Cardiovascular Health Behavior Prediction Model in Patients With Type 2 Diabetes.

BACKGROUND: To prevent cardiovascular disease in adults with type 2 diabetes, it is necessary to identify the factors that affect cardiovascular health behavior. OBJECTIVE: The aim of this study was to verify the causal relationship between illness perception and diabetes knowledge as cognitive representations, depression as emotional representations, self-efficacy as cognitive coping, and oral health and cardiovascular health behaviors as behavioral coping strategies. A hypothetical model was established based on a literature review and the self-regulation model. METHODS: In this study, a cross-sectional survey design was used, and the participants were adults 30 years or older who had been given a diagnosis of type 2 diabetes for more than 6 months and were recruited from South Korea. Data from 272 participants were collected through face-to-face interviews or Google surveys in 2021, and analyzed using SPSS 25.0 and AMOS 22.0. RESULTS: Oral health behavior (ß = 0.26, P < .001) and self-efficacy (ß = 0.16, P = .048) had a direct effect on cardiovascular health behavior, and illness perception (ß = 0.24, P = .018) and depression (ß = -0.25, P < .001) had an indirect effect through self-efficacy (ß = 0.24, P = .016), with a total explanatory power of 19.1%. Oral health behavior was directly affected by illness perception and self-efficacy, and self-efficacy was directly affected by illness perception, diabetes knowledge, and depression (P < .05). CONCLUSION: To practice cardiovascular health behaviors in adults with diabetes, self-efficacy for diabetes management should be enhanced. To this end, it is necessary to increase illness perception and knowledge, and reduce depression through cardiovascular disease prevention education for them, and the importance of oral health behaviors should also be emphasized.

Effect of risk factor-tailored autonomy enhancement education in the first-time middle-aged patients undergoing percutaneous coronary intervention: a randomized controlled trial.

PURPOSE: It is important for middle-aged patients who have undergone acute treatment for coronary artery disease to voluntarily improve their lifestyle and risk factors based on their recognition as patients with chronic diseases. This study conducted individual education to improve risk factors and tried to verify its effectiveness. METHODS: The hypothesis was verified by applying a randomized controlled pre- and post-test design through random assignment of two groups. Middle-aged (40-64 years) patients who underwent percutaneous coronary intervention for the first time were recruited from a university hospital in Seoul, Korea. For the experimental group, based on the Self-Determination Theory, risk factor- tailored counseling and education were provided individually for one hour based on the education booklet, and telephone counseling was conducted twice for 12 weeks. Differences in autonomous motivation, resilience, self-care compliance and biochemical indicators measured after 12 weeks in the experimental group and the control group were compared. Data were analyzed using SPSS/WIN ver. 22.0. RESULTS: The autonomous motivation, resilience, and self-care compliance of the experimental group were significantly higher than those of the control group (p < .05). Body mass index (p = .005) and current smoking rate (p < .001) were also significantly decreased in the experimental group but there was no significant difference in other biochemical parameters. CONCLUSION: For middle-aged patients with first coronary intervention, risk factor-tailored education emphasizing autonomy by nurses should be provided early after discharge. TRIAL REGISTRATION: This study was retrospectively registered in the Clinical Research Information Service and the identification number is KCT0008698(11/08/2023).

Prognostic implications for patients after myocardial infarction: an integrative literature review and in-depth interviews with patients and experts.

BACKGROUND: As patients with myocardial infarction (MI) survive for a long time after acute treatment, it is necessary to pay attention to the prevention of poor prognosis such as heart failure (HF). To identify the influencing factors of adverse clinical outcomes through a review of prospective cohort studies of post-MI patients, and to draw prognostic implications through in-depth interviews with post-MI patients who progressed to HF and clinical experts. METHODS: A mixed-method design was used that combined a scoping review of 21 prospective cohort studies, in-depth interviews with Korean post-MI patients with HF, and focus group interviews with cardiologists and nurses. RESULTS: A literature review showed that old age, diabetes, high Killip class, low left ventricular ejection fraction, recurrent MI, comorbidity of chronic disease and current smoking, and low socioeconomic status were identified as influencing factors of poor prognosis. Through interviews with post-MI patients, these influencing factors identified in the literature as well as a lack of disease awareness and lack of self-care were confirmed. Experts emphasized the importance of maintaining a healthy lifestyle after acute treatment with the recognition that it is a chronic disease that must go together for a lifetime. CONCLUSION: This study confirmed the factors influencing poor prognosis after MI and the educational needs of post-MI patients with transition to HF. Healthcare providers should continue to monitor the risk group, which is expected to have a poor prognosis, along with education emphasizing the importance of self-care such as medication and lifestyle modification.

