Validation of the Korean version of the Body Shape Questionnaire (K-BSQ): focus on young women.

In spite of more awareness about the increased concern of women about their body image and shape, a scale measuring the level of concern about body shape has not been developed in Korea yet. The currently available Body Shape Questionnaire (BSQ) was developed and validated within a Western context. Therefore, this study created the Korean version of the BSQ (K-BSQ) to target young women with concern about body shape. This study aimed to translate the 16-item version of the BSQ and examine the reliability and validity of the resulting scale. Participants included 243 young women aged 19-39 years from South Korea. The reliability and validity were examined using Cronbach's alpha, item analysis, factor analysis, and correlation with the Eating Attitudes Test (EAT). Results showed that the reliability was high, as indicated by a Cronbach's alpha of 0.95. The factor analysis of 16 items revealed two factors. They explained 65.74 percent of the variance in the Korean version of the BSQ. In addition, K-BSQ scores were related to those of the EAT significantly (r = 0.61, p < .001). It was concluded that the K-BSQ may serve as an appropriate instrument to measure the body shape concerns of young Korean women.

Effects of Child Sexual Abuse Prevention Education Program Using Hybrid Application (CSAPE-H) on Fifth-Grade Students in South Korea.

The purpose of this study was to test the effects of a child sexual abuse prevention education program using a hybrid application (CSAPE-H) by examining fifth-grade students' (a) knowledge for sexual abuse prevention and (b) self-protective behaviors against sexual abuse. A quasi-experimental, pretest /posttest design was used. Sixty-eight students from two schools participated. The intervention group (n = 48) received six sessions in CSA prevention education using the hybrid app, whereas the control group (n = 35) was taught using a lecture in a classroom environment. Between the two groups, there were significant differences in self-protective behaviors against CSA (t = 2.26, p = .027). In addition, educational satisfaction was significantly higher in the experimental group than the control group (t = 2.41, p = .019). A CSAPE-H may be effective for elementary school students, especially for self-protective behaviors.

Effects of Transfusion on Free Flap Survival: Searching for an Optimal Hemoglobin Threshold for Transfusion.

BACKGROUND: Microsurgical free tissue transfer is a popular technique nowadays. Because of its considerably exquisite procedure, various risk factors can affect surgical outcome. However, current key practices, especially those in blood transfusion, are in contention due to the lack of enough evidence. Therefore, the objective of this study was to investigate the impact of perioperative blood transfusion on microsurgical complication. METHODS: Data of a total of 168 patients who underwent microvascular free tissue transfer from 2013 through 2016 were retrospectively reviewed. Age, comorbidity, anatomical surgical site, preoperative and postoperative lowest hemoglobin (Hb) level, estimated blood volume loss, and final clinical flap outcome were compared between patients with and without transfusion treatment. Factors with a significance of p < 0.05 in univariate analysis were included in the multivariate logistic regression model to identify independent risk factors. RESULTS: Of 168 patients, 72 (43%) were in the transfusion group. Cross analysis statistics showed that flap failure in the transfusion group was 3.6 times higher (p = 0.018) than that in the control group. Multivariable analysis revealed that age (p = 0.083) and perioperative lowest Hb level (p = 0.021) remained as significant predictors of flap failure. Receiver-operating characteristic curve analysis showed that the appropriate lower limit of transfusion commencement of Hb was 8.75 g/dL (area under the curve: 0.721). CONCLUSION: A transfusion during perioperative period of free flap did not increase its failure rate. Rather than appropriate transfusion strategy, perioperative lowest Hb level, and age were significant predictors of flap failure. Therefore, transfusion can be confidently used in patients who undergo free flap without any hesitation. Results of this study provide practical evidence of performing perioperative transfusion for free tissue transfer patients.

Comparison of human umbilical cord blood-derived mesenchymal stem cells with healthy fibroblasts on wound-healing activity of diabetic fibroblasts.

