Depression Literacy, Associated Factors, and Correlation of Related Variables in Middle-Aged Korean Adults: A Cross-Sectional Study.

For the timely treatment and management of depression, a high level of depression literacy (DL) is needed. This study aimed to examine the level of DL and factors associated with DL among middle-aged Korean adults and to verify the relationship between DL, depression, and quality of life (QoL). This cross-sectional study included 485 participants aged 40 to 64 years recruited from five provinces in Korea. DL was measured using a 22-item questionnaire and analyzed by multiple linear regression and correlation analysis. The DL level of the participants was moderate and the correct answer rate was 58.6%. In particular, non-pharmacological treatments, differential symptoms, and pharmacological treatments were low. Out of the participants, 25.2% had depression, and the difference in DL between those with and without depression was not statistically significant. The positive factors associated with DL were being female, having higher education, and being employed. DL was not correlated with depression or psychological QoL. However, higher DL was associated with less heavy drinking, normal body mass index, and not smoking. Improving DL can help individuals seek timely professional help and reduce mental health disparities. Further studies should continue to investigate and develop the association between DL and health-related behaviors as well as depression and QoL to effectively treat and manage depression.

Individual Disaster Assistance For Socially Vulnerable People: Lessons Learned From the Pohang Earthquake in the Republic of Korea.

The Republic of Korea has been considered to be relatively safe from earthquake hazards because of the geological location of the Korean Peninsula, which has a low level of intraplate seismic activity. However, an earthquake with a moment magnitude of 5.4 struck the city of Pohang on November 15, 2017, causing 90 casualties and 52 million USD in property losses. During the recovery process after the earthquake, the Korean government provided individual disaster assistance to victims who reported their damages. However, the government disaster assistance could have been unfairly distributed among the socially vulnerable victims who essentially relied on that assistance. This study identifies whether the government disaster assistance was fairly distributed to socially vulnerable victims using a statistical model based on the data from the Pohang earthquake that occurred in 2017 in Korea. A conceptual model was constructed using a structural equation model (SEM) of three factors-social vulnerability, physical vulnerability, and the amount paid out in individual disaster assistance. Furthermore, interviews with and a survey of the victims were conducted to verify the problems identified by the conceptual model. This study found that socially vulnerable victims were less likely to take advantage of the government disaster assistance program.

Unmet needs of people with Parkinson's disease: A cross-sectional study.

AIMS: To identify the type and extent of unmet needs in people with Parkinson's disease and to examine the impact of health locus of control and family support on these needs. DESIGN: A cross-sectional study. METHODS: This study was conducted from October 2015 - February 2016 in Korea. Data were collected through questionnaires focusing on unmet needs, health locus of control, family support and clinical features. RESULTS: Therapeutic needs represented the highest percentage of unmet needs in people with Parkinson's disease (85.05%), followed by social/spiritual/emotional needs (82.72%). Physical needs were the lowest reported score (75.01%). Unmet needs were more frequent in those with more severe non-motor symptoms. Also, higher family support, internal locus of control and doctor locus of control were correlated with more unmet needs. CONCLUSION: Understanding factors that determine the type and degree of unmet needs in people with PD is important to provide appropriate nursing care. The findings of this study can be used for providing nursing interventions reflecting unmet needs and reducing their unmet needs to improve the overall well-being of people with PD. IMPACT: This study addressed unmet needs unmet needs specific to Parkinson's disease with respect to their nursing needs. Therapeutic needs were the highest unmet needs in people with PD, followed by social/spiritual/emotional needs, need for certainty and physical needs. The findings may be useful for nurses to identify the unmet needs of people with PD which need to be addressed. By reflecting on unmet needs, nurses can give personally tailored nursing care.

Assessment of Liver Function Using Pharmacokinetic Parameters of Gd-EOB-DTPA: Experimental Study in Rat Hepatectomy Model.