Influencing Factors for Cardiometabolic Risk in Korean Adolescents Based on 2010-2015 Data From the Korea National Health and Nutrition Examination Survey.

BACKGROUND: High academic stress and physical inactivity in Korean adolescents increase cardiometabolic risk factors, such as obesity, making it crucial to identify the factors influencing their risk. OBJECTIVE: Our aims were to determine differences in the prevalence of metabolic syndrome and its 5 components in Korean adolescents according to gender and to identify the influencing factors for cardiometabolic risk (individual risk factor ≥ 1). METHODS: Data related to adolescents from the Korean National Health and Nutrition Examination Survey (2010-2015) were assessed. Bivariate analyses to compare distribution and logistic regression analyses to examine the influencing factors were performed. RESULTS: Cardiometabolic risk (≥1 risk factor) was found in 33.2% and 32.6% of male and female adolescents, respectively, and metabolic syndrome (≥3 risk factors) was found in 2.0% and 2.3%, respectively. Among male adolescents, cardiometabolic risk was 1.66 times higher for the group that did not perform strength exercises ( P = .007). For female adolescents, the cardiometabolic risk was 2.44 times higher in 16- to 18-year-olds than in 12- to 15-year-olds ( P < .001) and 1.50 times higher in the non-aerobic-exercise group ( P = .030). Central obesity (waist-to-height ratio ≥ 0.47) increased cardiometabolic risk by 5.71 and 13.91 times in male and female adolescents, respectively ( P < .001). CONCLUSION: To reduce cardiometabolic risk profiles and future cardiovascular risk in Korean adolescents, school-based physical activity programs should be actively provided not only for students with central obesity but also for students who lack aerobic or strength exercises.

Validity and reliability of a Korean version of the Consultation and Relational Empathy (CARE) measure.

BACKGROUND: No validated tool is available to assess patients' perception of physician empathy in Korea. The objective of this study was to establish a Korean version of the Consultation and Relational Empathy (CARE) measure-originally developed in English and widely used internationally-and to examine its reliability and validity. METHODS: The CARE measure was translated into Korean and tested on 240 patients from one secondary care hospital and one tertiary care hospital in Korea. Internal consistency by Cronbach's alpha, exploratory analysis, and confirmatory factor analysis were conducted to verify the 10 items of the Korean CARE measure. RESULTS: The Korean CARE measure demonstrated high acceptability and face validity, excellent internal reliability (Cronbach's alpha = 0.97) and moderate test-retest reliability (Pearson correlation coefficient = 0.53; Spearman correlation coefficient = 0.51). Distribution of scores showed negative skewedness. Corrected item-total correlations ranged from 0.77-0.92, indicating homogeneity. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.949, and Bartlett's test of sphericity was good (χ2 = 3157.11, P < 0.001). Factor analysis yielded a single dimensional structure of physician empathy with all factor loadings exceeding 0.80 and showing excellent goodness of fit. CONCLUSION: This study supports the reliability and validity of the Korean CARE measure in a university hospital setting in Korea.

Oral health in adults with coronary artery disease and its risk factors: a comparative study using the Korea National Health and Nutrition Examination Survey data.

BACKGROUND: This study aimed to examine the relationship between oral health status and hygiene behavior among adults and elderly with preceding chronic disease or coronary artery disease history. METHODS: Data were obtained from the Korea National Health and Nutrition Examination survey conducted from 2016 to 2017. Cardiovascular risk group was defined as adults over the age of 30 with hypertension, diabetes, dyslipidemia, previous myocardial infarction, or angina. Adult and elderly groups were separated and analyzed by 1:1 propensity score matching (PSM), and complex sample logistic regression analysis was performed using SPSS and R programs. RESULTS: In adults, 25.1% of healthy group and 41.9% of the risk group were diagnosed with periodontal disease by dentist. In the elderly, 40.0% of the risk group had chewing problems and 17.5% had speaking problems. After PSM, in adults (n = 1661 each), both univariate and multiple logistic regression analyzes showed that the prevalence of periodontal disease was significantly higher in the risk group than in the healthy group (Odds Ratio = 1.21, p = .028). In the elderly (n = 715 each), univariate analysis showed that the risk group had more chewing and speaking problems than the healthy group, but there was no difference in multivariate analysis. CONCLUSIONS: Adults under the age of 65 years with cardiovascular risk require periodic evaluation and education on the importance of maintaining oral health for primary or secondary prevention. Healthcare professionals should provide patient education to help them maintain adequate oral health and oral hygiene.

