Customers' perception of the attributes of different formats of menu labeling: a comparison between Korea and the U.S

BACKGROUND/OBJECTIVES@#This study compared the perception of customers from Korea and the U.S. on the attributes of different formats of menu labeling The specific objectives were 1) to compare the customers' perceived usefulness, ease-of-understanding, clarity, and attractiveness of different formats of menu labeling between Korea and the U.S.; and 2) to compare the customers' use intention to different formats of menu labeling between Korea and the U.S. @*SUBJECTS/METHODS@#A survey was conducted in Korea and the U.S. The participants were allocated randomly to view 1 of the 7 restaurant menus that varied according to the following types of menu labeling formats: (type 1) kcal format, (type 2) traffic-light format, (type 3) percent daily intake (%DI) format, (type 4) kcal + traffic-light format, (type 5) kcal + %DI format, (type 6) traffic-light + %DI format, and (type 7) kcal + traffic-light + %DI format. A total of 279 Koreans and 347 Americans were entered in the analysis. An independent t-test and 1-way analysis of variance were performed. @*RESULTS@#Koreans rated type 4 format (kcal + traffic light) the highest for usefulness and attractiveness. In contrast, Americans rated type 7 (kcal + traffic light + %DI) the highest for usefulness, ease-of-understanding, attractiveness, and clarity. Significant differences were found in the customers' perceived attributes to menu labeling between Korea and the U.S. Americans perceived higher for all the 4 attributes of menu labeling than Koreans. @*CONCLUSIONS@#The study is unique in identifying the differences in the attributes of different formats of menu labeling between Korea and the U.S. Americans rated the most complicated type of menu labeling as the highest perception for the attributes, and showed a higher use intention of menu labeling than Koreans. This study contributes to academia and industry for practicing menu labeling in different countries using different formats.

Comparison of college students' behavior toward nutrition information communication between Korea and the US

BACKGROUND/OBJECTIVES@#The expansion of menu labeling to restaurants has created a need to study customers' behavior toward nutrition information. Therefore, the purpose of this research was to compare college students' behavior toward nutrition information communication between Korea and the US. This study consisted of three objectives: 1) to compare the frequency of usage as well as degree of trust regarding smartphone-based communication channels in the acquisition of nutrition information among college students between Korea and the US, 2) to compare knowledge-sharing behavior related to nutrition information among college students between Korea and the US, and 3) to identify the role of country in the process of knowledge-sharing behavior. @*SUBJECTS/METHODS@#A survey was distributed via the web to college students in Korea and the US. Data were collected in the 2nd week of March 2017. Completed responses were collected from 423 Koreans and 280 Americans. Differences between Koreans and Americans were evaluated for statistical significance using a t-test. In order to verify the effects of knowledge self-efficacy and transactive memory capability on knowledge-sharing behavior related to nutrition information, a regression analysis was performed. @*RESULTS@#Significant differences were found in the frequency of usage as well as degree of trust in communication channels related to nutrition information between Korean and American college students. While knowledge self-efficacy and tractive memory capability had positive effects on knowledge-sharing behavior related to nutrition information, country had a significant effect on the process. @*CONCLUSIONS@#This study is the first to compare customer behavior toward nutrition information acquisition and sharing between Korea and the US. Comparative research on nutrition information revealed differences among the different countries. Therefore, this study contributes to the body of knowledge on the nutrition information research, in particular, by providing a comparison study between countries.

Relationships among behavioral beliefs, past behaviors, attitudes and behavioral intentions toward healthy menu selection

BACKGROUND/OBJECTIVES: Obesity is a serious concern worldwide, for which the restaurant industry holds partial responsibility. This study was conducted to estimate restaurant consumers' intention to select healthy menu items and to examine the relationships among behavioral beliefs, past behaviors, attitudes and behavioral intentions, which are known to be major determinants of consumer behaviors. SUBJECTS/METHODS: An online, self-administered survey was distributed for data collection. The study sample consisted of customers who reported having visited casual dining restaurants in the last three months at the time of the survey. Structural equation modeling was used to verify the fit of the proposed research model. RESULTS: Structural equation modeling revealed that the proposed model supports the sequential, mediated (indirect) relationships among behavioral beliefs, past behaviors, attitudes and behavioral intentions toward healthy menu selection. CONCLUSION: This study contributes to the available literature regarding obesity by adding past behaviors, one of the most influential variables involved in prediction of future behaviors of consumers, to the TPB model, enabling a better understanding of restaurant consumers' rational decision process regarding healthy menu choices. The results of this study provide practical implications for restaurant practitioners and government agencies regarding ways to promote healthy menus.