Objectives: To determine whether the pharmacokinetic parameters of Gd-EOB-DTPA can identify the difference in liver function in a rat hepatectomy model. Methods: A total of 56 eight-week-old male Sprague-Dawley rats were divided into the following groups: control group without hepatectomy (n = 16), 70% hepatectomy group (n = 14), and 90% hepatectomy group (n = 26). On postoperative day 2, Gd-EOB-DTPA (0.1 mmol/kg) was injected intravenously and serial blood samples were obtained. Pharmacokinetic analysis was performed using a noncompartmental method. Statistical analysis was performed using one-way analysis of variance and post hoc pairwise group comparisons. Results: After excluding 6 rats that died unexpectedly, blood samples were obtained from 16, 14, and 20 rats in the control group, 70% hepatectomy group, and 90% hepatectomy group. There was a significant increase in area under the concentration-time curve from time zero to the time of the last measurable concentration between the 70% and 90% hepatectomy group (P < 0.001). The volume of distribution at steady state was significantly decreased between the control and 70% hepatectomy group (P < 0.001). The clearance was significantly different in all pairwise group comparisons (P < 0.001). Conclusions: The vascular clearance of Gd-EOB-DTPA can identify the difference in liver function in a rat hepatectomy model.

Quantified Risk Assessment for Major Hepatectomy via the Indocyanine Green Clearance Rate and Liver Volumetry Combined with Standard Liver Volume.

BACKGROUND: Preoperative risk assessment for post-hepatectomy liver failure (PHLF) is essential for major hepatectomy. We intended to establish a standard liver volume (SLV) formula for Korean patients and validate the predictive power of the indocyanine green clearance rate constant (ICG-K) fraction of future remnant liver (FRL) (FRL-kICG) to total liver volume (TLV). METHODS: This study comprised 2 retrospective studies. Part I established SLV formula and acquired ICG pharmacokinetic data from 2155 living donors. In part II, FRL-kICG cutoff was determined using 723 patients who underwent right liver resection for hepatocellular carcinoma. RESULTS: In part I, the formula SLV (mL) = -456.3 + 969.8 × BSA (m(2)) (r = 0.707, r (2) = 0.500, p = 0.000) was derived with mean volume error of 10.5%. There was no correlation between TLV and ICG retention rate at 15 min. With a cutoff of 0.04 with hepatic parenchymal resection rate (PHRR) limit of 70%, 99.0% of our living donors were permissible for left or right hepatectomy. In part II, 25 hepatocellular carcinoma patients (3.5%) showed an FRL-kICG or SLV-corrected FRL-kICG <0.05. Of these, 4 (16 %) died of PHLF, whereas only 2 (0.3%) died in the other patient group with both an FRL-kICG and SLV-corrected FRL-kICG ≥ 0.05 (P = 0.000). CONCLUSIONS: The FRL-kICG appears to reliably predict PHLF risk quantitatively. We suggest FRL-kICG cutoffs of 0.04 and 0.05 with PHRR limits of 70% and 65% for normal and diseased livers, respectively. Further validation with large patient population in multicenter studies is necessary to improve FRL-kICG predictability.

Consideration of additional factors in Sequential Organ Failure Assessment score.

PURPOSE: The Sequential Organ Failure Assessment (SOFA) score, originally developed to assess organ failure status, is widely used as a prognostic indicator in intensive care unit patients. Additional prognostic factors, such as age and comorbidities, may complement the predictive performance of the SOFA. METHODS: In total, 1049 consecutive patients were enrolled prospectively. SOFA and other admission-based intensive care unit scores were recorded during the first 24 hours. A complemented SOFA (cSOFA) score model was constructed by adding age and comorbidity scores to the original SOFA score, based on logistic regression analysis. The predictive performance was evaluated with regard to hospital mortality by receiver operating characteristics analysis. The Hosmer-Lemeshow goodness-of-fit test was used to assess calibration of the model, and leave-one-out cross-validation was performed. RESULTS: The cSOFA score (maximum 30 points) was calculated as the SOFA score (24 points) + age score (2 points) + comorbidity score (4 points). The cSOFA score model showed satisfactory calibration and cross-validation performance. The AUC (95% CI) of the cSOFA score (0.812 [0.787-0.835]) was higher than the SOFA score (0.743 [0.715-0.769], P < .0001). CONCLUSION: The performance of the SOFA score to predict hospital mortality can be improved by considering age and comorbidity factors.

Mortality after in-hospital cardiopulmonary resuscitation: multicenter analysis in Korea.

