot, transplanting plants, and collecting natural objects. In conclusion, the electromyography data obtained during this study suggest that green care farming interventions may be effective for training specific muscles of the upper and lower limbs.

This study investigated whether coding (computer programming) and horticultural activities alone and combined have psychophysiological and psychological effects. Compulsory computer programming has been required in elementary schools in South Korea since 2018. A total of 34 participants, who were students between the ages of 11 and 16 years were involved in the study. Participants undertook the following activities in random order: connecting components, coding, horticultural activities, and combining coding and horticultural activities (run program, horticultural activities, and coding modifications). Brain waves were measured during the activity, and a subjective self-report evaluation was conducted at the end of each activity. In a spectral edge frequency of 50% of the alpha spectrum band, which indicates a comfortable, stable, and relaxed state, there was a significant difference in the left prefrontal pole when participants performed a combination of coding and horticultural activities (P < 0.001). In addition, there were significant differences in the coding activities based on horticultural activities (P < 0.05, P < 0.001), with a relatively low beta, indicating attention and alertness; relative mid beta, indicating active awareness; ratio of SMR to theta, indicating focused attention; and the ratio of mid beta to theta, indicating concentrated focus. It is judged that activities involving plant engagement can contribute to comfort, stability, focused attention, and positive effects in response to active stimuli. As a result of a subjective evaluation, it was found that horticultural activities had a positive effect on participants’ emotions (P < 0.01). This study demonstrates that horticulture-based coding activities have a positive impact on physiological relaxation and cognitive enhancement, and are also associated with subjectively reported positive emotions.

This study investigated the activity of upper- and lower-extremity muscles for 15 agricultural tasks of agro-healing. For the development of an agro-healing program using farm resource types, 15 selected agro-healing activities (namely, digging, raking, fertilizing, planting transplants, tying plants to stakes, watering, harvesting, washing, cutting, cooking, collecting natural objects, decorating natural objects, interacting with dogs, walking dogs, and feeding fish) were extracted and performed in a total of 21 adults (average age: 42.29 ± 14.76 years) at D Care Farm in Cheongju, Korea, from June to July 2022. Before these activities, informed consent was obtained from participants and muscle activity of the upper and lower extremities was measured. Muscle activation during activity performance was measured using electromyography (EMG), and the rating of perceived exertion for each activity was investigated. Bipolar surface EMG electrodes were attached at 16 locations on the left and right upper-extremity muscles (anterior deltoid, biceps brachialis, brachioradialis, and flexor carpi ulnaris) and lower-extremity muscles (vastus lateralis, vastus medialis, biceps femoris, and gastrocnemius). The results indicated that the activity of the lower-extremity muscles was higher than that of the upper-extremity muscles during 15 agricultural activities. During plant-mediated activity and animal-assisted activities, the rate of right muscle use was higher than that of left muscle use among the upper-extremity muscles, whereas the rate of right and left muscle use showed a similar tendency among the lower-extremity muscles. During plant-mediated activities, agricultural activities involving the use of heavy tools highly activated the right forearm muscle (flexor carpi ulnaris), whereas holding and interacting with animals highly activated the left forearm muscles (biceps brachialis, brachioradialis, and flexor carpi ulnaris). It is expected that the EMG data obtained in this study can be used as basic biomechanical data when designing an agro-healing program to improve physical function.

To align with global trends and the swift pace of technological advancements, it is imperative to consistently update the professional standards and curriculum for horticultural therapists to meet evolving professional demands. This study used the developing a curriculum (DACUM) method to analyze the tasks and duties of Korean horticultural therapists and subsequently tailor a specialized training program for them. First, 11 experts in the horticultural therapy field participated in workshops to develop a DACUM chart that included the definitions, tasks, knowledge, skills, and attitudes of horticultural therapists. A job performance evaluation survey for horticultural therapists was also developed through these workshops. The 300 participants of the online survey were members of the Korea Horticultural Therapy and Welfare Association. The survey consisted of a 5-point Likert scale of the current performance level and future requirement level for each qualification grade. Demographic information and responses to each question were computed using a frequency analysis and percentages, grade-specific task performance evaluations comprised a one-way batch analysis of variance, and statistical significance levels were set to P < 0.05. The horticulture professional curriculum was based on competencies derived from the job analysis and online conferences with 10 professionals who participated in the DACUM workshops. The job analysis results revealed six duties with a total of 32 tasks. The results of the job performance evaluation showed that there was a great demand for the development of their convergence capabilities. Accordingly, in response to these results, new interdisciplinary convergence fields such as horticultural therapy and science (information technology), horticultural therapy, and humanities education were introduced into the specialized training. The results of this study will be valuable for improving the skills and expertise of horticulture therapists to meet social needs.