Perinatal outcomes associated with prepregnancy body mass index and weight gain during pregnancy / 대한산부인과학회지

OBJECTIVE: To examine the association between prepregnancy body mass index (BMI), gestational weight gain and perinatal outcomes. METHODS: The data of women who delivered at term in our institute from January 2005 to December 2007 were analyzed retrospectively. Four categories of prepregnancy BMI and three categories of gestational weight gain were constructed and used maternal, neonatal outcomes. RESULTS: This study included 225 women with term delivered in our institute. According to prepregnancy BMI categories, lean ( or =25) were 35, 132, 31, 27, respectively. According to gestational weight gain categories, lean (13.5 kg) were 73, 44, 108, respectively. Gestational weight gain above guidelines was common in low prepregnancy weight group, this difference was statistically significant. In women with increased prepregnancy BMI was associated with increased risk of gestational diabetes mellitus, cesarean section rate, and large for gestational age (LGA) (P<0.05). In women with overweight gain during pregnancy was associated with increased cesarean section rate and LGA (P<0.05). CONCLUSION: Increased prepregnancy BMI was associated with increased gestational diabetes mellitus, cesarean section rate, and LGA. Also excessive weight gain during pregnancy was associated with increased cesarean section rate and LGA.

Clinical study of unusual ectopic pregnancies / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to evaluate the clinical characteristics and the management of the unusual ectopic pregnancies. METHODS: Sixty one patients who were diagnosed as unusual ectopic pregnancies in the Department of Obstetrics and Gynecology, Inje University Ilsan Paik Hospital from December 1999 to June 2006, were retrospectively analyzed. The chief complaints, past histories, time of diagnosis, serum beta-hCG concentrations and method of the management were reviewed. RESULTS: During the designated study period, the incidence rate of the ectopic pregnancy was 9.5% of the all deliveries and that of the unusual ectopic pregnancy was 18.8% of the total ectopic pregnancies. In twenty two cases, implantation sites were not found out exactly by sonography at initial diagnosis. Theses ectopic pregnancies were cornual pregnancy (3 cases), ovarian pregnancy (6 cases), abdominal pregnancy (3 cases), and unclassified unusual ectopic pregnancy (10 cases). Unusual ectopic pregnancies which were diagnosed before six weeks of gestation were eleven cases. These unusual ectopic pregnancies were 6 cases in cervical pregnancy, 1 case in abdominal pregnancy, and 4 cases in unclassified unusual ectopic pregnancy. Initial mean serum beta-hCG concentration was the highest in cornual pregnancies and the lowest in abdominal pregnancies. MTX (methotrexate) was administered in seven cases, operation was done in forty six cases, and expectant management was done in nine cases. All initial treatment was successful except one case with cornual pregnancy, which was MTX administered with alternative regimen. CONCLUSIONS: In our study the diagnostic accuracy of the unusual ectopic pregnancy was 63.9% and the successful treatment was done in 98.3% of them. There were significant statistical differences between the serum beta-hCG concentrations and the kinds of unusual ectopic pregnancies (p<0.001).

Sonographic Diagnosis of Fetal Intracranial Hemorrhage in a Gravida on Warfarin Therapy

A 34-year-old Korean woman who had been taking warfarin for 14 years after mitral valve replacement became pregnant. She was heparinized betwen 6 and14 weeks of gestation and was then restarted on oral anticoagulants. At 32 weeks of gestation, fetal ultrasonography revealed overt enlargement of the left lateral ventricles. There was an echogenic mass in the right hemisphere with mild ventricular enlargement. An elective repeat cesarean section was performed. Three days later, the neonate underwent a Burr-hole procedure, from which bloody fluid was drained and the intracranial hemorrhage was confirmed. We must keep in mind the severe adverse fetal outcomes associated with warfarin-induced fetal intracranial hemorrhage during pregnancy. Despite its therapeutic advantages, regular fetal monitoring, ultrasonography, and management of prothrombin time are needed.