Individualized education focusing on self-management improved the knowledge and self-management behaviour of elderly people with atrial fibrillation: A randomized controlled trial.

AIM: This study examined the effect of an individualized educational intervention on the knowledge, attitudes and self-management ability after 12 weeks for outpatients with atrial fibrillation. METHODS: A randomized control-group pretest-post-test experimental design was used. Elderly outpatients with atrial fibrillation aged over 65 years were recruited from a university hospital in Korea. The experimental group received a 50-min individualized education on self-management, one telephone counselling after 8 weeks and maintenance of a self-management diary for 12 weeks. Data were collected from November 2017 to April 2018 and analysed using SPSS 22.0 for descriptive statistics and hypothesis testing. RESULTS: The participants' mean age was 71.9 (4.6) years. Compared to the control group (n = 29), the experimental group (n = 31) showed a significantly greater improvement in knowledge regarding atrial fibrillation and stroke prevention (t = -2.27, p = .027) and self-management behaviours (t = -8.02, p < .001). There were no significant group differences in attitudes towards atrial fibrillation. CONCLUSION: The findings suggest that education for elderly people with atrial fibrillation should be individualized, focusing on self-management in daily life to prevent cardiovascular complications. Future research is needed to confirm the long-term effects of such education programmes.

A Prediction Model of Rehabilitation Motivation in Middle-Aged Survivors of Stroke in Rehabilitation Facilities in Korea.

BACKGROUND: To improve the health outcomes of survivors of stroke, it is critical that they are highly motivated to engage in rehabilitation activities. Despite the increasing prevalence of strokes among middle-aged adults, there is limited knowledge regarding factors that may affect survivors' motivation to engage in rehabilitation. OBJECTIVE: The aim of this study was to examine the relationship among factors that predict the rehabilitation motivation of middle-aged survivors after a stroke through structural equation modeling. METHODS: A total of 200 middle-aged (40-64 years) survivors of stroke from 9 rehabilitation hospitals in Korea completed questionnaires on depressive symptoms, self-efficacy, social support, and rehabilitation motivation. Information on clinical characteristics, including physical function (activities performed during daily life), was collected through the review of medical records. Structural equation modeling was used to construct a prediction model of rehabilitation motivation. RESULTS: The average subject's age was 56.2 ± 6.6 years, and the mean time since the event of their stroke was 15.02 ± 8.95 months. Subjects' self-efficacy (being able to live everyday life) after their stroke (ß = .500, P < .001) and the social support provided by family and medical personnel (ß = .284, P < .010) directly affected their rehabilitation motivation. The bootstrapping method showed that depressive symptoms indirectly affected rehabilitation motivation through self-efficacy, as did physical function. CONCLUSIONS: In middle-aged survivors of stroke, self-efficacy and social support play a critical role in maintaining intrinsic motivation to engage in rehabilitation activities. Self-efficacy should be evaluated periodically and improved by encouraging individuals to achieve goals, emphasizing their self-regulation, especially among those who reported depressive symptoms and low physical function.

Implantable Cardioverter Defibrillator Shocks and Psychological Distress: Examining the Mediating Roles of Implantable Cardioverter Defibrillator-Related Concerns and Perceived Control.

