Impact and process evaluations were performed in order to verify the effectiveness of a public health nutrition program developed for child-bearing aged women in Korea. Participants included 58 high school girls who were divided into two groups. Each group received four 50 - 60 minute nutrition education lectures regarding healthy eating, osteoporosis, constipation and nutrition labeling in every two weeks. Each session took 50 - 60 minutes. Regarding nutrition knowledge, there was a significant increase of degree of perception (p = 0.0004), but no change in degree of accuracy after implementation (p = 0.9522). Nutrition education was also effective in attitude change, showing more participants were ready to change their eating behaviors in terms of meal regularity (p = 0.0455) and less processed food intake (p = 0.0143). After implementing nutrition education, effective behavioral changes were observed in milk consumption (p = 0.0037) and meal regularity (p = 0.0882) as well as daily activity such as stair use (p = 0.0701). However, nutrition education had no effect on body mass index and perceived health status. In process evaluation conducted by a 9 item questionnaire, grand mean score was 4.17 +/- 0.72 out of 5. Proportion of items with scores higher than 4 ranged 68-91%. These results suggest that the nutrition education program used in this study was effective and useful. For a wider use of this program, more research was recommend for a strategy development of program diffuse.
Body Mass Index ; Constipation ; Eating ; Education* ; Feeding Behavior ; Female* ; Food Labeling ; Humans ; Korea ; Lectures ; Meals ; Milk ; Osteoporosis ; Public Health* ; Surveys and Questionnaires

Purpose: This study aimed to analyze the mass and social media contents and structures related to particulate matter before and after the policy enforcement of the comprehensive countermeasures for particulate matter, derive nursing implications, and provide a basis for designing health policies. Methods: After crawling online news articles and posts on social networking sites before and after policy enforcement with particulate matter as keywords, we conducted topic and semantic network analysis using TEXTOM, R, and UCINET 6. Results: In topic analysis, behavior tips was the common main topic in both media before and after the policy enforcement. After the policy enforcement, influence on health disappeared from the main topics due to increased reports about reduction measures and government in mass media, whereas influence on health appeared as the main topic in social media. However semantic network analysis confirmed that social media had much number of nodes and links and lower centrality than mass media, leaving substantial information that was not organically connected and unstructured. Conclusion Understanding of particulate matter policy and implications influence health, as well as gaps in the needs and use of health information, should be integrated with leadership and supports in the nurses’ care of vulnerable patients and public health promotion.

Purpose: To evaluate the feasibility of pediatric low-dose facial CT reconstructed with filtered back projection (FBP) using adequate kernels. Materials and Methods: We retrospectively reviewed the clinical and imaging data of children aged < 10 years who underwent facial CT at our emergency department. The patients were divided into two groups: low-dose CT (LDCT; Group A, n = 73) with a fixed 80-kVp tube potential and automatic tube current modulation (ATCM) and standard-dose CT (SDCT; Group B, n = 40) with a fixed 120-kVp tube potential and ATCM. All images were reconstructed with FBP using bone and soft tissue kernels in Group A and only bone kernel in Group B. The groups were compared in terms of image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Two radiologists subjectively scored the overall image quality of bony and soft tissue structures. The CT dose index volume and dose-length product were recorded. Results: Image noise was higher in Group A than in Group B in bone kernel images (p < 0.001). Group A using a soft tissue kernel showed the highest SNR and CNR for all soft tissue structures (all p < 0.001). In the qualitative analysis of bony structures, Group A scores were found to be similar to or higher than Group B scores on comparing bone kernel images. In the qualitative analysis of soft tissue structures, there was no significant difference between Group A using a soft tissue kernel and Group B using a bone kernel with a soft tissue window setting (p > 0.05). Group A showed a 76.9% reduction in radiation dose compared to Group B (3.2 ± 0.2 mGy vs. 81.9 ± 11.1 mGy; p < 0.001). Conclusion The addition of a soft tissue kernel image to conventional CT reconstructed with FBP enables the use of pediatric low-dose facial CT protocol while maintaining image quality.

OBJECTIVE: To evaluate the efficacy of a mammography boot camp (MBC) to improve radiologists' performance in interpreting mammograms in the National Cancer Screening Program (NCSP) in Korea. MATERIALS AND METHODS: Between January and July of 2013, 141 radiologists were invited to a 3-day educational program composed of lectures and group practice readings using 250 digital mammography cases. The radiologists' performance in interpreting mammograms were evaluated using a pre- and post-camp test set of 25 cases validated prior to the camp by experienced breast radiologists. Factors affecting the radiologists' performance, including age, type of attending institution, and type of test set cases, were analyzed. RESULTS: The average scores of the pre- and post-camp tests were 56.0 +/- 12.2 and 78.3 +/- 9.2, respectively (p < 0.001). The post-camp test scores were higher than the pre-camp test scores for all age groups and all types of attending institutions (p < 0.001). The rate of incorrect answers in the post-camp test decreased compared to the pre-camp test for all suspicious cases, but not for negative cases (p > 0.05). CONCLUSION: The MBC improves radiologists' performance in interpreting mammograms irrespective of age and type of attending institution. Improved interpretation is observed for suspicious cases, but not for negative cases.
Adult ; Aged ; Breast Neoplasms/*radiography ; Education, Medical, Continuing/*standards ; Education, Professional, Retraining ; Female ; Humans ; Male ; *Mammography ; Middle Aged