Comparison of perinatal outcomes with gestational weeks and severity of disease in the preterm delivery associated with preeclampsia / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to comparison of perinatal outcomes with gestational weeks and severity of disease in the preterm delivery associated with preeclampsia. METHODS: Of the 274 cases, we reviewed retrospectively the medical records of 176 preeclampsia mothers and infants delivered before 37 weeks of gestation in the Department of Obstetrics and Gynecology, Inje University Ilsanpaik Hospital from January 2000 to December 2006. RESULTS: In preeclampsia related to premature birth, it was not different the frequency of maternal age and parity in both mild and severe group. Among indications of delivery, nonreassuring fetal heart rate pattern was most frequent in mild preeclampsia, and maternal condition was in severe preeclampsia. In addition, the rate of cesarean section was higher in severe preeclampsia. Only the severity of preeclampsia was related to prognosis in mothers. On the other hands, gestational weeks on delivery and severity of preeclampsia were related to prognosis in neonates who were born 27(+0)~33(+6) gestatonal weeks. In each group of delayed birth, no statistical significance was observed in maternal and neonatal complications according to birth delay. CONCLUSIONS: In case of maternal complications, severity of preeclampsia is related to prognosis. In case of neonatal complications, if the delivery is between 27(+0)~33(+6) gestational weeks, gestational weeks and severity of preeclampsia are importatnt indicators related to the neonate's prognosis. After 34(+0) gestational weeks, severity of preeclampsia and gestational weeks of delivery are not related to the neonate's prognosis.

Nutrition in pregnancy / 대한산부인과학회지

Pregnancy consists of a series of small, continuous physiologic adjustments that affect the metabolism of all nutrients. The adjustments undoubtedly vary widely from woman to woman depending on her prepregnancy nutrition, genetic determinants of fetal size, and maternal lifestyle behavior. A healthy and varied diet is important during pregnancy because the maternal diet must provide sufficient energy and nutrients to meet the mother's usual requirements, as well as the needs of the growing fetus, and enable the mother to lay down stores of nutrients required for fetal development as well as for lactation. The dietary recommendations for pregnant women are actually very similar to those for other adults, but with a few notable exceptions. There is an increased requirement for energy, protein and several micronutrients during pregnancy. The importance of good dietary advice during pregnancy is a healthy, balanced diet, in particular plenty of iron- and folate-rich foods. In addition, a folic acid supplement (400 microgram/day) is recommended prior to and up to 12th week of gestation, and vitamin D supplement (10 microgram/day) is recommended throughout pregnancy. As well as following a healthy, balanced diet, staying physically active is also very important during pregnancy. Exercise can help prevent excess weight gain during pregnancy and help the mother return to a normal weight after the birth. Regular aerobic exercises (walking, swimming) during pregnancy help improve or maintain physical fitness and body image. Certain population groups may require closer attention during pregnancy, including teenage girls, women from certain ethnic group, and women from lower socio-economic backgrounds. Efforts to achieve good maternal nutritional status preconception as well as throughout gestation best assure a good milieu for fetal growth and development and maternal health.

Checklist for decision of delivery between 32 and 36 weeks of gestation / 대한주산의학회잡지

No abstract available.

Expression of Survivin in extrapelvic endometriosis / 대한산부인과학회지

OBJECTIVE: To examine survivin expression in extrapelvic endometriosis. METHODS: The study group consisted of 14 cases with extrapelvic endometriosis which were confirmed histologically. The control group (total, n=47) was divided into 2 groups. Group I included normal endometrium (n=34) obtained from hysterectomy specimens with myoma and without endometriosis. Group II included ovarian endometrioma (n=13) obtained from laparoscopy. Expression of survivin was immunohistochemically confirmed. RESULTS: In extrapelvic endometriosis, the expression of nucleus in glandular epithelium and stromal cells were significantly stronger than normal endometrium. But cytoplasm expression of glandular epithelial cells and stromal cells in extrapelvic endometriosis showed statistically lower in comparison with normal endometrium. In ovarian endometrioma, the expression of nucleus in glandular epithelial cells and stromal cells was significantly stronger than normal endometrium. But the expression of nucleus in glandular epithelial cells with ovarian endometrioma was stronger than during proliferative phase but was not significant. Also cytoplasm expression of ovarian endometrioma was lower than normal endometrium. There was no difference in survivin expression between extrapelvic endometriosis and ovarian endometrioma. CONCLUSIONS: In extrapelvic endometriosis, survivin expression was stronger than normal endometrium except cytoplasm. Our findings suggest that increased survivin expression may contribute to survival of extrapelvic implants.

