When should healthcare workers with COVID-19 return to work? An analysis of follow-up antigen test results after a positive COVID test

BackgroundUnder CDCs guidance for mitigating healthcare worker (HCW) staffing shortages, COVID-positive HCW may return to work as early as five days after their initial positive test without a negative antigen test, if symptoms are improving. Recent studies suggest a robust correlation between a positive COVID-19 antigen test and infectiousness. MethodsFrom January to June 2022, HCW employed by a large health system who tested positive for COVID on a PCR test were instructed to isolate and return for a rapid antigen test on day 5 or later if they had been fever-free for 24 hours and their symptoms were improving. We conducted chi-squared tests and a multivariate logistic regression to assess the association between demographic characteristics, vaccination status, and days from the initial positive PCR test on RTW antigen test results. ResultsCompared to day 5, HCW had a lower odds of a positive antigen result on day 7 (OR: 0.39, p<0.0001) and after at least 8 days (OR: 0.16, p<0.0001). Unexpectedly, a positive antigen result was more likely among HCW who were vaccinated (OR: 1.41, p <0.05), boosted for more than 90 days prior (OR: 2.21, p<0.0001), and boosted within 90 days (OR: 2.08, p < 0.01) compared to not being vaccinated. ConclusionsOur findings suggest that HCW returning to work before day 7 following a positive PCR test may still be infectious and future guidelines addressing contingency staffing should reflect these findings in order to minimize possible transmission in the healthcare setting. The finding that boosted individuals had over twice the odds of returning positive on the follow up antigen test compared to unvaccinated HCWs merits additional research.

A Pilot Study for Development of a Gender Variable Model for Health Research in Korea

Background@#For gendered innovations to be streamlined in health research, researchers need tools to measure gender variables quantitatively. Because gender is a sociocultural concept which varies by culture, it is important to check feasibility of using tools developed in western countries before using them in Korea. The objective of this study is to conduct a pilot study for adapting a questionnaire measuring gender variables from the literature for the Korean population. @*Methods@#The research was conducted in two steps: 1) modification of questionnaire by an expert group, and 2) an on-line survey of 3,000 adults, in three age groups, balanced in sex. The questionnaire was composed of 7 gender variables with 2 to 6 items, constituting a total of 24 5-point Likert scale items. Gender variable scores were calculated as the average of Z-scores of items pertaining to each variable. @*Results@#Participants were 45.6% men, 43.9% women, and 10.5% other gender. Scores of five gender variables-caregiver tension, work tension, independence, emotional intelligence, and discrimination-were significantly different among sex and gender groups. Among gender variables, work strain, caregiver strain, and discrimination had notable influences on health status and health-related behaviors among survey participants. @*Conclusions@#Several gender variables were related to health status and health behaviors in Korean adults. This is the first attempt in Korea to quantify gender characteristics to be used for health research. Further studies are needed to verify the questionnaire and methods developed in this study for use with diagnosed disease outcomes.

The Knowledge, Attitudes, Performance, and Barriers of Nurses to Pain in Oncology Settings:A Multi-Center Study

Purpose@#The purpose of this study was to examine knowledge, attitudes, performance, and barriers to pain management of nurses working in oncology settings. @*Methods@#This cross-sectional study was conducted on 222 nurses in five tertiary hospitals in Korea.The period of data collection was 1 September to 30 November 2018. Participants were surveyed using the Nurse Knowledge and Attitudes Survey Regarding Pain (NKASRP), a pain management performance, and barriers questionnaire. The data were analyzed through independent t-test and One-way ANOVA, and the post-hoc test was conducted with the Scheffé test using the SPSS 23 program. @*Results@#According to the study, oncology nurses’ knowledge and attitudes to pain received a score of 26.4±3.77 (out of 41 points) and the performance received a score of 3.24±0.35 (out of 4 points). Among the barriers to pain management, time constraints were the most frequent medical staff-related factor, and reluctance to take opioids was the most frequent patient-related factor. In terms of factors related to the health care system, strict regulation of opioids was the most significant. There was a significant positive correlation between knowledge and attitude of pain management and performance of pain management. @*Conclusion@#Based on the findings of this study, it is recommended that structured education programs to be developed and implemented to enhance knowledge, attitudes, and performance on pain.