We compared the effects of horticultural activities according to cognitive demand levels on psychophysiological responses in adults. Thirty-two adults in their 20s were included. Participants performed 10 horticultural activities (raking, planting transplants, fertilizing, tying plants to stakes, harvesting, sowing, conducting cuttage, planting potted plants, cutting and washing, arranging flowers) for 150 seconds at two levels of cognitive demand. Electroencephalographic (EEG) and electrocardiographic measurements were acquired during the activity. After each activity, the participants’ emotional states were evaluated using the semantic differential method (SDM). The EEG results, according to comparison by activity, showed that for nine activities, excluding raking, relative theta decreased when performing tasks at a level of high cognitive difficulty (HCD) compared with those with a low cognitive difficulty (LCD), and relative beta, relative gamma, fast alpha, and relative low beta increased, indicating activation of the prefrontal cortex. In the relative theta power spectra, the cuttage activity was found to be the lowest when performing tasks at a high level high cognitive difficulty, and the working memory function was activated the most compared with other activities. When sowing at a low level of cognitive demand, participants’ heart rate decreased and stabilized. When potted plants were harvested at a high level of cognitive difficulty, the ratio of low frequency to high frequency increased, and the sympathetic nervous system was activated. In addition, when planting transplants, and cutting and washing were performed at a high level of cognitive difficulty, and the standard deviation of the RR interval was high, indicating a high ability of the autonomic nervous system to resist stress. As a result of the SDM, the emotional state according to task difficulty was found to be more stable and relaxed than high cognitive difficulty, but a significant increase in comfort, relaxation, and naturalness was achieved when nine gardening tasks with low cognitive difficulty were performed, with the exception of sowing. The results of this study show that tasks with high cognitive difficulty activate working memory, whereas those with low cognitive difficulty stabilize and relax brain activation. Therefore, this study confirmed that an intervention in horticultural activities with an appropriate level of cognitive difficulty could have a significant effect on psychophysiological changes in adults.

Heart rate variability (HRV) is an effective tool for objectively evaluating physiological stress indices in psychological states. This study aimed to develop multiple linear regression equations to predict HRV variables using physical characteristics, body composition, and heart rate (HR) variables (eg, sex, age, height, weight, body mass index, fat-free mass, percent body fat, resting HR, maximal HR, and HR reserve) in Korean adults. Six hundred eighty adults (male, n = 236, female, n = 444) participated in this study. HRV variable estimation multiple linear regression equations were developed using a stepwise technique. The regression equation’s coefficient of determination for time-domain variables was significantly high (SDNN = adjusted R 2 : 73.6%, P

Contact with the natural environment has positive effects on physical and mental health and well-being. This study aimed to investigate the effects of tactile stimulation on the psychophysiological responses of adults, using natural gardening elements. The participants were 30 adults (20–60 years old). The participants received tactile stimulation by touching five natural elements with their hands and feet, and tactile stimulation for each natural element was performed for 90 s. Geranium, tiny ardisia, decomposed granite soil, log hardwood, and culture soil were used as tactile stimulation factors for the hand, and moss, grass, pebble, bark, and culture soil were used as tactile stimulation factors for the foot. Oxyhemoglobin (oxy-Hb) concentrations in the prefrontal cortex during the stimulation as well as blood pressure and pulse rate after each activity were measured. Additionally, the semantic differential method was used to evaluate the psychological effects of contact with the elements on the participants. Compared to before tactile stimulation, the oxy-Hb concentration related to prefrontal lobe cortical activity significantly decreased in some sections using tiny ardisia, log hardwood, and culture soil on the hands, and using grass, moss, pebble, and bark on the feet. Blood pressure also showed a significant decrease after tactile stimulation using geranium, tiny ardisia, and log hardwood. The findings of this study suggest that tactile stimulation using natural gardening elements could be a significant intervention in inducing physiological stability and reducing stress by calming the activity of the prefrontal cortex.