Various types of skin substitutes composed of fibroblasts and/or keratinocytes have been used for the treatment of diabetic ulcers. However, the effects have generally not been very dramatic. Recently, human umbilical cord blood-derived mesenchymal stromal cells (hUCB-MSCs) have been commercialised for cartilage repair as a first cell therapy product using allogeneic stem cells. In a previous pilot study, we reported that hUCB-MSCs have a superior wound-healing capability compared with fibroblasts. The present study was designed to compare the treatment effect of hUCB-MSCs with that of fibroblasts on the diabetic wound healing in vitro. Diabetic fibroblasts were cocultured with healthy fibroblasts or hUCB-MSCs. Five groups were evaluated: group I, diabetic fibroblasts without coculture; groups II and III, diabetic fibroblasts cocultured with healthy fibroblasts or hUCB-MSCs; and groups IV and V, no cell cocultured with healthy fibroblasts or hUCB-MSCs. After a 3-day incubation, cell proliferation, collagen synthesis levels and glycosaminoglycan levels, which are the major contributing factors in wound healing, were measured. As a result, a hUCB-MSC-treated group showed higher cell proliferation, collagen synthesis and glycosaminoglycan level than a fibroblast-treated group. In particular, there were significant statistical differences in collagen synthesis and glycosaminoglycan levels (P = 0·029 and P = 0·019, respectively). In conclusion, these results demonstrate that hUCB-MSCs may have a superior effect to fibroblasts in stimulating diabetic wound healing.

Development and Preliminary Testing of a Smartphone-Based Injury-Prevention Application (S-IPA) for Teachers at Child-Care Centers in South Korea.

The purpose of this study was to develop a smartphone-based injury-prevention application (S-IPA) for teachers working in child-care centers, and to test the satisfaction level of the users of the application (app). Through a literature review and needs assessment, an app compatible with the Apple iPhone operating system was developed. The app was verified and the mean total satisfaction with 7 features of the app was 7.76 (± 1.13) on a score of 1-10. The result of the S-IPA survey showed a positive response, indicating a high potential for use as a teacher's educational guide, which would provide an effective information delivery system for the prevention of possible injuries at child-care centers.

Effects of neodymium-yttrium-aluminum garnet (Nd:YAG) pulsed high-intensity laser therapy on full thickness wound healing in an experimental animal model.

OBJECTIVE: Wound healing can be aided by the use of low- and medium-intensity lasers. The use of pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) high-intensity laser therapy (HILT) with a 1064-nm wavelength laser provides deeper and more efficient penetration into tissue as it is being less absorbed by chromophores in tissue, e.g., hemoglobin, melanin, and water, thereby enhancing the wound-healing process. In this study, we examined the effect of HILT on wound healing with a Q-switched pulsed Nd:YAG laser in an animal model. DESIGN: Sixty SKH1 hairless male mice (seven weeks old) were randomly divided into four groups according to the amount of laser fluence: control, group 1 (0.8 J/cm2), group 2 (1.6 J/cm2), and group 3 (2.0 J/cm2). Laser treatment was provided to groups 1, 2, and 3 with a 1064-nm Q-switched Nd:YAG laser. Histological analysis was performed with hematoxylin and eosin staining, Masson's Trichrome staining, and Ki-67 staining. RESULTS: Statistically significant increases in the accumulation of collagen fibers, thickness of granulation tissue, and numbers of fibroblasts were observed in group 2 (treated with 1.6 J/cm2) as compared with the control (no laser treatment), group 1 (treated with 0.8 J/cm2), and group 3 (treated with 2.0 J/cm2). CONCLUSION: Nd:YAG HILT stimulated fibroblast proliferation and increased extracellular matrix production. We expect that this therapy could accelerate the wound-healing process.

Analysis of Malpractice Claims Associated with Surgical Site Infection in the Field of Plastic Surgery.