The Knowledge, Attitudes, Performance, and Barriers of Nurses to Pain in Oncology Settings:A Multi-Center Study

Purpose@#The purpose of this study was to examine knowledge, attitudes, performance, and barriers to pain management of nurses working in oncology settings. @*Methods@#This cross-sectional study was conducted on 222 nurses in five tertiary hospitals in Korea.The period of data collection was 1 September to 30 November 2018. Participants were surveyed using the Nurse Knowledge and Attitudes Survey Regarding Pain (NKASRP), a pain management performance, and barriers questionnaire. The data were analyzed through independent t-test and One-way ANOVA, and the post-hoc test was conducted with the Scheffé test using the SPSS 23 program. @*Results@#According to the study, oncology nurses’ knowledge and attitudes to pain received a score of 26.4±3.77 (out of 41 points) and the performance received a score of 3.24±0.35 (out of 4 points). Among the barriers to pain management, time constraints were the most frequent medical staff-related factor, and reluctance to take opioids was the most frequent patient-related factor. In terms of factors related to the health care system, strict regulation of opioids was the most significant. There was a significant positive correlation between knowledge and attitude of pain management and performance of pain management. @*Conclusion@#Based on the findings of this study, it is recommended that structured education programs to be developed and implemented to enhance knowledge, attitudes, and performance on pain.

What influences aromatase inhibitor continuation intention among breast cancer survivors?

Purpose@#Aromatase inhibitors (AIs) are widely prescribed for postmenopausal women with breast cancer and are known to cause musculoskeletal pain. This study aimed to identify factors associated with AI continuation intention among breast cancer survivors (BCS). @*Methods@#A cross-sectional survey was conducted on 123 BCS (stages I–III), who had been taking AIs for at least 6 weeks. Participants were recruited from a cancer center in Goyang, Korea, from September to November 2019. Descriptive statistics, Welch analysis of variance, Pearson correlation coefficients, and simple linear regression were used for the analysis. @*Results@#Belief in endocrine therapy was a significant predictor of AI continuation intention (β=.66, p<.001). The majority of participants (87.0%) reported experiencing musculoskeletal pain since taking AIs and the score for the worst pain severity within 24 hours was 5.08±2.80 out of 10. Musculoskeletal pain, however, was not associated with AI continuation intention. Fear of cancer recurrence (FCR) was clinically significant (≥13) for 74.0% of the respondents (mean, 17.62±7.14). Musculoskeletal pain severity and pain interference were significantly associated with FCR (r=.21, p<.05; r=.35, p<.01, respectively). Pain interference was significantly associated with belief in endocrine therapy (r=–.18, p<.05). @*Conclusion@#AI continuation intention can be modified by reinforcing patients’ belief in endocrine therapy. Musculoskeletal pain may have a negative effect on belief in endocrine therapy and increase FCR among BCS. Thus, awareness of musculoskeletal pain during AI therapy should be raised and further research is required to develop multidisciplinary pain management strategies and clinical guidelines to reinforce belief in endocrine therapy.

Psychosocial support interventions for women with gestational diabetes mellitus: a systematic review

Purpose@#This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). @*Methods@#The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality. @*Results@#Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels. @*Conclusion@#Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.

Quality of Life and Characteristics of Depression with Subjective Cognitive Decline in Korean Adults :Data from the Seventh Korea National Health and Nutrition Examination Survey / 정신신체의학