BACKGROUND: Although the implantable cardioverter defibrillator (ICD) has a survival benefit for the prevention of sudden cardiac death, ICD recipients commonly experience emotional distress as a consequence of ICD shocks. OBJECTIVE: The aim of this study was to examine whether the association between ICD shocks and psychological distress (anxiety and depressive symptoms) is mediated by ICD-related concerns and perceived control among ICD recipients. METHODS: This was a multinational cross-sectional observational study of 334 ICD recipients. Patients reported the number of shocks received since ICD implantation and completed questionnaires to assess anxiety, depressive symptoms, ICD-related concerns, and perceived control. A path analysis was conducted to explore the relationship of receiving ICD shocks with anxiety and depressive symptoms and the mediating effects of ICD-related concerns and perceived control. RESULTS: Of the 334 ICD recipients, 39.2% experienced ICD shocks at least once since implantation. There was no direct effect of ICD shocks on anxiety and depressive symptoms. Experiencing ICD shocks was indirectly associated with an increased likelihood of anxiety and depressive symptoms via the pathways of ICD-related concerns and perceived control (indirect effects on anxiety = 0.060, 0.043; indirect effect on depressive symptoms = 0.025, 0.073). CONCLUSION: Experiencing defibrillator shocks was associated with psychological distress in ICD recipients; the relationship was fully mediated by ICD-related concerns and perceived control. These results suggest that clinicians should routinely assess ICD-related concerns and perceived control in patients with ICD. Research is needed to develop and test interventions to decrease emotional distress related to the ICD shock experience.

Sex Differences in Heart Failure Symptoms and Factors Associated With Heart Failure Symptoms.

BACKGROUND: A majority of patients with heart failure (HF) experience HF symptoms. Some literature suggests sex differences in the status of and also factors associated with HF symptoms. However, information on common HF symptom status and factors associated with HF symptoms in male and female patients is scarce. OBJECTIVES: The aim of this study was to examine HF symptom status and factors associated with HF symptoms in male and female patients with HF. METHODS: Descriptive data on HF symptoms, psychological factors (depressive symptoms and perceived control), sociodemographic factors (age and sex), clinical factors (body mass index, comorbidities, medication, and left ventricular ejection fraction), and a behavioral factor (self-care) were collected in 70 male and 49 female patients with HF. Mann-Whitney U tests, χ tests, and stepwise regression models were used to address the objectives. RESULTS: Fatigue was the most common HF symptom in both sexes, but male patients had less severe HF symptoms, including frequency, severity, and/or distress. In male patients, 2 psychological and 2 clinical factors (comorbidities and use of diuretics) were significantly associated with HF symptoms (adjusted R = 0.669, P < .001), whereas in female patients, only depressive symptoms were significantly associated with HF symptoms (adjusted R = 0.679, P < .001). DISCUSSION: There were sex differences in HF symptoms and the factors associated with HF symptoms. Clinicians and researchers need to recognize and manage psychological factors in both sexes and clinical factors in male patients by using effective interventions to improve HF symptoms.

Poor Oral Health Predicts Higher 10-Year Cardiovascular Risk: A Propensity Score Matching Analysis.

BACKGROUND: Although the association between periodontitis and cardiovascular disease (CVD) has been reported, whether periodontitis and poor oral health behavior influence CVD risk remains unclear. OBJECTIVE: The aim of this study was to examine whether periodontal disease and poor oral health behavior predict 10-year general CVD risk using the Framingham Risk Score. METHODS: Patients older than 30 years with no CVD history (n = 8370) were selected using cross-sectional study data from the Korean National Health and Nutrition Examination Survey in 2013 and 2014. To reduce selection bias in this population-based study, propensity score matching analysis was used with SPSS and R programs to compare CVD risk. RESULTS: Overall, 39.2% of the study population (n = 3277) had a global CVD risk of  10% or greater. In the low- and at-risk groups, 20.7% and 45.3% of patients, respectively, were diagnosed with periodontal disease by a dentist. Moreover, 43.2% and 62.8% of the low- and at-risk group patients, respectively, brushed teeth less than 3 times a day. After 1:1 propensity score matching of the low-risk (n = 1135) and at-risk (n = 1135) groups, bivariate analyses showed that a diagnosis of periodontal disease and less frequent toothbrushing were associated with a higher CVD risk (P < .001). Logistic regression analysis also showed that patients having periodontal disease and who brushed teeth less frequently were 1.38 and 1.33 times, respectively, more likely to be at risk of CVD (P < .001). CONCLUSION: Education on periodontitis management and oral hygiene behavior should be included, when strategies for public risk reduction of CVD are developed.

Long-term effects of nurse-led individualized education on middle-aged patients with acute coronary synrome: a quasi-experimental study.