Postoperative infections are rare after plastic surgery; however, when present, they can affect the aesthetic outcome. Currently, many malpractice lawsuits are associated with surgical site infection. The present study aimed to analyze malpractice claims associated with surgical site infection in the field of plastic surgery through a review of Korean precedents. We analyzed the type of procedure, associated complications, and legal judgment in these cases. Most claimants were women, and claims were most often related to breast surgery. The common complications related to surgical site infection were deformity, scar, and asymmetry. Among the 40 cases, 34 were won by the plaintiff, and the mean claim settlement was 2,832,654 KRW (USD 2,636.6). The reasons for these judgements were as follows: 1) immediate bacterial culture tests were not performed and appropriate antibiotics were not used; 2) patients were not transferred to a high-level hospital or the infection control department was not consulted; 3) surgical site infection control measures were not appropriate; and 4) surgical procedures were performed without preoperative explanation about surgical site infection. The number of claims owing to surgical site infection after surgery is increasing. Infection handling was one of the key factors that influenced the judgement, and preoperative explanation about the possibility of infection is important. The findings will help surgeons achieve high patient satisfaction and reduce liability concerns.

The Legal Doctrine on 'Limitation of Liability' in the Precedent Analysis on Plastic Surgery Medical Malpractice Lawsuits.

This study intended to review the precedents on plastic surgery medical malpractice lawsuits in lower-court trials, classify the reasons of 'limitation of liability' by type, and suggest a standard in the acknowledgement of limitation of liability ratio. The 30 lower-court's rulings on the cases bearing the medical negligence of the defendants acknowledged the liability ratio of the defendants between 30% and 100%. Ten cases ruled that the defendants were wholly responsible for the negligence or malpractice, while 20 cases acknowledged the limitation of liability principle. In the determination of damage compensation amount, the court considered the cause of the victim side, which contributed in the occurrence of the damage. The court also believed that it is against the idea of fairness to have the assailant pay the whole compensation, even there is no victim-side cause such as previous illness or physical constitution of the patient, and applies the legal doctrine on limitation of liability, which is an independent damage compensation adjustment system. Most of the rulings also limited the ratio of responsibility to certain extent. When considering that the legal doctrine on limitation of liability which supports concrete validity for the fair sharing of damage, the tangible classification of causes of limitation of liability suggested in this study would be a useful tool in forecasting the ruling of a plastic surgery medical malpractice lawsuit.

Survey of reconstructive microsurgery training in Korea.

BACKGROUND: Microsurgical technique in reconstructive surgery is important. Despite recognizing this fact, there are no systematized microsurgery training programs in Korea. The purpose of this study was to diagnose the current training programs and discuss the direction that is needed to improve them. METHODS: The authors conducted a survey of graduates of a plastic surgery residency program. The questionnaire included the volume of microsurgery, training environment, area of microsurgery, department(s) performing microsurgery, and the frequency with which flaps were used. RESULTS: Many specialties other than plastic surgery involved microsurgical procedures. The volume of microsurgery cases was disproportionate between large and small hospitals, creating an imbalance of residents' experience with microsurgical procedures. The increase in microsurgical procedures being performed has increased the number of surgeons who want to train in microsurgery. CONCLUSION: Increasing the number of microsurgery training programs will create more microsurgeons in Korea.

Corrective epicanthoplasty in patients with unnatural results of prior epicanthoplasty: rearrangement of the orbicularis oculi muscle above the medial canthal tendon.

BACKGROUND: Medial epicanthal fold operations are among the most frequent cosmetic procedures performed on Asians. However, in complicated patients with this procedure, as yet no effective method has been reported. We have therefore developed a modified epicanthoplasty method for correcting unnatural results in patients who have gone through prior epicanthoplasty. METHODS: In this study, corrective epicanthoplasty was performed on 85 patients in the interval from January 2006 to December 2011. The age of these patients ranged from 18 to 67 years, with a mean age of 29.3 years. The follow-up period ranged from 13 months to 5 years, with a mean of 2.8 years. The 2 major complaints leading to the procedure were either presence of a prominent incisional scar with contracted tissue around the medial canthal area or relapse of the fold. RESULTS: After the procedure, in each case, a contracted scar was released, and most patients seemed to be satisfied with the plasty. There was no case of definite relapse, hypertrophic scar, or lacrimal apparatus injury. Two patients experienced more overcorrection than anticipated. We reduced these patients' overcorrected epicanthal fold by repeating this procedure. A few patients complained about mild redness around their wounds, but after several months, most of them experienced improvement. CONCLUSIONS: We have presented a method for correction of complicated epicanthoplasty, an area in which there have been no previously reported results. This modified method is simple in design, easy to perform, and effectively corrects medial epicanthoplasty.