Objectives@#：This study aimed to investigate quality of life, severity of depression, suicidality, subjective health and subjective stress of depression with subjective cognitive decline in Korean adults. @*Methods@#：We used the 7th KNHANES data to enroll 415 participants with a score of 10 or higher on Patient Health Questionnaire-9 (PHQ-9), aged 20-64. Depression was divided into two groups based on the presence/absence of subjective cognitive decline. Demographic and psychological characteristics were compared between two groups. Correlation analysis of subjective cognitive decline, quality of life, depression, suicidal idea was car-ried out. To detect which variables influenced quality of life, a multiple regression analysis was carried out. @*Results@#：Among the 415 participants, 98 had depression with subjective cognitive decline. We identified sig-nificant differences in age, marital status, education, employment between the two groups. After adjusting for these variables, depression with subjective cognitive decline had lower EuroQol-5D index scores, more severe depressive symptoms without cognition and worse subjective health than depression without cognitive decline. There was a significant correlation between subjective cognitive decline and quality of life (r=-0.236, p<0.001), suicidal idea (r=0.182, p<0.001), depression score without cognition (r=0.108, p=0.028). Through multiple regression analysis, subjective cognitive decline was predictor of reduced quality of life (β=-0.178, p<0.001). @*Conclusions@#：Depression with subjective cognitive decline has poor quality of life and severe depression. Cognitive decline should be considered to improve treatment result in depression.

Comparison of the Suicide Attempt Characteristics Associated with Mixed and Non-Mixed Depression in Koreans / 정신신체의학

Objectives@#：This study aimed to compare the characteristics of suicide attempts among Korean patients with mixed and non-mixed depression. @*Methods@#：Patients who visited the emergency room due to a suicide attempt and participated in the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior study were included. Using the Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS), 111 patients were classified into the mixed depression (n=46) and non-mixed depression groups (n=65). The Koukopoulos Mixed Depression Rating Scale (KMDRS) score was calculated using the MADRS and YMRS scores. Suicide attempt characteristics were evaluated using the Columbia Suicidal Severity Rating Scale (C-SSRS) and Suicide Intent Scale (SIS). @*Results@#：In the mixed depression group, the reason item among the ideation intensity score of the C-SSRS was higher, and the deterrent item score was lower. Scores on the timing and suicide note items of the SIS were higher, and scores for overt communication items were lower in the mixed depression group. The KMDRS score was positively correlated with the C-SSRS ideation intensity and total SIS score. After adjusting for additional variables,the KMDRS scores had a significant effect on the C-SSRS ideation intensity and total SIS scores. @*Conclusions@#：The mixed depression group showed a difference in the intensity of suicidal ideation and suicidal intention compared to those in the non-mixed depression group. The overall suicidal ideation intensity and suicidal intention increased according to the degree of mixed depression.

What influences aromatase inhibitor continuation intention among breast cancer survivors?

Purpose@#Aromatase inhibitors (AIs) are widely prescribed for postmenopausal women with breast cancer and are known to cause musculoskeletal pain. This study aimed to identify factors associated with AI continuation intention among breast cancer survivors (BCS). @*Methods@#A cross-sectional survey was conducted on 123 BCS (stages I–III), who had been taking AIs for at least 6 weeks. Participants were recruited from a cancer center in Goyang, Korea, from September to November 2019. Descriptive statistics, Welch analysis of variance, Pearson correlation coefficients, and simple linear regression were used for the analysis. @*Results@#Belief in endocrine therapy was a significant predictor of AI continuation intention (β=.66, p<.001). The majority of participants (87.0%) reported experiencing musculoskeletal pain since taking AIs and the score for the worst pain severity within 24 hours was 5.08±2.80 out of 10. Musculoskeletal pain, however, was not associated with AI continuation intention. Fear of cancer recurrence (FCR) was clinically significant (≥13) for 74.0% of the respondents (mean, 17.62±7.14). Musculoskeletal pain severity and pain interference were significantly associated with FCR (r=.21, p<.05; r=.35, p<.01, respectively). Pain interference was significantly associated with belief in endocrine therapy (r=–.18, p<.05). @*Conclusion@#AI continuation intention can be modified by reinforcing patients’ belief in endocrine therapy. Musculoskeletal pain may have a negative effect on belief in endocrine therapy and increase FCR among BCS. Thus, awareness of musculoskeletal pain during AI therapy should be raised and further research is required to develop multidisciplinary pain management strategies and clinical guidelines to reinforce belief in endocrine therapy.

Psychosocial support interventions for women with gestational diabetes mellitus: a systematic review

Purpose@#This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). @*Methods@#The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality. @*Results@#Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels. @*Conclusion@#Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.