Anxiety disorders are the most prevalent and disabling mental disorders, causing health-related burdens. With the increasing demand for and interest in safe and acceptable anxiolytics, several studies report the anxiolytic effects of lavender aromatherapy, providing evidence of its physiological and psychological effects. However, existing reviews comprehensively cover the effects of different modes of delivering aromatherapy. Therefore, this review assesses the efficacy of lavender essential oil inhalation in reducing anxiety. The titles and abstracts of relevant articles published over the last five years were searched in PubMed, Web of Science, and Scopus databases. This review only included clinical trials that utilized lavender inhalation for anxiety treatment. Eleven studies comprising 972 participants were included. Of these, 10 reported significantly decreased anxiety levels after lavender oil inhalation. The physiological measures of vital signs, including blood pressure, heart rate, respiratory rate, pulse, and saturation, were conducted in three trials, showing that lavender oil inhalation could physiologically affect anxiety levels. Lavender oil inhalation is a safe and feasible anxiolytic intervention for treating people with diverse types of anxiety. Data from further studies with a high-quality design and accurate information are necessary to confirm the validity of these findings and elucidate the anxiety-reducing mechanisms of lavender inhalation.

This study was conducted to determine the physiological and psychological benefits of integrating software coding and horticultural activity. Participants included 30 adults in their 20s. The subjects randomly engaged in activities—namely, connecting Arduino components, coding, planting, and a combined coding and horticultural activities. During the activity, two subjective evaluations were conducted at the end of each activity, and participants’ brain waves were measured. The spectral edge frequency 50% of alpha spectrum band (ASEF50) and ratio of sensorimotor rhythm from mid beta to theta (RSMT) were activated in the prefrontal lobe as participants performed combined coding and horticultural activities. When performing these combined activities, relative beta (RB) increased, and relative theta (RT) decreased in the prefrontal lobe. In addition, ASEF50, relative low beta (RLB), and relative mid beta (RMB) were activated during plant-based activities (planting and a combined coding and horticultural activities). The subjective evaluations revealed that the plant-based activities had a positive effect on participants’ emotions. This study shows that activities combining coding and horticulture had a positive impact on physiological relaxation and increased concentration in adults compared with other activities and was also linked with positive subjectively reported emotions.

The aim of this study was to compare the physiological and psychological effects in the elderly during horticultural and nonhorticultural activities as leisure activities. A total of 58 participants aged 65 or older (29 men and 29 women; average age, 74.0 ± 4.7) whose cognitive function was within the normal range were included in this study. Participants performed four horticultural and four nonhorticultural activities for 2 min, respectively. The study had a cross-over experimental design. Electroencephalography was performed during all the activities. Subjective evaluation of emotions was performed using the Profile of Mood States immediately after each activity. The collected statistical data were analyzed using Duncan’s test as a post-analysis of variance test to verify the differences in the results of electroencephalography and the Profile of Mood States according to the different activities. In the results of the electroencephalography, the relative beta, gamma, low-beta, and ratio of sensorimotor rhythm to theta indices indicate that the degree of brain activity in the prefrontal lobe was high during activities such as washing leaves, transplanting plants, and reading news. The results of the Profile of Mood States showed that during activities such as arranging flowers, transplanting, and washing leaves, the total mood disorder score was lowered, indicating a positive effect on the mood of the participants. This study shows that activities such as washing leaves, transplanting, and reading news have a positive effect on the cognitive function of elderly people by increasing brain activity.

This study aimed to compare the brain activity and emotional states of elementary school students during horticultural and nonhorticultural activities. A total of 30 participants with a mean age of 11.4 ± 1.3 years were included. This experiment was conducted at Konkuk University campus in Korea. Participants performed horticultural activities such as harvesting, planting, sowing seeds, and mixing soil. Nonhorticultural activities included playing with a ball, solving math problems, watching animation videos, folding paper, and reading a book. The study had a crossover experimental design. Brain activity of the prefrontal lobes was measured by electroencephalography during each activity for 3 minutes. On completion of each activity, participants answered a subjective emotion questionnaire using the semantic differential method (SDM). Results showed that relative theta (RT) power spectrum was significantly lower in both prefrontal lobes of participants when engaged in harvesting and reading a book. The relative mid beta (RMB) power spectrum was significantly higher in both prefrontal lobes when participants engaged in harvesting and playing with a ball. The ratio of the RMB power spectrum to the RT power spectrum reflects concentration. This ratio increased during harvesting activity, indicating that children’s concentration also increased. The sensorimotor rhythm (SMR) from mid beta to theta (RSMT), another indicator of concentration, was significantly higher in the right prefrontal lobe during harvesting than during other activities. Furthermore, SDM results showed that the participants felt more natural and relaxed when performing horticultural activities than nonhorticultural activities. Horticultural activities may improve brain activity and psychological relaxation in children. Harvesting activity was most effective for improving children’s concentration compared with nonhorticultural activities.