The effect of coping knowledge on emergency preparedness in elementary school students.

The purpose of this study was to examine the effect of coping knowledge for emergency preparedness in Korean elementary school students. A school-based coping education program was provided seven times to 271 fourth- and fifth-grade students in two urban schools by researchers with the school nurses. The Process Model of Stress and Coping and Self-Care Deficit Theory were the theoretical frameworks used to guide this research. The Coping Knowledge for Emergency Situations Questionnaire, developed by the authors, was used to gather data. In the coping education group, there was statistically significant improvement in the coping knowledge (t = 4.589, p < .001) from that of the control group (n = 270). The results highlight the importance of emergency preparedness for elementary school students and the need to develop educational programs for various emergency situations.

Restoration of the medial epicanthal fold: reverse skin redraping method in patients unsatisfied with epicanthoplasty.

BACKGROUND: Many Asians receive epicanthoplasty to improve their medial epicanthal fold.Excessive performance of such surgery may cause multiple unwanted results, but there is no report on any restoration method for an overcorrected result of epicanthoplasty. Accordingly, the authors have created a new method for reversely restoring the excessively corrected medial epicanthal fold using skin-redraping epicanthoplasty (Plast Reconstr Surg. 2007;119:703-710). METHODS: During the interval between January 2009 and April 2011, 35 patients received surgery for restoration of the epicanthal fold using the authors' method, which involves sufficiently elevating the skin flap and redraping it to reconstruct the epicanthal fold. This method is very simple to design and perform, and it effectively covers the excessively exposed lacrimal lake. In addition, it can be used independently of the type of prior epicanthoplasty. RESULTS: After the surgery, 2 patients experienced overcorrection, and we repeated the epicanthoplasty. In the other patients, there was no severe complication except for mild redness, a condition that improved after several months. The mean measured distance between the medial canthi after the surgery was 36.8 mm, corresponding to a total lengthening effect of 4.5 mm. This improved the aggressive facial expression caused by the exposed lacrimal lake, and the eyes no longer appeared to be too close together. Moreover, in the case of patients who had more visible scars due to prior epicanthoplasty on the medial epicanthal area, the overall scar length decreased. CONCLUSIONS: This method is simple in design and easy to perform. It can also control the degree of restoration with an additional advantage of reducing a prior scar. Using this method, we could effectively restore the overcorrected epicanthal fold.

Awareness of using chatbots and factors influencing usage intention among nursing students in South Korea: a descriptive study.

PURPOSE: Artificial intelligence (AI) has had a profound impact on humanity; in particular, chatbots have been designed for interactivity and applied to many aspects of daily life. Chatbots are also regarded as an innovative modality in nursing education. This study aimed to identify nursing students' awareness of using chatbots and factors influencing their usage intention. METHODS: This study, which employed a descriptive design using a self-reported questionnaire, was conducted at three university nursing schools located in Seoul, South Korea. The participants were 289 junior and senior nursing students. Data were collected using self-reported questionnaires, both online via a Naver Form and offline. RESULTS: The total mean score of awareness of using chatbots was 3.49±0.61 points out of 5. The mean scores of the four dimensions of awareness of using chatbots were 3.37±0.60 for perceived value, 3.66±0.73 for perceived usefulness, 3.83±0.73 for perceived ease of use, and 3.36±0.87 for intention to use. Significant differences were observed in awareness of using chatbots according to satisfaction with nursing (p<.001), effectiveness of using various methods for nursing education (p<.001), and interest in chatbots (p<.001). The correlations among the four dimensions ranged from .52 to .80. In a hierarchical regression analysis, perceived value (ß=.45) accounted for 60.2% of variance in intention to use. CONCLUSION: The results suggest that chatbots have the potential to be used in nursing education. Further research is needed to clarify the effectiveness of using chatbots in nursing education.