A retrospective cohort study of maternal and perinatal risk factors on intrauterine fetal death / 대한산부인과학회지

OBJECTIVES: The purpose of this study was to investigate the clinical characteristics and the risk factors of Intrauterine fetal death (IUFD). METHODS: We did retrospective review and investigated the risk factors from medical records of the 62 pregnancies with IUFD between January 2000 and December 2007. Also we statistically analyzed that maternal and perinatal risk factors compared with 3,887 live-birth pregnancies. RESULTS: The overall incidence of IUFD was 1.57%. The age distribution of mother with IUFD was between 21 to 41, and was highest in the 30 to 34 year old age group (41.94%). There were 29 cases (46.78%) with nulliparous and 5 cases (8.06%) with previous IUFD. IUFD was the most prevalent (48.39%) at 20-29 weeks of gestation and the sex ratio of male versus female fetus was 1.03:1. Most of cases (80.64%) were delivered vaginally (spontaneous labor: 62.90%, labor induction: 17.74%), and laparotomy was 19.35%. Risk factors were maternal obesity, infection, placental abnormality, advanced maternal age (> or =35), and unexplained cause in that order. 50 cases included more than two risk factors. The risk analysis showed statistically significant risk in preeclampsia (OR 2.733; 95% CI 1.408-5.306) and placental abruption (OR 5.190; 95% CI 2.165-12.441). CONCLUSION: Identification of risk factors for IUFD assists the clinician in performing a risk assessment for each patient. Clinicians need to be able to assess each patient's risk for IUFD and to have a low threshold to evaluate fetal growth in at-risk pregnancies.

Evaluation of Preterm Delivery between 32(+0)-33(+6) Weeks of Gestation

Preterm labor after 34 weeks of gestation has shown no great difference from fullterm labor in terms of neonatal morbidity and mortality when proper antepartum management (antibiotics or steroids treatment) is done. However, various studies have discussed different views on the risks and safety of preterm delivery at 32(+0)- 33(+6) weeks of gestation. We evaluated the complications of different preterm groups that included the neonates born at 32(+0)-33(+6) weeks of gestation (142), stratified randomly selected neonates born at 34(+0)-36(+6) weeks of gestation (267) and neonates born after 37(+0) weeks of gestation (356) at our hospital between December 1999 and April 2006. As a result, it was found that neonates born at 3(+0)-36(+6) weeks of gestation showed no great difference from infants born at full term. However, neonates born at 32(+0)-33(+6) weeks were more likely to be admitted to neonatal intensive care unit or develop neonatal complications significantly than the neonates born at 34(+0)- 36(+6) weeks and at full term. Therefore, it is suggested that neonates born at 32(+0)-33(+6) weeks have higher risk of neonatal complications following their preterm labor than those born at later than 34(+0) weeks. Thus, it would be difficult to accept the idea that preterm labor at 32(+0)-33(+6) weeks is safe.

The Clinical Features and Neonatal Outcomes of Thrombocytopenia in Pregnancy / 대한주산의학회잡지

OBJECTIVE: The aim of this study was to evaluate the proper management based on 6 years of experience in Inje University Ilsan Paik Hospital by review of the clinical features of thrombocytopenia in pregnancy. METHODS: A survey about causing factors, diagnosis, obstetric outcomes and management of thrombocytopenia in pregnancy at Inje University Ilsan Paik Hospital from December 1999 to September 2005 was done by retrospectively. RESULTS: The total number of delivery was 3002 and total number of thrombocytopenia in pregnancy was 70 (2.3%), of which 37 were gestational thrombocytopenia and 10 were ITP. The thrombocytopenia associated with PIH was 21, pancytopenia was 1 case, and thrombocytopenia associated with liver cirrhosis was 1 case. The obstetric and perinatal outcomes were similar between groups. But 1 case of ITP pregnancy, there was neonatal intraventricular hemorrhage was observed. CONCLUSION: Gestational thrombocytopenia is the most common cause of thrombocytopenia. It is characterized by mild maternal thrombocytopenia and is not associated with adverse maternal or fetal outcomes. The ITP patients should be carefully monitored during the antenatal care visits, also preeclampsia, HELLP, and the primary thrombotic microangiopathies need careful monitoring, but these disease can be differentiated from one another in most cases.

