Purpose: The purpose of this study was to develop a scale to measure professionalism of clinical nurses and evaluate the reliability and validity of the scale. Methods: DeVellis’s scale-development eight steps were applied.The initial items were developed through a literature review and discussion with investigators, and the content validity was verified by seven experts. The data were collected from 250 hospital nurses for exploratory factor analysis and 217 hospital nurses for confirmatory factor analysis. Exploratory and confirmatory factor analyses were utilized to assess the construct validity. Cronbach’s ⍺ was used to test the internal consistency reliability. Results: The results of the exploratory and confirmatory factor analyses showed that the scale comprised four factors: professional skill(eight items), sense of ethics (five items), knowledge-seeking activities (four items), and autonomy(three items). The four-factor structure was validated (x2 =600.85 p<.001, GFI=.88, CFI=.84, RMSEA=.07), and Cronbach’s ⍺ for the total scale was .84. Conclusion The study results showed satisfactory reliability and validity of the professionalism measurement scale for clinical nurses. This scale has potential as an appropriate instrument for measuring clinical nurse professionalism.

Propionibacterium acnes, a gram-positive, anaerobic, and aerotolerant bacterium that is found frequently in the skin as part of the human microbiome causes inflammatory acne, shoulder infection, and the contamination of medical devices. The study goals were the antibiotic resistant and molecular epidemiological characterization of the P. acnes isolates in Korea. A total of 22 P. acnes isolates originated from diverse patients were obtained from three National Culture Collections for Pathogens in South Korea. The hemolytic properties and minimum inhibitory concentrations (MIC) of five antibiotics (tetracycline, doxycycline, clindamycin, erythromycin, and minocycline) were determined. Only one isolate showed high MIC values and resistance to all five antibiotics. Genotypic characterization was achieved by multilocus sequence typing (MLST) for eight loci (aroE, guaA, tly, camp2, atpD, gmk, lepA, and sodA) and repetitive-sequence-based PCR (rep-PCR) analysis using the DiversiLab kit. MLST revealed four phylogroups that were type IA₁ (27.3%), type IA₂ (18.2%), type IB (13.6%), and type II (40.9%). Rep-PCR results demonstrated three clusters that were cluster I (39.1%), cluster II (45.5%), and cluster III (13.6%). The isolates of cluster I were part of phylogroup type IA (both IA₁ and IA₂), and the isolates of cluster II belonged to phylogroup type II. All isolates of phylogroup type IB were hemolytic and belonged to cluster III. The results of rep-PCR clustering analysis showed a good correlation with those of MLST phylogroups, suggesting that rep-PCR could be an alternative method to track P. acnes subtype lineages.
Acne Vulgaris ; Anti-Bacterial Agents ; Clindamycin ; Doxycycline ; Erythromycin ; Humans ; Korea ; Methods ; Microbial Sensitivity Tests ; Microbiota ; Multilocus Sequence Typing* ; Polymerase Chain Reaction* ; Propionibacterium acnes* ; Propionibacterium* ; Shoulder ; Skin

BACKGROUND: Retention of gestational weight can be a significant contributor to obesity related complications. Few studies have assessed the impact of behavioral factors in Korea. This study was performed to identify the impact of factors on weight change at 1 year postpartum. METHODS: A questionnaire was sent twice by mail to 635 women who delivered singleton infant without complications in Seoul Asan Hospital from January 2002 to March 2002 and 97 available responses were received. Parity, pre-pregnancy weight, fullterm weight and postpartum behaviors were collected from routine medical records and questionnaire. RESULTS: Mean age was 30.5 years and mean pre-pregnancy BMI was 20.9 kg/m2. Mean total weight gain during pregnancy was 13.6+/-4.3 kg/m2 weight change at 1 year postpartum was 1.9+/-3.8 kg. Nearly 17.5% of women experienced a major weight gain of 4.5 kg at 1 year postpartum. Women who had higher pre-pregnancy BMI (> or =23 kg/m2) were at high risk for major weight gained at 1 year postpartum (OR: 4.14). Women who gained 13.6 kg or more during pregnancy and with lower income were at high risk for major weight gain at 1year postpartum (OR: 5.28, 4.13 respectively). CONCLUSION: Pre-pregnancy BMI, gestational weight gain and household monthly income are significantly associated with weight change at 1year postpartum. These findings support the need of the guidelines for preventing major weight retention associated with pregnancy.
Chungcheongnam-do ; Family Characteristics ; Female ; Humans ; Infant ; Korea ; Medical Records ; Obesity ; Parity ; Postal Service ; Postpartum Period* ; Pregnancy ; Seoul ; Weight Gain*