Mycobacterium vaccae is a species of nonpathogenic bacterium that lives naturally in soil. This study compared the physiological effects at a metabolomic level with autonomic nervous system responses in adults during soil-mixing activities, based on the presence or absence of M. vaccae in the soil. Twenty-nine adult participants performed soil-mixing activities for 5 minutes using sterilized soil with culture media and M. vaccae, respectively. Blood samples were drawn twice from each participant after each activity. Electroencephalograms and electrocardiograms were measured during the activity. Serum metabolites underwent metabolite profiling by gas chromatography, followed by multivariate analyses. Soil-emitted volatile organic compounds were identified using the solid-phase microextraction and gas chromatography-mass spectroscopy, followed by multivariate analyses. The volatile compound analysis revealed that the metabolites related to esters and sulfur-containing compounds are greater in soil with M. vaccae. Serum metabolomics revealed that the treatment group (soil inoculated by M. vaccae) possesses relatively higher levels of inter-alia organic and amino acids compared with the control group (soil mixed with culture media). In the treatment group, the electroencephalogram and electrocardiogram revealed that alpha band activity of the occipital lobe increases, while heart rate decreases. This study concludes that M. vaccae soil contact can affect human metabolic and autonomic reactions.

Background: Children in modern society are exposed to high levels of stress. Various previous studies have reported that horticultural activities help children’s emotional stability. The objective of this study is to develop and implement a horticultural therapy program to improve the emotional intelligence, resilience, and self-efficacy of elementary school students. Methods: A total of 582 Korean students (11–13 years old) from 28 schools participated in this study. The horticultural therapy program consisted of seven sessions and was conducted once a week for 60 min per session, during regular or after-school classes. Before and after the horticultural therapy program, emotional intelligence, resilience, and self-efficacy of the elementary school students were assessed using questionnaires. At the end of the program, students evaluated their satisfaction with the program. Results: The horticultural therapy program significantly improved emotional intelligence (p = 0.000), resilience (p = 0.001), and self-efficacy (p = 0.003) of the elementary students participating in this study. After the program, emotional intelligence improved both male and female students. In resilience and self-efficacy, male students improved after the program, but female students did not. Conclusion: This study may show a potential of horticultural therapy for psycho-emotional health of children. Keywords: Complementary and alternative medicine, Horticultural education, School farming, Socio-horticulture

This study was conducted to compare the concentration and emotional condition of elementary school students performing an intensive assignment in the presence or absence of foliage plants, using electroencephalography (EEG) and a modified semantic differential method (SDM). In a crossover experimental design, 30 elementary students performed a 3-min intensive age-appropriate arithmetic assignment in the presence or absence of foliage plants. Continuous EEG monitoring in the frontal lobe was performed using a wireless dry EEG device. Immediately thereafter, subjective evaluation of emotions was performed using the SDM. The concentration of the male elementary students was significantly higher when the assignment was performed in the presence vs. absence of plants as evidenced by the increase in the ratio of spectral edge frequency of 50 and a decrease in the relative theta power spectrum in the right frontal lobe. The SDM results revealed a significant psychological relaxation when the assignment was performed in the presence of plants. Therefore, the presence of foliage plants in the space where the elementary students performed the intensive assignment led to positive effects on concentration and emotional condition.