A Prospective Study of Comparison of Cervical Ripening with Oral vs Vaginal Misoprostol in Nulliparous Women / 대한주산의학회잡지

OBJECTIVE: To compare the safety and efficacy of oral misoprostol, vaginal misoprostol, and oxytocin-only users for cervix ripening and labor induction in nulliparous women. METHODS: Randomly selected 11 patients were orally administered 50 microgram of misoprostol at first and then 100 microgram every 4 hours and the other 9 patients were vaginally administered 25 microgram of misoprostol at first after then the same doses every 4 hours. They all were nulliparous women with Bishop score 6 or less. Another 19 patients were oxytocin only users for cervical ripening and labor induction, who were nulliparous women with Bishop score 6 or less, and reviewed these medical records retrospectively. RESULTS: There were no differences among these three groups in patient characteristics such as maternal age, gestational age, parity and initial Bishop score. In oral misoprostol group, it took shorter time to get Bishop score 8 or more and become effacement 60% or more than vaginal misoprostol group. On the contrary, in vaginal misoprostol group, it took shorter time to become full dilatation and deliver than oral misoprostol group. However there were no significant statistical differences between two groups in obstetric and neonatal outcomes. CONCLUSION: Oral and vaginal misoprostol are effective in cervical ripening but there were no significant statistical differences in perinatal outcomes. Among many regimens of misoprostol administration for cervix ripening in nulliparous women, there is no standardized method until now. More studies will be needed for safe application of this drug.

Group B Streptococcal Colonization Rate in Korean Pregnant Women / 대한산부인과학회지

OBJECTIVE: To evaluate the colonization rate of the group B streptococcus (GBS) in Korean pregnant women and their neonates, and the antimicrobial susceptibility of isolated GBS. METHODS: From March 2005 to May 2005, pregnant women who visited 3 obstetric clinics in Goyang-si and Paju-si for antenatal care after 35 weeks of gestation were enrolled. According to Centers for Disease Control and Prevention (CDC) guideline for collecting and processing clinical specimens for group B streptococcal culture, specimens were obtained from the lower third of the vagina and perianal areas, and then inoculated on Todd-Hewitt broth. The test for antimicrobial susceptibility was performed by a disc diffusion method. RESULTS: Of the 273 pregnant women, 13 (4.8%) had a positive culture from at least 1 site (vaginal culture 6, perianal culture 3, both 4). No GBS colonization was found in their neonates. The antibiotic resistance rate was 53.9% (7/13) for erythromycin and 61.5% (8/13) for clindamycin. CONCLUSION: In this study, the colonization rate of group B streptococci in Korean pregnant women was found to be lower than those reported in USA, Western Europe, and other Asian countries. The antibiotic resistance rate for erythromycin and clindamycin was higher than those reported in other countries. Further evaluation was needed to establish the screening and chemoprophylaxis guideline for Korean pregnant women.

An Effect of Massive Proteinuria in Pregnancy Induced Hypertension / 대한산부인과학회잡지

OBJECTIVE: This study was investigated on the relationship the degrees of proteinuria with the maternal characteristics, maternal and the neonatal outcomes. The correlation between the result of single urine protein- to-creatinine ratio and the amount of 24 hour urine protein was also investigated. METHODS: From December 1999 to June 2002, 63 patients were enrolled in this study. They were divided into two groups by the degree of proteinuria at 24 hour urine, single urine and dip stick test, respectively. Each two groups was compared with the maternal characteristics, gestational age, the maternal and the neonatal outcomes. The correlation between single urine protein-to-creatinine ratio and the amount of 24 hour urine protein was analyzed statistically. RESULTS: Each two groups of single urine and dip stick test had no differences in maternal characteristics, gestational age, maternal and the neonatal outcomes. However, in two of 24 hour urine, massive proteinuria group had poor maternal and neonatal outcomes compared with control group (p value 0.01). Single urine protein-to-creatine ratio and the amount 24 hour urine protein had borderline correlation (p value 0.064). CONCLUSION: The presence of proteinuria influences on maternal and neonatal outcomes. Moreover, the massive proteinuria group had more maternal and neonatal complication than control group. The result of single urine protein-to-creatine ratio had borderline correlation with the amount of protein in 24 hour urine collection.