Elementary school students' awareness of the use of artificial intelligence chatbots in violence prevention education in South Korea: a descriptive study.

PURPOSE: This study aimed to identify students' awareness of the use of a chatbot (A-uC), a type of artificial intelligence technology, for violence prevention among elementary school students. METHODS: The participants comprised 215 students in the fourth to sixth grades in Chuncheon, South Korea, and data were collected via a self-reported questionnaire. RESULTS: The mean A-uC score was 3.43±0.83 out of 5 points. The mean scores for the 4 sub-dimensions of the A-uC tool were 3.48±0.80 for perceived value, 3.44±0.98 for perceived usefulness, 3.63±0.92 for perceived ease of use, and 3.15±1.07 for intention to use. Significant differences were observed in A-uC scores (F=59.26, p<.001) according to the need for the use of chatbots in violence prevention education. The relationships between intention to use and the other A-uC sub-dimensions showed significant correlations with perceived value (r=.85, p<.001), perceived usefulness (r=.76, p<.001), and perceived ease of use (r=.64, p<.001). CONCLUSION: The results of this study suggest that chatbots can be used in violence prevention education for elementary school students.

Research Trends of Follow-Up Care after Neonatal Intensive Care Unit Graduation for Children Born Preterm: A Scoping Review.

The purpose of this study was to describe the trends of research on follow-up care after neonatal intensive care unit (NICU) graduation for children born preterm. This scoping review was conducted according to Arksey and O'Malley's guidelines. Reviewed studies were searched in PubMed, CHINAHL, and Web of Science. Fifteen studies were analyzed according to general characteristics, elements of follow-up care after NICU graduation, and characteristics of follow-up care intervention after NICU graduation. Most research was conducted in the medical field (60%), with experimental studies (40%) being the majority, and a few studies focused on families (3%) and parents (3%). The major follow-up care after NICU graduation elements were growth/developmental monitoring and support, continuity of care, parent- and family-centered elements, and a multidisciplinary approach. The intervention methods included home visits, phone calls, video calls, and applications. In addition, the intervention period ranged from two weeks to three years. It is suggested that multidisciplinary research with interactive media for a various age of children over longer periods for further study.

The Influence of Social Media Affinity on Eating Attitudes and Body Dissatisfaction in Philippine Adolescents.

PURPOSE: This study aimed to examine the influence of social media affinity on eating attitudes and body dissatisfaction among adolescents in the Philippines. METHODS: The participants were 114 junior high school students enrolled in 7th to 10th grade in Cavite Province, Philippines. The collected data were analyzed in SPSS, using descriptive statistics, the independent t-test, one-way analysis of variance, Pearson correlation coefficients, and stepwise multiple linear regression. RESULTS: The factors affecting eating attitudes were body dissatisfaction (ß=-.47, p<.001), social media affinity (ß=.33, p<.001) and grade (10th grade) (ß=-.28, p<.001), and the factors influencing body dissatisfaction were eating attitudes (ß=-.65, p<.001) and social media affinity (ß=.17, p=.041). CONCLUSION: In order to promote healthy eating attitudes and to improve body satisfaction among Philippine adolescents, educational strategies tailored to social media users will be needed.

[Empathy, Awareness and Attitudes toward Violence among Elementary School Students]. / 초등학생의 공감 ì •ë„ì™€ í­ë ¥ì— 대한 인식 및 태도.

PURPOSE: The purpose of this study was to investigate empathy, awareness, and attitudes toward violence among elementary school students. METHODS: The participants were 195 fifth and sixth grade students in Y elementary school. The data collection period was from June 24 to July 4, 2019. RESULTS: Empathy scores significantly differed according to participants' gender and need for education on violence prevention. Attitudes towards violence (permissive and neglectful) significantly differed according to students' grade and need for education on violence prevention. Empathy was negatively correlated with permissive attitudes toward violence (r=-.26, p<.001) and neglectful attitudes toward violence (r=-.24, p=.001). CONCLUSION: The results of this study are expected to be utilized as basic data for education on violence prevention through empathy.