Risk Factors for COVID-19-associated hospitalization: COVID-19-Associated Hospitalization Surveillance Network and Behavioral Risk Factor Surveillance System

BackgroundIdentification of risk factors for COVID-19-associated hospitalization is needed to guide prevention and clinical care. ObjectiveTo examine if age, sex, race/ethnicity, and underlying medical conditions is independently associated with COVID-19-associated hospitalizations. DesignCross-sectional. Setting70 counties within 12 states participating in the Coronavirus Disease 2019-Associated Hospitalization Surveillance Network (COVID-NET) and a population-based sample of non-hospitalized adults residing in the COVID-NET catchment area from the Behavioral Risk Factor Surveillance System. ParticipantsU.S. community-dwelling adults ([≥]18 years) with laboratory-confirmed COVID-19-associated hospitalizations, March 1- June 23, 2020. MeasurementsAdjusted rate ratios (aRR) of hospitalization by age, sex, race/ethnicity and underlying medical conditions (hypertension, coronary artery disease, history of stroke, diabetes, obesity [BMI [≥]30 kg/m2], severe obesity [BMI[≥]40 kg/m2], chronic kidney disease, asthma, and chronic obstructive pulmonary disease). ResultsOur sample included 5,416 adults with COVID-19-associated hospitalizations. Adults with (versus without) severe obesity (aRR:4.4; 95%CI: 3.4, 5.7), chronic kidney disease (aRR:4.0; 95%CI: 3.0, 5.2), diabetes (aRR:3.2; 95%CI: 2.5, 4.1), obesity (aRR:2.9; 95%CI: 2.3, 3.5), hypertension (aRR:2.8; 95%CI: 2.3, 3.4), and asthma (aRR:1.4; 95%CI: 1.1, 1.7) had higher rates of hospitalization, after adjusting for age, sex, and race/ethnicity. In models adjusting for the presence of an individual underlying medical condition, higher hospitalization rates were observed for adults [≥]65 years, 45-64 years (versus 18-44 years), males (versus females), and non-Hispanic black and other race/ethnicities (versus non-Hispanic whites). LimitationsInterim analysis limited to hospitalizations with underlying medical condition data. ConclusionOur findings elucidate groups with higher hospitalization risk that may benefit from targeted preventive and therapeutic interventions.

Interim Analysis of Risk Factors for Severe Outcomes among a Cohort of Hospitalized Adults Identified through the U.S. Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET)

BackgroundAs of May 15, 2020, the United States has reported the greatest number of coronavirus disease 2019 (COVID-19) cases and deaths globally. ObjectiveTo describe risk factors for severe outcomes among adults hospitalized with COVID-19. DesignCohort study of patients identified through the Coronavirus Disease 2019-Associated Hospitalization Surveillance Network. Setting154 acute care hospitals in 74 counties in 13 states. Patients2491 patients hospitalized with laboratory-confirmed COVID-19 during March 1-May 2, 2020. MeasurementsAge, sex, race/ethnicity, and underlying medical conditions. ResultsNinety-two percent of patients had [≥]1 underlying condition; 32% required intensive care unit (ICU) admission; 19% invasive mechanical ventilation; 15% vasopressors; and 17% died during hospitalization. Independent factors associated with ICU admission included ages 50-64, 65-74, 75-84 and [≥]85 years versus 18-39 years (adjusted risk ratio (aRR) 1.53, 1.65, 1.84 and 1.43, respectively); male sex (aRR 1.34); obesity (aRR 1.31); immunosuppression (aRR 1.29); and diabetes (aRR 1.13). Independent factors associated with in-hospital mortality included ages 50-64, 65-74, 75-84 and [≥]85 years versus 18-39 years (aRR 3.11, 5.77, 7.67 and 10.98, respectively); male sex (aRR 1.30); immunosuppression (aRR 1.39); renal disease (aRR 1.33); chronic lung disease (aRR 1.31); cardiovascular disease (aRR 1.28); neurologic disorders (aRR 1.25); and diabetes (aRR 1.19). Race/ethnicity was not associated with either ICU admission or death. LimitationData were limited to patients who were discharged or died in-hospital and had complete chart abstractions; patients who were still hospitalized or did not have accessible medical records were excluded. ConclusionIn-hospital mortality for COVID-19 increased markedly with increasing age. These data help to characterize persons at highest risk for severe COVID-19-associated outcomes and define target groups for prevention and treatment strategies. Funding SourceThis work was supported by grant CK17-1701 from the Centers of Disease Control and Prevention through an Emerging Infections Program cooperative agreement and by Cooperative Agreement Number NU38OT000297-02-00 awarded to the Council of State and Territorial Epidemiologists from the Centers for Disease Control and Prevention.