The Influence of Epidural Anesthesia on the Progress of Labor and Perinatal Outcomes / 대한산부인과학회잡지

OBJECTIVE: To determine that epidural anesthesia need not increase Cesarean delivery rates and prolong labor. METHODS: From December 1999 to May 2002, 1,585 deliveries were in Ilsan Paik Hospital. We selected 70 (epidural group) and 87 (non-epidural group) singleton, nulliparous, term, cephalic presentation without antenatal complications. We compared duration of labor, rates of Cesarean delivery and perinatal outcomes between these two groups. RESULTS: The duration of active and second stage of labor were not prolonged in the epidural group. Cesarean delivery rates was 8.6% (n=70) in the epidural group and 9.2% (n=87) in the non-epidural group, so there was no significant difference. Perinatal outcomes was no significant difference between the two groups. CONCLUSION: Epidural anesthesia during labor provides the best pain relief and does not increase the Cesarean delivery rates. The duration of the active, second stage of labor and perinatal outcomes was not different between these two groups.

A Case Patient None of Any Operation History Found Suture Needle in Uterus / 대한산부인과학회잡지

In past, there were some cases about foreign body, like gauze or metallic operative material, in abdominal cavity and they were associated with surgical procedure mostly. Recently we experienced a case of lost suture needle in uterus. She did not received any surgical procedures and just had 2 times of vaginal deliveries. The needle was found during pelvic surgery for hemoperitoneum. She was not known the fact that she had a foreign body in uterus. Although the patient complained chronic pelvic pain intermittently before visit hospital, she just thought of the nature of pain is like dysmenorrhea or nonspecific abdominal pain. The case considers about the moving of suture needle which was lost during vaginal delivery and fixed in the uterus and causing chronic pelvic pain. We report the case with a brief review of the literature.

The Efficacy of Color Doppler Ultrasound in Diagnosis and Management of Placenta Previa with Accreta / 대한산부인과학회잡지

OBJECTIVE: To evaluate the efficacy of color Doppler ultrasound in diagnosis and management of placenta previa with accreta. METHODS: Hospital records were reviewed all cases of placenta previa from December 1999 to June 2002, and seventy-four patients with placenta previa underwent color Doppler ultrasound in their second and third trimester. Four diagnostic criteria of placenta accreta were diffuse lacunar flow pattern, exhibiting diffusely dilated vascular channels throughout the whole placenta: focal lacunar flow pattern showing irregular sonolucent vascular lakes, regionally or focally within the intraparenchymal placental area: absence of subplacental vascular signals in the areas lacking the peripheral subplacental hypoechoic zone: interphase hypervascularity with abnormal blood vessels linking the placenta to the bladder. RESULTS: Twenty-four of the seventy-four patients diagnosed placenta previa with accreta according to the above criteria and thirteen of these have proven to placenta accreta histopathologically. In ten cases hysterectomy were done under the group of suspicious placenta accreta. The sensitivity, specificity, positive predictive value and negative predictive value were 100%, 83%, 56% and 100%. CONCLUSION: The color Doppler ultrasound was effective method for the diagnosis of placenta previa with accreta, so proper diagnosis will be helpful to management of placenta previa with accreta patients.

A Case of Malarial Infection in Pregnancy / 대한산부인과학회잡지

Recently, in Korea, imported malarial infections are increased and occasionally domestic infections are reported. But the malarial infected pregnant women are seldom cases and we have experienced second trimester infected one. She had no traveling and transfusion history. She delivered a healthy baby at term by repeated cesarean section and her baby had no evidence of congenital malarial infection. We treated her with hydroxychloroquine at antepartum and primaquine at postpartum. We present this case with a brief review of literatures.