BACKGROUND: This study examined the long-term effects of nurse-led, individualized education on self-efficacy, self-care compliance, and health-related quality of life (HRQoL) in middle-aged patients with new-onset acute coronary syndrome. METHODS: A quasi-experimental pretest-posttest design was used in the study. A cardiovascular nurse provided individualized education to the intervention group (n = 32), and self-efficacy, self-care compliance, and HRQoL at baseline and 3 and 12 months after discharge were compared to those of a control group (n = 30). Patients were recruited from a cardiovascular care unit at a university hospital between 2012 and 2013. Repeated measures analysis of variance was used to compare time-related changes. RESULTS: There was no significant difference in self-efficacy between the 2 groups over a fixed period (F = 3.47, p = 0.067) and showed no interaction between the 2 groups (F = 0.45, p = 0.636). However, significant differences were found in the main and interaction effects between the 2 groups and changes in self-care compliance over the follow-up period differed significantly between the 2 groups (F = 28.72, p < 0.001). Changes in mental HRQoL over the follow-up period differed significantly between the 2 groups (F = 33.34, p < 0.001) and significant interaction effect (F = 4.40, p = 0.040). CONCLUSIONS: Structured nurse-led education should be provided to middle-aged patients with new-onset acute coronary syndrome, as part of routine predischarge education, to increase self-care compliance and mental HRQoL and prevent secondary adverse events. TRIAL REGISTRATION: Trial registration number (TRN) is KCT0002454. The study was registered retrospectively with registration date July 9, 2017.

An examination of the association of cognitive functioning, adherence to sodium restriction and Na/K ratios in Korean heart failure patients.

AIMS AND OBJECTIVES: Maintaining adequate ratios of sodium-to-potassium requires heart failure patients to be adherent to recommended dietary guidelines. A potential deterrent to adherence is poor cognitive functioning. The aims of this study were to (1) estimate dietary sodium and potassium intake and sodium-to-potassium ratios and (2) examine the associations between cognitive functioning and sodium-to-potassium ratios. BACKGROUND: Cognitive impairment may impact levels of adherence and subsequently sodium-to-potassium ratios; however, little is known about the relationship of cognitive functioning, adherence to dietary restrictions and sodium-to-potassium ratios. DESIGN: This study used a descriptive correlational design. METHODS: Face-to-face interviews were conducted with heart failure patients with preserved or reduced left ventricular ejection fraction. Standard cognitive measures were used and included neuropsychological tests of global cognition, immediate and delayed recall, and executive function. Further, patients were instructed to complete a three-day food diary as an indirect measure of sodium-to-potassium intake. RESULTS: Ninety-one Korean patients with heart failure participated in this study (age 57 years, women 33%, education 10 years). A major underlying cause for heart failure was dilated cardiomyopathy (40%), followed by ischaemic cause (24%); the mean heart failure duration was 37 months. Average sodium intake was 3982 mg/day, with men consuming a significantly higher amount than women (4207 vs. 3523 mg). Potassium intake was 2583 mg/day, with both men and women consuming similarly insufficient amounts. Sodium-to-potassium ratio was 1·60, with men having a significantly elevated ratio compared with women (1·68 vs. 1·44). Cognitive function by sodium-to-potassium quartile groups showed nonlinear associations. CONCLUSION: Participants in the study consumed excessive sodium and insufficient potassium; correspondingly, elevated sodium-to-potassium ratios showed significant associations with cognitive function (memory). RELEVANCE TO CLINICAL PRACTICE: Dietary guidelines tailored to levels of cognitive function as well as Korean dining culture may be important in ensuring sodium-to-potassium balance in these heart failure patients.

10-year risk for cardiovascular disease among male workers in small-sized industries.

BACKGROUND: Health management or health promotion programs are limited, particularly for workers in small-sized industries. OBJECTIVES: This study aimed to identify the 10-year cardiovascular disease (CVD) risk using the general Framingham Risk Score and examine predictors of CVD risk adjusted for age among male workers. METHODS: Routine health screening data and self-reported questionnaires were collected from 12 933 male workers in 1041 industries from 2009 to 2011 in South Korea. RESULTS: The proportion of high CVD risk (Framingham Risk Score >20%) was 7.1% (n = 919). Most (83.5%) subjects were manufacturing workers, engaged in manual labor, with a mean (SD) age of 42.1 (9.2) years (range, 30-70 years). Younger workers were more likely to smoke cigarettes, drink alcohol heavily, and be physically inactive. A logistic regression analysis showed that after adjusting for age, occupation type, body mass index, physical activity, and alcohol consumption were significant predictors of 10-year CVD risk. CONCLUSION: To reduce CVD risk, education regarding lifestyle modification should be emphasized for small-sized industrial workers who are overweight, physically inactive, and heavy alcohol drinkers and who work as bus or taxi drivers. Careful attention is also needed for younger workers who are a latent risk group for the development of CVD.