A 36-year-old primivida, at 29 weeks of pregnancy with no smoking history, was admitted to the hospital complaining of cough for 3 days. Chest X-rays revealed atelectasis of the right upper lobe, and a transbronchial lung biopsy confirmed primary lung adenocarcinoma. After consulting with obstetricians and neonatologists, we wanted to deliver the child and treat the mother with chemoradiotherapy. But as she was adamantly opposed to treatment until fetal lung maturation was complete, we planned to delay the birth until 34 weeks, deliver the baby by caesarian section, and then treat the mother. However, maternal hypoxia and fetal distress resulted in an emergency delivery at 30 weeks. After delivery, we treated the mother's brain metastases with radiation therapy and systemic cisplatin-pemetrexed, but she deteriorated and expired 95 days after the diagnosis. Lung cancer during pregnancy is a rare disease and raises many medical and ethical issues in deciding the best course of therapy. We describe our clinical approach and review the potentially challenging features of managing a pregnant patient with lung cancer.
Adenocarcinoma ; Adult ; Anoxia ; Biopsy ; Brain ; Chemoradiotherapy ; Child ; Cough ; Emergencies ; Fetal Distress ; Humans ; Lung ; Lung Neoplasms ; Mothers ; Neoplasm Metastasis ; Parturition ; Pregnancy ; Pulmonary Atelectasis ; Rare Diseases ; Smoke ; Smoking ; Thorax

A 36-year-old primivida, at 29 weeks of pregnancy with no smoking history, was admitted to the hospital complaining of cough for 3 days. Chest X-rays revealed atelectasis of the right upper lobe, and a transbronchial lung biopsy confirmed primary lung adenocarcinoma. After consulting with obstetricians and neonatologists, we wanted to deliver the child and treat the mother with chemoradiotherapy. But as she was adamantly opposed to treatment until fetal lung maturation was complete, we planned to delay the birth until 34 weeks, deliver the baby by caesarian section, and then treat the mother. However, maternal hypoxia and fetal distress resulted in an emergency delivery at 30 weeks. After delivery, we treated the mother's brain metastases with radiation therapy and systemic cisplatin-pemetrexed, but she deteriorated and expired 95 days after the diagnosis. Lung cancer during pregnancy is a rare disease and raises many medical and ethical issues in deciding the best course of therapy. We describe our clinical approach and review the potentially challenging features of managing a pregnant patient with lung cancer.
Adenocarcinoma ; Adult ; Anoxia ; Biopsy ; Brain ; Chemoradiotherapy ; Child ; Cough ; Emergencies ; Fetal Distress ; Humans ; Lung ; Lung Neoplasms ; Mothers ; Neoplasm Metastasis ; Parturition ; Pregnancy ; Pulmonary Atelectasis ; Rare Diseases ; Smoke ; Smoking ; Thorax

OBJECTIVE: To evaluate the interpretive performance and inter-observer agreement on digital mammographs among radiologists and to investigate whether radiologist characteristics affect performance and agreement. MATERIALS AND METHODS: The test sets consisted of full-field digital mammograms and contained 12 cancer cases among 1000 total cases. Twelve radiologists independently interpreted all mammograms. Performance indicators included the recall rate, cancer detection rate (CDR), positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), and area under the receiver operating characteristic curve (AUC). Inter-radiologist agreement was measured. The reporting radiologist characteristics included number of years of experience interpreting mammography, fellowship training in breast imaging, and annual volume of mammography interpretation. RESULTS: The mean and range of interpretive performance were as follows: recall rate, 7.5% (3.3–10.2%); CDR, 10.6 (8.0–12.0 per 1000 examinations); PPV, 15.9% (8.8–33.3%); sensitivity, 88.2% (66.7–100%); specificity, 93.5% (90.6–97.8%); FPR, 6.5% (2.2–9.4%); and AUC, 0.93 (0.82–0.99). Radiologists who annually interpreted more than 3000 screening mammograms tended to exhibit higher CDRs and sensitivities than those who interpreted fewer than 3000 mammograms (p = 0.064). The inter-radiologist agreement showed a percent agreement of 77.2–88.8% and a kappa value of 0.27–0.34. Radiologist characteristics did not affect agreement. CONCLUSION: The interpretative performance of the radiologists fulfilled the mammography screening goal of the American College of Radiology, although there was inter-observer variability. Radiologists who interpreted more than 3000 screening mammograms annually tended to perform better than radiologists who did not.
Area Under Curve ; Breast ; Fellowships and Scholarships ; Mammography ; Mass Screening ; Medical Audit ; Observer Variation ; ROC Curve ; Sensitivity and Specificity

