The Association Between Blood Lead Levels and Coronary Artery Calcium Score Determined by Using Coronary Computed Tomography Angiography

Background@#Lead exposure is a known risk factor for cardiovascular disease (CVD), and coronary artery calcification (CAC) is a biomarker for diagnosing atherosclerotic CVD. This study investigated the association between blood lead level (BLL) and CAC using coronary computed tomography (CT) angiography. @*Methods@#This study enrolled 2,189 participants from the general population with no history or symptoms of CVD. All participants underwent coronary CT angiography, health examination, and BLL testing. The association between coronary artery calcium score (CACS) and BLL was analyzed. @*Results@#The arithmetic mean of BLL was 2.71 ± 1.26 μg/dL, and the geometric mean was 2.42 (1.64) μg/dL, ranging from 0.12 to 10.14 μg/dL. There was a statistically significant positive correlation between CACS and BLL (r = 0.073, P 0, < 10), 2.81 ± 1.25 μg/dL; mild grade (≥ 10, < 100), 2.74 ± 1.29 μg/dL; moderate grade (≥ 100, < 400), 2.88 ± 1.38 μg/dL; severe grade (≥ 400): 3.22 ± 1.68 μg/dL. The odds ratio for severe CAC was 1.242 in association with an 1 μg/dL increase in BLL (P = 0.042). @*Conclusion@#Using coronary CT angiography, we determined a positive correlation between BLL and CAC among participants without CVD from the general population. To reduce the burden of CVD, efforts and policies should be geared toward minimizing environmental lead exposure.

Factors Influencing Health-related Quality of Life among Older Korean Women with Osteoporosis: Using Data from Korea National Health and Nutrition Examination Survey 2015 to 2016 / 재활간호학회지

PURPOSE: The purpose of this study was to investigate osteoporosis prevalence and factors influencing health-related quality of life (HRQoL) among older Korean women with osteoporosis. METHODS: The study design was a retrospective study using secondary data analysis. Data for 1,355 women aged 65 and older from the Korea National Health and Nutrition Examination Survey (KNHANES) 2015 to 2016 were included. Linear regression analysis was conducted for influential factors on HRQoL, measured by the Euro Quality of Life-5D (EQ-5D). RESULTS: The prevalence of osteoporosis was 41.3% in older Korean women. The EQ-5D index score was lower in older women with osteoporosis (0.83) than those without osteoporosis (0.86). Lower HRQoL in older Korean women with osteoporosis was associated with lower household income, perceived health status as bad, comorbidity, activity restriction, and stress. CONCLUSION: The findings indicate that the prevalence of osteoporosis was high in older Korean women. In addition, healthcare professionals need to consider individual conditions such as economic status, perceived health status, other chronic diseases, activity restriction and level of stress for improvement of HRQoL in older Korean women with osteoporosis.

Effects of the Mental Health Promotion Program based on Positive Psychology for Adolescents with Problem Behavior / 한국간호교육학회지

PURPOSE: The purpose of this study was to examine the effects of the mental health promotion program based on Positive Psychology for adolescents with problem behavior. METHODS: The study used a nonequivalent control group pretest-posttest design. Eligible participants were first grade students in two high schools in K Province. The inclusion criteria for the study were those with scores in the upper 15% on the Korean Youth Self-Report. A total of 74 participants were assigned to an 8-session program (n=38) or to a control (n=36) group. The outcome variables were psychological well-being, depression, and self-esteem. RESULTS: There were no statistically significant differences in demographic variables or outcome variables, except self-esteem, between the two groups at the baseline. The experimental group had higher mean scores on psychological well-being and self-esteem and a lower mean score on depression. There were significant differences in psychological well-being (t=3.45, p=.001), self-esteem (F=5.45, p=.022), and depression (t=-2.80, p=.007) between the two groups. CONCLUSION: The mental health promotion program based on Positive Psychology was effective in decreasing depression as well as improving psychological well-being and self-esteem for adolescents with problem behavior. This study contributes to suggesting a framework for promoting mental health for high school students with problem behavior.

Comparison of the outcomes of robotic cholecystectomy and laparoscopic cholecystectomy

PURPOSE: This study compared the effects of robotic single-port cholecystectomy (RC) and 3-port laparoscopic cholecystectomy (LC) on patients' surgical pain, postoperative complications, and satisfaction. METHODS: One hundred twenty patients with gallbladder disease scheduled for either LC or RC were recruited. Each patient was followed up for 1 week after hospital discharge. RESULTS: Time stayed in operating room was longer in patients with RC, however their hospital stay was shorter than those with LC (t = 3.01, P = 0.003). Since patients with RC received more analgesics during the surgery (t = 3.98, P < 0.001), all participants' surgical pain level were analyzed by using analysis of covariance. Patients who underwent RC reported less surgical pain consistently at 6 hours and first day after surgery and 2 days and 1 week later than patients in the LC. Repeated measure analysis of variance also demonstrated that the RC with single-port might cause less pain throughout the postoperative period (F = 25.68, P < 0.001). Participants' conditions appeared stable without complications such as infection or bleeding regardless of the surgical type however, overall satisfaction with RC showed significantly higher than those with LC except for one item, “the cost of surgery.” CONCLUSION: These results suggested that the RC might be a better choice for people who concern about surgical pain and early hospital discharge. Since there were no differences in postoperative health status between the 2 groups, health care providers as an advocate can provide more reliable information to their patients.