Cluster dyads of risk factors and symptoms are associated with major adverse cardiac events in patients with acute myocardial infarction.

The purpose of this study was to examine the cluster dyads of risk factors and symptoms and their impact on the incidence of 12 month major adverse cardiac events (MACEs) among patients with first-time myocardial infarction (MI). In a descriptive study, a total of 522 patients completed semi-structured interviews for data on risk factors and symptoms. Patients were followed for 12 months to determine MACEs. Latent class cluster analysis was performed to identify risk factor clusters and symptom clusters. Logistic regression analysis was performed to determine the impact of cluster dyads on 12 month MACEs. There were 436 event-free survivors and 86 patients with MACEs for 12 months. Ten risk factors and 14 symptoms were clustered into two (dyslipidemia/smoking, hypertension/diabetes dominant) and three (typical, multiple, atypical) memberships, respectively. Six cluster dyads which were generated based on the association between risk factors and symptom clusters were a significant predictor of 12 month MACEs, with the incidence occurring three times higher in a dyad of hypertension/diabetes-and-atypical symptoms than a dyad of dyslipidemia/smoking-and-typical symptoms (odds ratio = 3.10, P = 0.01), after adjustment for age, gender and a type of MI diagnosis. The information on cluster dyads suggests that health-care providers need to consider both risk factors and symptoms at hospital presentation for risk stratification to prevent adverse outcomes.

Effects of a Remote Physical Activity Improvement Program on Male Office Workers with Metabolic Syndrome in Their 30s and 40s with Sedentary Behavior: A Randomized Controlled Trial.

PURPOSE: Sedentary office workers lack physical activity and have a high prevalence of metabolic syndrome (MetS). This study attempted to develop a remote physical activity improvement program for sedentary office workers and verify its effectiveness by applying it to male workers in their 30s and 40s with MetS. METHODS: This study used a randomized control group pretest-posttest design, and the study sample was 75 male workers recruited from an information and technology company. They were randomly assigned to either the intervention (n = 38) or control (n = 37) group. The remote physical activity improvement program was constructed based on the self-regulation theory emphasizing autonomy, and was conducted through non-face-to-face Zoom once a week for a total of 12 weeks. Health education, exercise training, small group meetings, and individual counseling were provided, and tailored text messages were sent to participants every day to encourage them to reflect on their lifestyle and practice exercise. RESULTS: The remote physical activity program significantly increased basic psychological needs (Z = -7.55, p < .001), intrinsic motivation (Z = -6.94, p < .001), health promotion behavior, (Z = -6.63, p < .001), and physical and physiological indicators (p < .05) in the intervention group compared to those in the control group. CONCLUSIONS: In managing MetS among office workers, it was found that remote education using the Zoom platform was effective, even during the coronavirus pandemic. As a strategy for health education in the workplace, remote education content needs to be developed and applied. TRIAL REGISTRATION: Clinical Research Information Service, KCT0009322.

[Effects of a Health Partnership Program Using Mobile Health Application for Male Workers with Cardiovascular Risk Factors in Small and Medium Enterprises: A Randomized Controlled Trial].

PURPOSE: This study aimed to apply a health partnership program using commercially available mobile health apps to improve cardiovascular risk factors in male employees and verify its effectiveness. METHODS: Using a randomized control group pretest-posttest design, male employees with cardiovascular risk factors from five small and medium-sized workplaces were randomly assigned to an experimental group (n = 32) and a control group (n = 31). The experimental group was encouraged to use three mobile health apps for 12 weeks to acquire the necessary cardiovascular disease-related information and practice strengthening training, walking, and diet management appropriate to their level. They also received feedback on their weekly activities and motivational text messages from health partners. Hypotheses were tested using the SPSS WIN 22.0. RESULTS: The experimental group showed a significant difference compared to the control group in terms of their perception of mobile health app (p < .05), self-efficacy for exercise and diet, self-management partnership, and cardiovascular disease prevention health behavior (p < .001). In particular, there were significant decreases in the body mass index, ratio, serum fasting blood sugar, total cholesterol, and triglyceride in the experimental group (p < .001); however, there was no significant difference in high-density lipoprotein-cholesterol. CONCLUSION: Intervention using mobile apps based on partnership with health managers is effective in improving the objective cardiovascular risk index in male employees; therefore, such intervention should be continuously used as a useful lifestyle modification strategy in the workplace.

