We examined dietary habits, food intakes, health status, and school and community life of meal skipping children, and investigated factors predicting meal skipping of children. A sample was composed of 944 children in low-income families who were provided with public meal service. The sample was obtained from the Survey of Meal Service for Poor Children conducted by the Korea Institute for Health and Social Affairs in 2007. Meal skipping was significantly associated with a lower nutrition and health status, and poor school performance of children, as hypothesized. The school age of child, family structure, region, job of caretaker, concern about diet, and the child's visit to welfare center significantly predicted frequency of meal skipping. We suggested a few implications for community practice to reduce meal skipping of children.
Child ; Diet ; Food Habits ; Humans ; Korea ; Meals ; Risk Factors

BACKGROUND: Clear and proper feedback is necessary to decrease the gap between knowledge and practice. Feedback can improve clinical competence of medical students up to expertise level.METHODS: A total of 180 4th-year students of Daegu-Kyungbuk consortium area participated in the scheduled feedback program of clinical performance examination on August 26th in 2017. Among them, 167 students filled out the questionnaire on helpfulness of the direct observation and feedback of faculty and standardized patient (SP), helpfulness for history taking (Hx), physical examination (PE), and patient-physician interaction (PPI), and any change of clinical competence and clinical reasoning of the students preand post-feedback. All the responses were measured on 5-point Likert scale.RESULTS: Among the total students, 88.6% responded that direct feedback at the practice is helpful, particularly 95.2% of faculty and 76.6% of SP. A 37.3% answered that it was helpful for all the categories of feedback, but only 25.3% for PE and 24.7% for Hx. A 56.3% responded that feedback is helpful for both disease questions and counseling practice. Mean score of self-assessment by the students increased from 2.52 to 3.36 for Hx, 2.30 to 3.24 for PE, 2.46 to 3.33 for clinical reasoning, 2.84 to 3.59 for PPI, and 2.44 to 3.28 for overall competence. And all these differences were found to be statistically significant (P <0.001)CONCLUSION: A majority of students responded that the direct feedback from faculty and SP was helpful at the clinical practice of Hx, PE, and PPI, and increased the level of clinical competence.
Clinical Competence ; Counseling ; Humans ; Mental Competency ; Physical Examination ; Self-Assessment ; Students, Medical

OBJECTIVE: This study aimed to examine whether educational stressors and relational stressors are associated with burnout in medical students and to test social support as a moderator between stressors and burnout. METHODS: A total of 263 medical students attending Gyeongsang National University composed the study sample. A standardized questionnaire was used to investigate educational and relational stressors, three dimensions of burnout, and social support of medical students. RESULTS: The findings showed that overall burnout is very high among Korean medical students, with 9.9% totally burned out. Educational and relational stressors were significantly associated with the risk of burnout in medical students after controlling for socio-demographics and health behaviors. Social support moderated educational and relational stressors on personal accomplishment, but did not moderate stressors on emotional exhaustion and depersonalization. CONCLUSION: Burnout level is substantially high among Korean medical students. Educational and relational stressors are significantly associated with burnout risk in Korean medical students. Social support had moderated educational and relational stressors on personal accomplishment. The results suggest that more social support for medical students is needed to buffer stressors on and burnout.
Burns ; Depersonalization ; Health Behavior ; Humans ; Students, Medical*

Potocki-Shaffer syndrome (PSS, OMIM #601224) is a rare contiguous gene deletion syndrome caused by haploinsufficiency of genes located on the 11p11.2p12. Affected individuals have a number of characteristic features including multiple exostoses, biparietal foramina, abnormalities of genitourinary system, hypotonia, developmental delay, and intellectual disability. We report here on the first Korean case of an 8-yr-old boy with PSS diagnosed by high resolution microarray. Initial evaluation was done at age 6 months because of a history of developmental delay, hypotonia, and dysmorphic face. Coronal craniosynostosis and enlarged parietal foramina were found on skull radiographs. At age 6 yr, he had severe global developmental delay. Multiple exostoses of long bones were detected during a radiological check-up. Based on the clinical and radiological features, PSS was highly suspected. Subsequently, chromosomal microarray analysis identified an 8.6 Mb deletion at 11p11.2 [arr 11p12p11.2 (Chr11:39,204,770-47,791,278)x1]. The patient continued rehabilitation therapy for profound developmental delay. The progression of multiple exostosis has being monitored. This case confirms and extends data on the genetic basis of PSS. In clinical and radiologic aspect, a patient with multiple exostoses accompanying with syndromic features, including craniofacial abnormalities and mental retardation, the diagnosis of PSS should be considered.
Child ; Chromosome Deletion ; Chromosome Disorders/diagnosis/*genetics/radiography ; Chromosome Mapping ; Chromosomes, Human, Pair 11/genetics/radiography ; Craniofacial Abnormalities/genetics ; Developmental Disabilities/genetics ; Exostoses, Multiple Hereditary/diagnosis/*genetics/radiography ; Humans ; Male ; Muscle Hypotonia/genetics ; Oligonucleotide Array Sequence Analysis ; Rare Diseases/*genetics ; Republic of Korea