Factors associated with the decision to undergo risk-reducing salpingo-oophorectomy among women at high risk for hereditary breast and ovarian cancer: a systematic review

This systematic review aims to identify factors associated with risk-reducing salpingo-oophorectomy (RRSO), including the uptake rate and decision timing, among women at high risk for hereditary breast and ovarian cancer (HBOC). We found 4,935 relevant studies using MEDLINE, Embase, CINAHL, and PsycINFO on July 6, 2020. Two authors screened the articles and extracted data. Twenty-four studies met the inclusion criteria. Quality assessment of articles was conducted using the Risk of Bias for Nonrandomized Studies tool. Five types of factors were identified (demographic factors, clinical factors, family history of cancer, psychological factors, and objective cancer risk). The specific significant factors were older age, having child(ren), being a BRCA1/2 carrier, mastectomy history, perceived risk for ovarian cancer, and perceived advantages of RRSO, whereas objective cancer risk was not significant. The uptake rate of RRSO was 23.4% to 87.2% (mean, 45.2%) among high-risk women for HBOC. The mean time to decide whether to undergo RRSO after BRCA testing was 4 to 34 months. RRSO decisions are affected by demographic, clinical, and psychological factors, rather than objective cancer risk. Nonetheless, women seeking RRSO should be offered information about objective cancer risk. Even though decision-making for RRSO is a complex and multifaceted process, the psychosocial factors that may influence decisions have not been comprehensively examined, including family attitudes toward RRSO, cultural norms, social values, and health care providers’ attitudes.

Relationship between Disability Self-Awareness and Insight in Patients with Schizophrenia / 생물치료정신의학

Objectives@#：We aimed to evaluate the relationship between disability self-awareness and insight in patients with schizophrenia. @*Methods@#：We enrolled 58 clinically stable patients with schizophrenia. The World Health Organization Disability Assessment Schedule (WHODAS) self-report was used to identify self-awareness of functional ability. The Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Schizophrenia Scale (CGI-SCH), and Personal and Social Performance Scale (PSP) were utilized to evaluate clinical symptoms and global function. Whereas Insight Scale for Psychosis (ISP) was applied for insight. Statistical analyses were performed using correlation and linear regression. @*Results@#：The WHODAS had a significant correlation with the general psychopathology subscale and total score of PANSS, CGI-SCH, and PSP. Moreover, ISP had a strong correlation with the overall WHODAS score and all domains. In the linear regression analysis, ISP had significant effects on the overall WHODAS score after adjusting for additional variables. @*Conclusion@#：Disability self-awareness was significantly correlated with the level of insight in patients with schizophrenia. Clinicians need to consider patients’ insight during the discussion of functional ability.

Pro-inflammatory Cytokine Levels and Cancer-related Fatigue in Breast Cancer Survivors: Effects of an Exercise Adherence Program / 한국유방암학회지

Purpose@#This study aimed to determine the effect of an exercise intervention on subjective cancer-related fatigue (CRF) and pro-inflammatory cytokine levels in breast cancer survivors (BCS). @*Methods@#BCS with greater than moderate CRF (≥ 4) were recruited and randomly assigned to experimental or control groups. The experimental group participated in a 12-week exercise adherence program (Better Life after Cancer - Energy, Strength, and Support; BLESS). Interleukin (IL)-6 and tumor necrosis factor-α (TNF-α) levels were determined at 3 time points (M1: baseline, M2: post-intervention, and M4: 6 months after intervention). Subjective fatigue was measured using the Korean version of the revised Piper Fatigue Scale. @*Results@#In this analysis of participants with physiological fatigue measures available (19 experimental, 21 control), there were no statistically significant differences in IL-6 (F = 1.157, p = 0.341), TNF-α levels (F = 0.878, p = 0.436), and level of fatigue (F = 2.067, p = 0.118) between the 2 groups at baseline. Fatigue in the experimental group showed statistically significant improvement compared to the control only at M2 (p = 0.022). There was no significant relationship between subjective and physiological fatigue at the 3 measurement points. @*Conclusion@#The BLESS intervention improved CRF in BCS immediately at post-intervention, and this study presents clinical feasibility for the management of CRF in BCS in the early survivorship phase who are already experiencing fatigue.