A Phenomenology Study of the Lived Experience of Homeless Persons / 정신간호학회지

PURPOSE: The purpose of this study was to explore the lived experiences of homeless persons. METHODS: A phenomenological methodology was used for the study. Participants were people enrolled in the Center for homeless persons in Kyunggi Province and eligible for the study. Data were collected through in-depth interviews with nine participants between October 13 and November 16, 2016. Data analysis was conducted using Colaizzi's method. RESULTS: Five themes and twenty meanings were formulated for experiences of homeless persons. The five themes were ‘Abandoning their life’, ‘Being familiar with a free homeless life’, ‘Being isolated from the world’, ‘Being impoverished’, ‘Desire to break away from the life of homelessness’. CONCLUSION: The study results suggest the need for a holistic understanding of the essential structure of the lived experiences of homeless persons. Mental health professionals need to understand the homelessness experiences from the client view and to develop programs that can help homeless persons reintegrate into the community.

CORRIGENDUM: Correction of the affiliation name. Comparison of the outcomes of robotic cholecystectomy and laparoscopic cholecystectomy

In the original publication, The authors found a mistake in funding statement. Also in the title page (1st affiliation) and main text, the authots would like to revise the affiliation name.

Influencing Factors on Externalized and Internalized Problem Behaviors among Adolescents: Focused on First Grade High School Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to investigate the influencing factors on externalized and internalized problem behaviors among high school students. METHODS: The subjects for this study were 707 students in two high schools in K province. The data were collected during the period from October to November, 2014 by use of questionnaires. The instruments used were the Korean Youth Self-report, Daily Hassles Questionnaire, State-Trait Anger Expression Inventory, and Ego Resiliency Scale. The data were analyzed using SPSS. RESULTS: Significant predictors to explain externalized problem behaviors comprised anger-out, anger-in, anger-control, relation with parents, daily stress, and religion. It was found that these factors explained 46% of externalized problem behavior. Ego resiliency, anger-in, daily stress, gender, relation with parent, and anger-out were significant predictors to explain internalized problem behaviors. It was found that these factors explained 45% of internalized problem behaviors. CONCLUSION: This study suggests that the influencing factors on problem behaviors differ from externalized and internalized problem behaviors. So these findings will provide the basic data to develop a program that is differentiated by problem behavior type.

Public Participation in the Process of Local Public Health Policy, Using Policy Network Analysis / 예방의학회지

OBJECTIVES: To assess the current public participation in-local health policy and its implications through the analysis of policy networks in health center programs. METHODS: We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts ('gu's) of Seoul. Participants of the policy network were selected by the snowballing method and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer. RESULTS: The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementation process, the program was led by the health center, while other actors participated passively. CONCLUSIONS: Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders, including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation.

Development and Evaluation of a Web-based Computer-Assisted Personal Interview System (CAPIS) for Open-ended Dietary Assessments among Koreans

The accuracy of dietary assessments has emerged as a major concern in nutritional epidemiology and new dietary assessment tools using computer technology to increase accuracy have been developed in many countries. The purpose of this study was to develop a web-based computer-assisted personal interview system (CAPIS) for conducting dietary assessment and to evaluate its practical utilization among Koreans. The client software was developed using Microsoft's ClickOnce technology, which allows communication with a database system via an http server to add or retrieve data. The system consists of a tracking system for the subject and researcher, a data-input system during the interview, a calculation system for estimating food and nutrient intake, a data-output system for presenting the results, and an evaluation system for assessing the adequacy of nutrient and food intake. Databases of the nutrient composition of common food (n = 3,642), recipes for common dishes (n = 1,886), and photos of serving sizes for food and dishes (n = 4,152) were constructed, and logical processes for data collection, calculation, and output were developed. The functionality, on-site applicability, and efficiency of CAPIS were evaluated in a convenience sample of 181 participants (61 males, 120 females; aged 24 to 85) by comparing with manual 24 hour recall method with paper questionnaire. The CAPIS was functioned adequately in the field survey in terms of completeness of function, security, and compliance of researcher and subjects. Regarding on-site applicability, 23.2%, 32.6%, 35.4%, and 43.7% of subjects reported that CAPIS was easier to recall their diet, to estimate the amount consumed, to communicate with the interviewer, and to concentrate on the interview than the manual method with paper questionnaire, respectively. Although CAPIS required more interview time (9 min 42 sec) compared to the manual method (7 min 30 sec), it saved time and cost for data coding and entry (15 min 35 sec) and gave high satisfaction from the prompt feedback after interview to the subjects, which increase efficiency to apply on the field survey. Our results suggest that the newly developed CAPIS is suitable for conducting personal interviews for dietary assessment in Korean population.

Anesthetic experience of a patient with severe change on respiratory mechanics in the prone position for spinal surgery / 대한마취과학회지

No abstract available.