Potocki-Shaffer syndrome (PSS, OMIM #601224) is a rare contiguous gene deletion syndrome caused by haploinsufficiency of genes located on the 11p11.2p12. Affected individuals have a number of characteristic features including multiple exostoses, biparietal foramina, abnormalities of genitourinary system, hypotonia, developmental delay, and intellectual disability. We report here on the first Korean case of an 8-yr-old boy with PSS diagnosed by high resolution microarray. Initial evaluation was done at age 6 months because of a history of developmental delay, hypotonia, and dysmorphic face. Coronal craniosynostosis and enlarged parietal foramina were found on skull radiographs. At age 6 yr, he had severe global developmental delay. Multiple exostoses of long bones were detected during a radiological check-up. Based on the clinical and radiological features, PSS was highly suspected. Subsequently, chromosomal microarray analysis identified an 8.6 Mb deletion at 11p11.2 [arr 11p12p11.2 (Chr11:39,204,770-47,791,278)x1]. The patient continued rehabilitation therapy for profound developmental delay. The progression of multiple exostosis has being monitored. This case confirms and extends data on the genetic basis of PSS. In clinical and radiologic aspect, a patient with multiple exostoses accompanying with syndromic features, including craniofacial abnormalities and mental retardation, the diagnosis of PSS should be considered.
Child ; Chromosome Deletion ; Chromosome Disorders/diagnosis/*genetics/radiography ; Chromosome Mapping ; Chromosomes, Human, Pair 11/genetics/radiography ; Craniofacial Abnormalities/genetics ; Developmental Disabilities/genetics ; Exostoses, Multiple Hereditary/diagnosis/*genetics/radiography ; Humans ; Male ; Muscle Hypotonia/genetics ; Oligonucleotide Array Sequence Analysis ; Rare Diseases/*genetics ; Republic of Korea

Purpose: This study aims to examine whether perceived levels of job stress, burnout, and mental health are different according to demographic characteristics and working conditions and to investigate the direct and indirect effects of job stress and burnout on the mental health of medical faculty members. Methods: The study sample consists of 855 faculty members in 40 medical schools nationwide in the 2020 Burnout of Faculty Members of Medical Schools in Korea data with a grant from the Korean Association of Medical Colleges. This study employed structural equation modeling to construct causality among latent variables in addition to t-test, analysis of variance, and correlation coefficients for bivariate analyses. Results: Perceived job stress, burnout, and mental health levels of medical faculty members showed significant group differences by demographic characteristics and working conditions. Job stress directly affected mental health (β=0.215, p<0.01) and indirectly affected mental health via burnout (β=0.493, p<0.001). Thus burnout significantly mediated the relationship between job stress and the mental health of medical faculty members. Conclusion This study found that job stress has direct and indirect effects on the mental health of medical faculty members, and burnout partially mediated this relationship. Further studies need to intervene in job stress and burnout to prevent the adverse mental health of medical faculty members and to introduce proper measures to improve working conditions affecting job stress and burnout.

PURPOSE: The purpose of this study was evaluation of the current status of medical students' documentation of patient medical records METHODS: We checked the completeness, appropriateness, and accuracy of 95 Subjective-Objective-Assessment-Plan (SOAP) notes documented by third-year medical students who participated in clinical skill tests on December 1, 2014. Students were required to complete the SOAP note within 15 minutes of an standard patient (SP)-encounter with a SP complaining rhinorrhea and warring about meningitis. RESULTS: Of the 95 SOAP notes reviewed, 36.8% were not signed. Only 27.4% documented the patient's symptoms under the Objective component, although all students completed the Subjective notes appropriately. A possible diagnosis was assessed by 94.7% students. Plans were described in 94.7% of the SOAP notes. Over half the students planned workups (56.7%) for diagnosis and treatment (52.6%). Accurate documentation of the symptoms, physical findings, diagnoses, and plans were provided in 78.9%, 9.5%, 62.1%, and 38.0% notes, respectively. CONCLUSION: Our results showed that third-year medical students' SOAP notes were not complete, appropriate, or accurate. The most significant problems with completeness were the omission of students' signatures, and inappropriate documentation of the physical examinations conducted. An education and assessment program for complete and accurate medical recording has to be developed.
Clinical Competence ; Diagnosis ; Education ; Humans ; Medical Records ; Meningitis ; Physical Examination ; Pilot Projects* ; Soaps* ; Students, Medical*