Opening Direct Electrochemical Fischer-Tropsch Synthesis Path by Interfacial Engineering of Cu Electrode with P-Block Elements.

The electrochemical synthesis of syngas (CO and H2) has garnered considerable attention in the context of Fischer-Tropsch (FT) synthesis employing thermal catalysts. Nonetheless, the need for a novel, cost-effective technique persists. In this investigation, we introduce a direct electrochemical (dEC) approach for FT synthesis that functions under ambient conditions by utilizing a p-block element (Sn and In) overlaid Cu electrode. Surface *CO and H* species were obtained in an electrolytic medium through the CO2 + H+ + e- → HOOCad → *CO (or direct CO adsorption) and H+ + e- → H* reactions, respectively. We have observed C2-7 long-chain hydrocarbons with a CnH2n+2/CnH2n ratio of 1-3, and this observation can be explained through the process of C-C coupling chain growth of the conventional FT synthesis, based on the linearity of the Anderson-Schulz-Flory equation plots. Thick Sn and In overlayers resulted in the dominant production of formate, while CO and C2H4 production were found to be proportional and inversely correlated to H2, C2H6, and C3-7 hydrocarbon production. The EC CO2/CO reduction used in dEC FT synthesis offers valuable insights into the mechanism of C2+ production and holds promise as an eco-friendly approach to producing long-chain hydrocarbons for energy and environmental purposes.

Ultraviolet Light-Assisted Decontamination of Chemical Warfare Agent Simulant 2-Chloroethyl Phenyl Sulfide on Metal-Loaded TiO2 /Ti Surfaces.

The application of ultraviolet (UV) light for the decontamination of chemical warfare agents (CWAs) has gained recognition as an effective method, especially for treating hard-to-reach areas where wet chemical methods are impractical. In this study, TiO2 /Ti was employed as a model catalyst, which was contaminated with 2-chloroethyl phenyl sulfide (CEPS), and subjected to photocatalytic decontamination using both UVB and UVC light. Additionally, photocatalytic decontamination efficiency by introducing Au, Pt, and Cu onto the TiO2 /Ti surface was explored. During the photodecomposition process under UVC light, at least eight distinct secondary byproducts were identified. It was observed that the introduction of overlayer metals did not significantly enhance the photodecomposition under UVC light instead overlaid Au exhibited substantially improved activity under UVB light. Whereas, photodecomposition process under UVB light, only five secondary products were detected, including novel compounds with sulfoxide and sulfone functional groups. This novel study offers valuable insights into the generation of secondary products and sheds light on the roles of overlayer metals and photon wavelength in the photodecontamination process of CWA.

The Moderating Effect of Mental Health on the Relationship Between Cardiovascular Disease Awareness and Health Behaviors of Middle-Aged Korean Chinese Workers With Cardiovascular Risk Factors in Korea.

INTRODUCTION: Cardiovascular disease (CVD) remains a leading cause of death in China and Korea, yet little is known about in Korean Chinese workers. The purpose of the study was to investigate the effects of CVD awareness and mental health on health behaviors and evaluate the moderating effect of mental health on the relationship between CVD awareness and health behaviors among Korean Chinese workers. METHOD: We used a cross-sectional design and convenience sampling of participants from Seoul in December 2021. Data were analyzed using descriptive statistics, Pearson's correlation coefficient, independent t tests, and hierarchical multiple regression analysis. RESULTS: CVD awareness, mental health, and health behaviors were relatively low and mental health showed a moderating effect on the relationship between the two variables. DISCUSSION: Understanding relationships between CVD awareness, socioculturally mediated health behaviors, and mental health issues is critical to CVD prevention among participants; moreover, mental health should be specifically assessed and targeted for improvement.