Development of a violence prevention educational program for elementary school children using empathy (VPEP-E).

PURPOSE: This study describes the development of a violence prevention educational program for elementary school children using empathy (VPEP-E) that teachers can use during class. METHODS: Hoffman's theory of empathy and Seels and Richey's (1994) ADDIE model were applied to develop this program. RESULTS: The developed program consisted of eight sessions: Orientation/definition of violence and empathy, types and boundaries of violence, look into my feelings, say it with a facial expression, preventing non-empathic violence due to social prejudice, preventing physical violence, verbal and online violence prevention: empathic conversation, and I can do well: review of the whole curriculum. The program was evaluated by 15 elementary school teachers, who considered it to be easily accessible to elementary school students. The final VPEP-E, which will be provided in eight times for 40 minutes each for fifth-grade students, will provide a basis for preventing violence by fostering empathy. CONCLUSION: We expect the developed educational program to be effective in preventing violence among elementary school students. However, further research involving children from various age groups is needed.

Effects of smartphone application education combined with hands-on practice in breast self-examination on junior nursing students in South Korea.

BACKGROUND: Breast self-examination is a convenient and effective way to detect breast abnormalities. Based on Dale's Cone of Experience theory, we hypothesized that the combination of a smartphone application with hands-on practice would have a greater impact than using a smartphone application alone. The purpose of this study was to compare the effects of different educational methods on (a) knowledge, (b) attitudes, (c) skills, and (d) students' satisfaction with the learning methods. METHODS: We conducted a pre- and post-test quasi-experimental design and developed a smartphone application using a video clip. One experimental group received smartphone-based education, another group received smartphone-based education combined with hands-on practice, and the control group received a one-time classroom lecture. We administered a pre-test, provided intervention, and conducted a post-test. RESULTS: Among the three groups, the knowledge and attitude of the experimental groups were significantly higher than that of the control group. In addition, the group using the combination of the smartphone application and hands-on practice showed the highest score changes in skills and satisfaction with the learning methods. CONCLUSIONS: Smartphone application use combined with hands-on practice could be an effective education method for breast self-examination.

Effect of Human Placental Extract Treatment on Random-Pattern Skin Flap Survival in Rats.

Background: Human placental extract (HPE), prepared from the placentas of healthy, postpartum females, displays various physiological activities, including antioxidative properties. In this study, a dorsal skin flap model was used to investigate the effect of HPE on flap viability in rats. Materials and methods: Forty male Sprague-Dawley rats underwent random-pattern skin flap surgeries. The animals were randomly divided among a control group and three treatment groups (localized injection (LI), 10 mg/kg/d localized HPE injections; low-dose treatment (LT), 10 mg/kg/d systemic HPE injections; high-dose treatment (HT), 40 mg/kg/d systemic HPE injections). Surviving skin flap areas were measured 7 days after surgery and tissue samples were stained with hematoxylin and eosin; vascular endothelial growth factor expression was determined immunohistochemically. To evaluate the antioxidant and antiapoptotic effects of HPE, malondialdehyde, glutathione peroxidase, and caspase-3 levels were examined. Results: Seven days after surgery, HPE-treated animals had significantly reduced necrotic areas, rats receiving the highest HPE dose demonstrated the greatest flap survival. In the HPE groups, the histopathological scores were lower than for the control group. Immunohistochemistry showed markedly more numerous vascular endothelial growth factor-positive cells in the HT group than in the C group. Malondialdehyde levels were significantly lower and glutathione peroxidase levels were higher in the HT group than in the C group. HPE treatment significantly inhibited apoptosis by lowering caspase-3 activity. Conclusions: HPE treatment yielded positive effects on flap survival, due to its antioxidant and antiapoptotic properties. These results suggest a new therapeutic approach for enhancing flap viability and accelerating wound repair.