Anesthetic experience of a patient with severe change on respiratory mechanics in the prone position for spinal surgery / 대한마취과학회지

No abstract available.

Mediating Effect of Therapeutic Relationship with Mental Health Professionals in the Relation between Hope and Recovery of Community Dwelling Patients with a Mental Illness / 정신간호학회지

PURPOSE: This study was conducted to examine the association among therapeutic relationship with mental health professionals, hope, and recovery, and to explore the mediation of therapeutic relationship with mental health professionals in the relation between hope and recovery in South Korean patients with a mental illness. METHODS: A cross-sectional study design was employed. Eligible participants were 99 people with a mental illness who were enrolled as members at two Community Mental Health Centers in Gyeonggi Province. Data were collected from October, 4 to 14, 2011. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and multiple regression analysis. RESULTS: Hope was positively correlated with recovery, and therapeutic relationship with mental health professionals was also positively associated with recovery. The mediating effect of therapeutic relationship with mental health professionals was found in the relation between hope and recovery. CONCLUSION: The results suggest that therapeutic relationship with mental health professionals plays an important role in promoting recovery of the patients with a mental illness. Therefore, mental health professionals should focus on developing a therapeutic relationship with their clients and also consider these recovery-related factors for persons who have a mental illness.

Reliability and Applicability of the Bayley Scale of Infant Development-II for Children With Cerebral Palsy

OBJECTIVE: To obtain reliability and applicability of the Korean version Bayley Scale of Infant Development-II (BSID-II) in evaluating the developmental status of children with cerebral palsy (CP). METHODS: The inter-rater reliability of BSID-II scores from 68 children with CP (46 boys and 22 girls; mean age, 32.54+/-16.76 months; age range, 4 to 78 months) was evaluated by 10 pediatric occupational therapists. Patients were classified in several ways according to age group, typology, and the severity of motor impairment by the level of the Gross Motor Function Classification System (GMFCS). The measures were performed by video analysis, and the results of intraclass correlation (ICC) were obtained for each of the above classifications. To evaluate the clinical applicability of BSID-II for CP, its correlation with the Gross Motor Function Measure (GMFM), which has been known as the standard motor assessment for CP, was investigated. RESULTS: ICC was 0.99 for the Mental scale and 0.98 for the Motor scale in all subjects. The values of ICC ranged from 0.92 to 0.99 for each age group, 0.93 to 0.99 for each typology, and 0.99 to 1.00 for each GMFCS level. A strong positive correlation was found between the BSID-II Motor raw score and the GMFM total score (r=0.84, p<0.001), and a moderate correlation was observed between the BSID-II Mental raw score and the GMFM total score (r=0.65, p<0.001). CONCLUSION: The Korean version of BSID-II is a reliable tool to measure the functional status of children with CP. The raw scores of BSID-II showed a great correlation with GMFM, indicating validity of this measure for children with CP on clinical basis.

Resilience of Families with Elderly Patients with Dementia / 정신간호학회지

PURPOSE: The purpose of this study was to pave the way for developing nursing intervention strategies to enhance family resilience by identifying unique patterns of resilience in families of elderly patients with dementia. METHODS: The Q-methodology was used to define types and describe characteristics of family resilience. After in-depth interviews with 12 family members of patients with dementia and study of related literature, final 50 Q-samples were selected by collecting the opinions of experts. The selected 50 Q-statements were sorted by 30 family members (P-samples). The PC-QUNAL program was used to analyze Q-sort data. RESULTS: Four distinctive Q-factors for family resilience were identified: I. Seeking positive meaning, II. Developing reasonable cooperation with family members, III. Accepting reality passively, IV. Depending on external resources. CONCLUSION: Families caring for elderly patients with dementia show unique patterns of family resilience, which result from multi-factors, such as their own belief systems or culture, organizational patterns, and communication processes, in dealing with crisis. The results of this study can be useful in confirming the types of resilience of families of patients with dementia and their characteristics, and the underlying data can be used as to develop tailored nursing strategies for strengthening family capacities to master adversity.

Factors Influencing Sleep Quality in Clinical Nurses / 정신간호학회지

PURPOSE: The purpose of this study was to identify sleep quality, job stress, symptoms of stress (SOS), and coping and to examine factors influencing sleep quality in clinical nurses. METHODS: A cross-sectional study was conducted with 265 clinical nurses at three general hospitals. A self-administrated questionnaire was used for data collection, and data were analyzed using descriptive statistics, Pearson correlation coefficients, t-test, ANOVA, and backward multiple regression with the SAS statistical program. RESULTS: Sleep quality showed significant differences according to the sociodemographic characteristics of age, length of work, education, current workplace, current job position, shift work, and marital status. Sleep quality was negatively associated with SOS and job stress. Significant factors influencing sleep quality of the clinical nurses were cognitive-behavioral SOS, physiological SOS, inappropriate rewards, physical work environment, and shift work. CONCLUSION: The findings indicate that cognitive-behavioral SOS, physiological SOS, job stress regarding inappropriate rewards and physical work environment, and shift work are useful to predict levels of sleep quality of clinical nurses. These factors should be considered when developing nursing interventions to improve sleep quality of clinical nurses through stress management.