Background: The restricted environment in prison negatively affects psychological health of prisoners, which in turn affects the rehabilitation of the prisoners. Previous studies have shown that horticultural activities were effective in improving psychological health of prisoners. The objectives were to develop a horticultural therapy (HT) program and to determine the association of 12 sessions with participants’ psychological health using case analysis. Methods: Five cases who were imprisoned at K correctional institution in Gyeonggi-do, South Korea participated in this study. They were diagnosed as a potential risk group of psychological health. The prisoners participated in a HT program once a week (12 weeks, 90 min per session) between April and June 2018 at K correctional institution. The program consisted of cultivation-centered horticultural activities. At the completion of the HT program, depression (Beck Depression Inventory), anger (State-Trait Anger Expression Inventory), self-esteem (Rosenberg Self-esteem Scale), and life satisfaction (Satisfaction with Life Scale) were evaluated. Positive changes were found through observations of interviews, workbooks, and emotional change checklists that were recorded in each session. Results: We observed positive changes in the prisoners’ health conditions measured before and after participating in the HT program. The prisoners who participated in the HT program showed decreased depression (–2.6), and increased self-esteem (+1.2) and life satisfaction (+4.0). Conclusions: The prisoner rehabilitation HT program was associated with improvements in the participants’ psychological health. Future efforts will be required to investigate the effects of an HT program with a larger sample size to perform statistical analysis for providing convincing evidence.

Purpose This study aimed to investigate clinical and radiological factors that may predict high-grade vesicoureteral reflux (VUR) in patients with febrile urinary tract infection (UTI). Methods We retrospectively analyzed medical records of 446 patients diagnosed with febrile UTI from March 2008 to February 2017. All patients underwent renal-bladder ultrasonography (RBUS), 99mTc dimercaptosuccinic acid (DMSA) renal scan, and voiding cystourethrography (VCUG), and were divided in to 3 groups: a high-grade VUR group (n=53), a low-grade VUR group (n=28), and a group without VUR (n=365). Results The recurrence and non-Escherichia coli infection rates in febrile UTI were significantly higher in the high-grade VUR group than in the other two groups (P

Graves' disease, the main cause of hyperthyroidism in the pediatric age group, is very rare in children younger than 4 years old but can seriously interfere with growth and development if not recognized and treated. Here we report a case of a 3-year-old girl with Graves' disease who presented with goiter, exophthalmos, heat intolerance, and hyperactivity. At her first visit, her serum concentrations of triiodothyronine (T3) and free thyroxine (free T4) were normal, whereas that of thyroid-stimulating hormone (TSH) was decreased. Antimicrosomal antibody was 7,053.94 IU/mL, and TSH-binding inhibitory immunoglobulin was 31.62%. A thyroid scan showed diffuse enlargement with markedly increased uptake of both thyroid glands. Although T3 and free T4 levels were initially normal, she developed hyperthyroidism 3 months later. She was finally diagnosed with Graves' disease and treated with methimazole for 6 months. This is the first report of Graves' disease in children younger than 4 years old in Korea.

BackgroundDiabetes education and lifestyle modification are critical components in controlling blood glucose levels of people with type 2 diabetes. Until now, available data on the effectiveness of education with respect to the duration of diabetes are limited. We investigated whether adherence to lifestyle behavior modification prompted by diabetes education was influenced by the duration of diabetes.MethodsTwo hundred and twenty-five people with type 2 diabetes were recruited for an intensive, collaborative, group-based diabetes education program with annual reinforcement. We divided the patients into two groups based on the duration of their diabetes prior to the education program (≤1 year [≤1Y] vs. ≥3 years [≥3Y]). Dietary habits, physical activity, and the frequency of blood glucose self-monitoring were evaluated with a questionnaire prior to education and at the follow-up endpoint.ResultsThe mean follow-up period was 32.2 months. The mean hemoglobin A1c (A1C) value was significantly lower in the ≤1Y group. Self-care behaviors, measured by scores for dietary habits (P=0.004) and physical activity (P

This study was conducted to measure the metabolic costs of daily activities in community-dwelling adults aged over 65 years. Eighteen elderly adults performed five daily activities—walking, cleaning with a vacuum cleaner, washing dishes, and gardening (making a vegetable bed and maintaining a garden)—in a laboratory setting. The participants performed each activity for 5 minutes and then rested in a chair for 5 minutes prior to starting the next activity. They wore a portable telemetric calorimeter and a heart rate monitor during the five activities and resting periods to measure the metabolic cost and heart rate. The five daily activities were observed to be of low to moderate intensity (from 2.3 ± 0.5 metabolic equivalents to 4.6 ± 0.5 metabolic equivalents).