PURPOSE: Mycoplasma pneumoniae (M. pneumoniae) is one of the most common causes of community-acquired pneumonia in children. The clinical course is typically self-limited and benign; however, rare cases of severe pneumonia can develop despite appropriate antibiotic therapy. We studied the effects of methylprednisolone pulse therapy on severe refractory M. pneumoniae pneumonia in children. METHODS: The clinical effects of methylprednisolone therapy were evaluated retrospectively in 12 children with severe refractory M. pneumoniae pneumonia, which was diagnosed serologically. All patients developed respiratory distress, high fever, and initial lobar pneumonic consolidation based on radiological findings. All clinical symptoms deteriorated despite appropriate antibiotic therapy. Thus, children were treated with intravenous methylprednisolone pulse therapy in addition to antibiotics. RESULTS: The average febrile period before admission was 4.9+/-1.7 days, and fever persisted in all children until steroid administration. Methylprednisolone pulse therapy (30 mg/kg) was given 5.4+/-2.5 days after admission. After methylprednisolone pulse therapy, clinical symptoms improved in all patients without adverse events. The fever subsided 0-2 h after initiation of corticosteroid therapy. The abnormal radiological findings resolved within 2.6+/-1.3 days, and the high C-reactive protein levels (6.7+/-5.9 mg/dL) on admission decreased to 1.3+/-1.7 mg/dL within 3.0+/-1.1 days after starting corticosteroid therapy. CONCLUSIONS: Three-day methylprednisolone pulse therapy could be applied to treatment of refractory M. pneumoniae pneumonia despite appropriate antibiotic therapy and appeared to be efficacious and well-tolerated.
Anti-Bacterial Agents ; C-Reactive Protein ; Child* ; Fever ; Humans ; Methylprednisolone* ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Retrospective Studies

The purpose of this study was to investigate the dietary behavior, dietary intakes and internet searches regarding diseas by college students participating in a nutrition education web class. The study subject were 1184 college students and crosssectional survey was conducted by a self-administered questionnaire. The questionnaire deal with anthropometric data, diseas, dietary behaviors, dietary intakes, and the use of nutrition information via the internet. The data was analyzed using a SPSS PC program. Disease group was 19.6% (male: 17.1%, female: 21.9%) and non-disease group was 80.4% (male: 82.9%, female: 78.1%) of subjects. As for the kinds of diseas, the male disease group had stomach diseas (15.7%), ozena (15.7%), hepatitis (10.8%) and allergic disease (7.8%), etc, and the female disease group had stomach diseas (32.8%), allergic diseas (12.0%), bronchitis and bronchial asthma (10.4%), anemia (7.2%), and constipation (1.6%), etc. Non-disease group showed significantly higher irregularity of meal time compared to disease group. Also, Disease group showed significantly higher concern about nutrition and health, worse recognition of theirown nutrition and health satus, and made greater efforts to prevention diseas compared to the non-diseas group. In the male subjects, the average intake of Calories, Vitamin B2 and calcium was lower than the Korean RDA and in the female subjects, those of Calories, calcium and Fe were lower than the Korean RDA. Most of the diseas (97%) and the non-disease (98.2%) groups had positive attituds toward the usefulness of internet nutrition information. The disease group showed a higher confidence in the internet nutrition information and recognition of internet information on poisons compared to the non-diseas group. However, this difference was not significant. Therefore. it is necessary to provide sientifically proven nutrition of information via the internet for college students in order to promote healthful lifestyles and to prevent diseas.
Anemia ; Asthma ; Bronchitis ; Calcium ; Constipation ; Education* ; Female ; Hepatitis ; Humans ; Internet* ; Life Style ; Male ; Meals ; Poisons ; Rhinitis, Atrophic ; Riboflavin ; Stomach ; Surveys and Questionnaires

PURPOSE: This is a descriptive study conducted in order to survey sleep patterns and factors responsible for sleep disturbance among adolescent cancer patients after hospital admission. METHODS: The study group included 46 adolescent cancer patients aged 10 to 19 who received admission care in multi-bed hospital rooms from March to June 2016. Data on patterns and quality of sleep, and factors causing sleep disturbance were recorded using the Verran and Snyder-Halpern (VSH) Sleep Scale, the Pittsburgh Sleep Quality Index (PSQI), and a sleep disturbance questionnaire. RESULTS: There was no difference in patterns and quality of sleep prior to and after hospital admission in the study group. However, patients experienced sleep disturbance, as defined by PSQI > 5, both before (5.43) and after (6.30) admission. The most important physical, emotional and environmental factors causing sleep disturbance after admission were nocturnal diuresis, monotony of admission care, and crying of younger patients respectively. CONCLUSION: This study focused on sleep patterns and factors causing sleep disturbance after hospital admission for adolescent cancer patients. Future studies should aim to develop nursing interventions resulting in an environment that improves sleep quality. Additional studies should focus on developing daytime programs to determine the impact of admission care on other quality of life parameters.
Adolescent* ; Crying ; Diuresis ; Humans ; Nursing ; Quality of Life ; Sleep Wake Disorders