Correlation between Performance-Based and Interview-Based Cognitive Measurements in Patients with Schizophrenia

Objective@#The Measurement and Treatment Research to improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) is used to measure the cognitive function of patients with schizophrenia. In some situations, interview-based measures such as the Schizophrenia Cognition Rating Scale (SCoRS) may be appropriate. In this study, we analyzed the correlation between performance- and interview-based measurements in patients with schizophrenia. @*Methods@#Fifty-six clinically stable patients were recruited. To evaluate cognitive function, we used the MCCB performance-based measure and the SCoRS interview-based measure. Measurements were taken at baseline, and 2 weeks and 3 months later. Spearman correlations were computed between each SCoRS item’s interviewer rating and each MCCB score. @*Results@#The correlation between the MCCB overall T score and the SCoRS global score was the strongest (r=-0.52), while the SCoRS total score and the MCCB Speed of Processing score also correlated (r=-0.48). The SCoRS global score showed statistically significant correlations with all seven MCCB domains and the overall T score. @*Conclusion@#This study reveals correlations between MCCB domains and SCoRS items. Since we find that interview-based measurements are highly correlated with performance-based measurements, we suggest them as a useful cognitive function evaluation tool that can easily be applied in clinical settings.

Factors associated with the decision to undergo risk-reducing salpingo-oophorectomy among women at high risk for hereditary breast and ovarian cancer: a systematic review

This systematic review aims to identify factors associated with risk-reducing salpingo-oophorectomy (RRSO), including the uptake rate and decision timing, among women at high risk for hereditary breast and ovarian cancer (HBOC). We found 4,935 relevant studies using MEDLINE, Embase, CINAHL, and PsycINFO on July 6, 2020. Two authors screened the articles and extracted data. Twenty-four studies met the inclusion criteria. Quality assessment of articles was conducted using the Risk of Bias for Nonrandomized Studies tool. Five types of factors were identified (demographic factors, clinical factors, family history of cancer, psychological factors, and objective cancer risk). The specific significant factors were older age, having child(ren), being a BRCA1/2 carrier, mastectomy history, perceived risk for ovarian cancer, and perceived advantages of RRSO, whereas objective cancer risk was not significant. The uptake rate of RRSO was 23.4% to 87.2% (mean, 45.2%) among high-risk women for HBOC. The mean time to decide whether to undergo RRSO after BRCA testing was 4 to 34 months. RRSO decisions are affected by demographic, clinical, and psychological factors, rather than objective cancer risk. Nonetheless, women seeking RRSO should be offered information about objective cancer risk. Even though decision-making for RRSO is a complex and multifaceted process, the psychosocial factors that may influence decisions have not been comprehensively examined, including family attitudes toward RRSO, cultural norms, social values, and health care providers’ attitudes.

Socioeconomic inequalities in obesity among Korean women aged 19-79 years: the 2016 Korean Study of Women's Health-Related Issues / 한국역학회지