Internal jugular phlebectasia (IJP) is a fusiform dilatation of the internal jugular vein (IJV), usually presented as a neck mass in children. Accurate diagnosis from carefully directed history, physical examination, and radiological study could result in lifesaving therapy. We performed our study to suggest possible clinical diagnostic criteria for IJP in Korean children. We reviewed three cases of IJP (patients group) and compared the diameter of the internal jugular phlebectasias with diameters of IJVs in ten normal children (control group) using ultrasonography (USG). There were no significant differences in the range of diameters in the resting state between the two groups. The diameters on the right side, compared with those on the left side, showed no statistical significance (p < 0.05). Te range of expanding diameter and average expanding ratios (resting state to Valsalva maneuver X 100%) showed a statistical difference between the two groups (p < 0.05).
Child ; Child, Preschool ; Dilatation, Pathologic/*ultrasonography ; Female ; Human ; Jugular Veins/*ultrasonography ; Korea ; Male ; Valsalva's Maneuver

BACKGROUND: Careful consideration should be given administering a blood transfusion according to the transfusion criteria because blood components may cause various adverse reactions. In the future, a shortage of blood is inevitable due to strengthening the criteria of donor deferral and the increasing population of aged people, and this will cause a significant dearth of the blood supply. Therefore, we have developed a computerized blood auditing program for reducing the amount of blood transfused by changing the transfusion practices of clinicians. METHODS: The blood audit program was developed to automatically check the clinical information, the pretransfusion laboratory test results, the operation etc of patients who are undergoing transfusion based on the laboratory information system (LIS). The criteria for appropriateness were based on the national transfusion guideline and the transfusion criteria of Severance Hospital. We evaluated the transfusion appropriateness of transfusing red blood cells (RBCs) and fresh frozen plasma (FFP) from April, 2009 to June, 2009 using this audit program. RESULTS: RBCs were transfused to 2,353 patients over 5,652 episodes, and a total of 11,055 units were transfused. FFP was transfused to 574 patients over 1,228 episodes and a total of 4,258 units were transfused. We found that 1,120 (19.9%) RBC transfusion episodes and 377 (30.7%) FFP transfusion episodes were inappropriate. The proportion of inappropriate transfusion was higher in surgical departments than that in medical departments. CONCLUSION: Our computerized audit program evaluated a high number of transfusions in a short time, and we obtained results reflecting the entire past history of transfusions, and we can continuously audit transfusion using this program. We think that feedback to physicians who order transfusions would improve the appropriate use of transfusion.
Aged ; Blood Transfusion ; Clinical Laboratory Information Systems ; Erythrocytes ; Humans ; Plasma ; Tissue Donors

OBJECTIVES: Cognitive behavioral therapy of schizophrenia has been developed as a psychological therapy for drug resistant patients with schizophrenia. However, there are some controversial issues regarding the size and mode of the therapeutic effect. The aim of this study is to compare the effect of cognitive behavioral therapy with supportive therapy after treatment. METHODS: Patients with drug resistant schizophrenia were randomly allocated, and stratified according to two mental health institutes to two different therapy groups. We used four assessment scales to evaluate residual symptoms of patients in detail. Patients were assessed twice by a blind rater, at baseline and after treatment. RESULTS: No significant differences in the change of PANSS (Positive and Negative Syndrome Scale) scores were observed between the cognitive behavioral therapy and supportive therapy groups at one month after treatment. There was no significant difference in change of K-PSYRATS (Korean-Psychotic Symptom Rating Scale)-Delusion score, however, a trend toward significance in K-PSYRATS - Hallucination was observed between the two groups. In the aspect of insight, a significant difference in the change of SDMD-K (The Scale to assessment Unawareness of Mental Disorder-Korean version) score was observed between the two groups after treatment. CONCLUSION: Despite remarkable development of pharmacotherapy for schizophrenia, many patients still suffer from residual symptoms. Findings of this study showed that cognitive behavioral therapy can improve the insight of patients and reduce the severity of residual positive symptoms, especially hallucination. Cognitive behavioral therapy should be practiced effectively in the psychiatric clinic and community mental health system.
Academies and Institutes ; Cognitive Therapy ; Hallucinations ; Humans ; Mental Health ; Schizophrenia ; Weights and Measures