PURPOSE: The purpose of this study is to evaluate factors associated with the mortality of patients admitted to intensive care units (ICUs) after in-hospital cardiopulmonary resuscitation (CPR) and the impact of a hospital rapid response system (RRS) on patient mortality in Korea. MATERIALS AND METHODS: A prospective multicenter cohort study was done in 22 ICUs of 15 centers from July 1, 2010, to January 31, 2011. We only enrolled patients admitted to ICUs after in-hospital CPR and divided eligible patients into 2 groups-survivors and nonsurvivors. RESULTS: Among 4617 patients, 150 patients were admitted post-CPR, 76 died, and 74 survived. At 24 hours, the Sequential Organ Failure Assessment score, Simplified Acute Physiology Score II, and the best Glasgow Coma Scale were significantly lower in the nonsurvivors than in the survivors. In multivariate analysis, the Simplified Acute Physiology Score II and presence of lower respiratory infection were both independently associated with mortality. At the first hour after admission, lowest serum potassium and highest heart rate were associated with mortality. At 24 hours after admission, lowest mean arterial pressure, HCO3 level, and venous oxygen saturation level; highest heart rate; and use of vasoactive drugs were associated with mortality. The mortality of patients in hospitals with an RRS was not significantly different from that of hospitals without an RRS. CONCLUSION: Various physiologic and laboratory parameters were associated with the mortality of post-CPR ICU admitted patients, and the presence of an RRS did not reduce mortality of these patients in our study.

Long-term incidence, risk factors, and management of biliary complications after adult living donor liver transplantation.

A considerable proportion of adult living donor liver transplantation (LDLT) recipients experience biliary complication (BC), but there are few reports regarding BC based on long-term studies of a large LDLT population. The present study examined BC incidence, risk factors and management using single-center data from 259 adult patients (225 right liver and 34 left liver grafts) between 2000 and 2002. The mean follow-up period was 46 +/- 14 months. Biliary reconstruction included single duct-to-duct anastomosis (DD, n = 141), double DD (n = 19), single hepaticojejunostomy (HJ, n = 67), double HJ (n = 28), and combined DD and HJ (n = 4). There were 12 episodes of anastomotic bile leak and 42 episodes of anastomotic stenosis in 50 recipients. Most leaks occurred within the first month, whereas stenosis occurred over 3 yr. Most stenoses were successfully treated using radiological intervention. Cumulative 1-, 3-, and 5-yr BC rates were 12.9%, 18.2%, and 20.2%, respectively. BC occurred much more frequently in right liver grafts compared to left liver grafts (P = 0.024). Stenosis-free survival curves for right liver graft recipients were similar for all reconstruction groups. When right liver graft recipients with single biliary reconstructions were grouped according to graft duct size and type of biliary reconstruction, DD involving a small-sized duct (less than 4 mm in diameter) was found to be a BC risk factor (P = 0.015), whereas HJ involving such duct sizes was not found to be associated with a higher risk (P = 0.471). In conclusion, close surveillance for BC appears necessary for at least the first 3 yr after LDLT. We found that most BC could be successfully controlled using radiological intervention. In terms of anastomotic stenosis risk, HJ appears a better choice than DD for right liver grafts involving ducts less than 4 mm in diameter.

Fatores que determinam a freqüência às consultas ginecológicas: estudo comparativo entre duas classes sócio-econômicas / Factors determining the frequency to gynaecologic consultation: comparative study between 2 socioeconomic classes

Avaliamos neste estudo as causas que levam as mulheres a consultarem ou näo o ginecologista com regularidade, através de um questionário aplicado a 200 mulheres divididas em dois grupos de nível sócio-econômico diferente. Relacionamos a freqüência de compararecimento às seguintes variáveis: idade, instruçäo, classe social, trabalho, preferência pelo sexo do ginecologista, prole e vida sexual. As causas mais freqüentes de ausência de acompanhamento ginecológico foram a falta de uma patologia evidente (61%) e a vergonha de se expor ao exame ginecológico (17%). A literatura revisada aponta diferentes recursos para superar estes e outros obstáculos encontrados. Grande ênfase é dada à educaçäo para saúde, principalmente na adolescência, por ser uma faixa de baixa freqüência de consultas e, por outro lado, grande receptividade à aquisiçäo de novos conhecimentos