OBJECTIVES@#While the prevalence of obesity in Asian women has remained stagnant, studies of socioeconomic inequalities in obesity among Asian women are scarce. This study aimed to examine the recent prevalence of obesity in Korean women aged between 19 years and 79 years and to analyze socioeconomic inequalities in obesity.@*METHODS@#Data were derived from the 2016 Korean Study of Women's Health-Related Issues. The chi-square test and logistic regression analysis were used to analyze the associations between socioeconomic factors and obesity using Asian standard body mass index (BMI) categories: low (<18.5 kg/m²), normal (18.5-22.9 kg/m²), overweight (23.0-24.9 kg/m²), and obese (≥25.0 kg/m²). As inequality-specific indicators, the slope index of inequality (SII) and relative index of inequality (RII) were calculated, with adjustment for age and self-reported health status.@*RESULTS@#Korean women were classified into the following BMI categories: underweight (5.3%), normal weight (59.1%), overweight (21.2%), and obese (14.4%). The SII and RII revealed substantial inequalities in obesity in favor of more urbanized women (SII, 4.5; RII, 1.4) and against of women who were highly educated (SII, -16.7; RII, 0.3). Subgroup analysis revealed inequalities in obesity according to household income among younger women and according to urbanization among women aged 65-79 years.@*CONCLUSIONS@#Clear educational inequalities in obesity existed in Korean women. Reverse inequalities in urbanization were also apparent in older women. Developing strategies to address the multiple observed inequalities in obesity among Korean women may prove essential for effectively reducing the burden of this disease.

Utilization of Work-Family Balance Support Policy and Factors Associated with Retention Intention among Married Female Officers with Preschool Children / 여성건강간호학회지

PURPOSE: This study aimed to identify utilization of the work-family support policy (WFSP) and factors affecting retention intention among Korean female military officers. METHODS: This cross-sectional survey recruited 103 married female officers from the Korean Army, Navy, and Air force with preschool-aged children through convenience and snowball sampling. Via online surveys from June to November, 2018, the participants self-reported retention intention, work-family conflict, job satisfaction, and utilization of the WFSP. The data were analyzed using descriptive statistics, independent t-tests, one-way analysis of variance, Pearson's correlation coefficient, and multiple linear regression. RESULTS: Retention intention (22.29±5.98) was reported at the mid-level, lower than scores reported in the literature for female workers. Work-family conflict (32.51±5.29) and job satisfaction (63.10±7.45) were above the midpoint levels. Use of maternity leave (100.0%) and parental leave (92.2%) was high, especially compared to the rates of child-care day off (20.4%) and parenting time (20.4%). ‘Noticeable increases in childcare services within the army’ (22.8%) was reported as the supportive measure needed the most by female military officers. Job satisfaction (β=.43, p≤.001), the use of parenting time (β=−0.29, p=.002), living type (β=−.18, p=.043), and service type (β=−.16, p=.035) significantly influenced retention intention. CONCLUSIONS: The findings highlight the priority areas of importance within the WFSP and suggest that a family-friendly culture can improve female officers' retention intention. Accordingly, policy changes at the Ministry of National Defense improving the system to enhance a family-friendly culture in the military is expected to strengthen the retention intention of female officers and contribute to excellence in the military workforce.

Socioeconomic inequalities in obesity among Korean women aged 19-79 years: the 2016 Korean Study of Women's Health-Related Issues / 한국역학회지

OBJECTIVES: While the prevalence of obesity in Asian women has remained stagnant, studies of socioeconomic inequalities in obesity among Asian women are scarce. This study aimed to examine the recent prevalence of obesity in Korean women aged between 19 years and 79 years and to analyze socioeconomic inequalities in obesity.METHODS: Data were derived from the 2016 Korean Study of Women's Health-Related Issues. The chi-square test and logistic regression analysis were used to analyze the associations between socioeconomic factors and obesity using Asian standard body mass index (BMI) categories: low (<18.5 kg/m²), normal (18.5-22.9 kg/m²), overweight (23.0-24.9 kg/m²), and obese (≥25.0 kg/m²). As inequality-specific indicators, the slope index of inequality (SII) and relative index of inequality (RII) were calculated, with adjustment for age and self-reported health status.RESULTS: Korean women were classified into the following BMI categories: underweight (5.3%), normal weight (59.1%), overweight (21.2%), and obese (14.4%). The SII and RII revealed substantial inequalities in obesity in favor of more urbanized women (SII, 4.5; RII, 1.4) and against of women who were highly educated (SII, -16.7; RII, 0.3). Subgroup analysis revealed inequalities in obesity according to household income among younger women and according to urbanization among women aged 65-79 years.CONCLUSIONS: Clear educational inequalities in obesity existed in Korean women. Reverse inequalities in urbanization were also apparent in older women. Developing strategies to address the multiple observed inequalities in obesity among Korean women may prove essential for effectively reducing the burden of this disease.