BACKGROUND: Sarcopenia is the loss of muscle mass leading to decreased muscle strength, physical disability, and increased mortality. The genesis of both sarcopenia and osteoporosis is multifactorial, and several factors that play a role in osteoporosis are thought to contribute to sarcopenia. This study evaluated the association between sarcopenia and bone density and health-related quality of life in Korean men. METHODS: We used the data of 1,397 men over 50 years of age from the 2009 Korean National Health and Nutrition Examination Survey. Sarcopenia was defined as the appendicular skeletal muscle mass divided by height2 (kg/m2) < 2 standard deviations below the sex-specific mean for young adults. Health-related quality of life was measured by the EuroQol-5 dimension (EQ-5D) instrument. Logistic regression analysis was performed to evaluate the relationship between sarcopenia, bone density, and health-related quality of life. RESULTS: The T-score of the lumbar spine, total femur, and femur neck in bone mineral density in subjects with sarcopenia were lower than those in subjects without sarcopenia. The score of the EQ-5D index was significantly lower and the rate of having problems with individual components of health-related quality of life was higher in the sarcopenic group. After adjustment for age and body mass index, the odds ratios (ORs) (95% confidence interval [CI]) for sarcopenia were 2.06 (1.07-3.96) in osteopenic subjects and 3.49 (1.52-8.02) in osteoporotic subjects, respectively. After adjustment, the total score of the EQ-5D index was significantly lower in the sarcopenic subjects. The ORs (95% CI) for having problems of mobility and usual activity of the EQ-5D descriptive system were 1.70 (1.02-2.84) and 1.90 (1.09-3.31), respectively. CONCLUSION: Sarcopenia was associated with decreased bone mineral density in Korean men. In addition, sarcopenia was related to poor quality of life, especially with regard to mobility and usual activity. Greater attention to and evaluation for sarcopenia are needed in subjects showing low bone mineral density to prevent and manage poor quality of life.
Body Mass Index ; Bone Density ; Bone Diseases, Metabolic ; Electrolytes ; Femur ; Femur Neck ; Humans ; Logistic Models ; Male ; Muscle Strength ; Muscle, Skeletal ; Muscles ; Nutrition Surveys ; Odds Ratio ; Osteoporosis ; Quality of Life ; Sarcopenia ; Spine ; Young Adult

BACKGROUND: Current guidelines for the treatment of hyperlipidemia propose lifestyle modification as a first-line intervention. The aim of this study was to identify the factors which determine responsiveness of LDL-cholesterol lowering to lifestyle modification in hypercholesterolemic patients. METHODS: A total of 109 patients aged between 30 and 70 years (52 men and 109 women) who were diagnosed with hypercholesterolemia between July 2007 and February 2008 at Asan Medical Center were enrolled in this study. The patients were educated on lifestyle modifications by trained family physicians. We measured clinical, anthropometric, lifestyle parameters and lipid profiles initially and at eight weeks after education. Stepwise multiple linear regression models were used to assess covariates and variance components. RESULTS: The serum level of LDL-cholesterol decreased in both women (8.0 +/- 15.37%, P < 0 .001) and men (4.95 +/- 9.81%, P < 0.001). In women, dietary adherence (beta = 0.267, P = 0.004), change in physical activity duration (beta = 0.196, P = 0.034) and menopausal state (beta = -0.207, P = 0.026) were significant predictors in response of percent change in LDL-cholesterol. In men, dietary adherence (beta = 0.372, P = 0.007) was a predictor in response of percent change in LDL-cholesterol. CONCLUSION: Adherence to lifestyle modification was a main factor which had influenced on response of percent change in LDL-C levels. In women, however, menopausal state was also an important factor.
Aged ; Female ; Humans ; Hypercholesterolemia ; Hyperlipidemias ; Life Style ; Linear Models ; Male ; Motor Activity ; Physicians, Family

PURPOSE: Elevated circulating oxidized low density lipoprotein (Ox-LDL) levels are associated with increased risk of atherosclerosis, which may be due to high plasma homocysteine (Hcy) and low intakes of antioxidants. We investigated the contribution of dietary intakes of antioxidants to Hcy-induced LDL oxidation in atherosclerotic patients (AP) and controls. MATERIALS AND METHODS: Male AP (n = 101) who were confirmed by coronary angiography and 91 controls were evaluated by blood biochemistry and dietary intakes. To determine whether homocysteine is an independent risk factor for atherosclerosis, subjects were divided into three groups; low- (< or = 6.9 uM/L), normal- (7 uM-12 uM/L) and high- (> or = 12.1 uM/L) Hcy. RESULTS: Plasm levels of homocysteine and LDL were higher, but plasma apo A-I in HDL and folate were lower in the AP group. The odds ratio (OR) for the risk of atherosclerosis was 3.002 [95% confidence interval (CI), 1.27-7.09] for patients in the highest tertile with homocysteine > or = 12.1 uM/L. AP having high homocysteine levels had low intakes of vitamin A, beta-carotene and vitamin C. By logistic regression analysis, age, body mass index (BMI), plasma LDL, plasma folate, and low intakes of vitamin A and beta-carotene were found to be risk factors for atherosclerosis in patients with high-Hcy, but dietary B vitamins including folate were not. CONCLUSION: A high-Hcy level was a risk factor for atherosclerosis in patients with high Ox-LDL levels. High intakes of antioxidants appeared to be a protective factor for atherosclerosis, perhaps exerting a pro-oxidative effect on LDL when combined with high levels of Hcy and LDL. However, more evidence for the benefits of B vitamins as a homocysteine-lowering therapy is needed.

BACKGROUND: Metabolic syndrome (MetS), characterized by abdominal obesity, hypertriglyceridemia, low high-density lipoprotein (HDL) cholesterol, high blood pressure, and high fasting glucose level, is a common risk factor for cardiovascular diseases and associated complications. We examined the relationship between the metabolic syndrome and risk of chronic kidney disease (CKD) in Korean women. METHODS: We used data from 10,170 women, aged 30-89 years, who had visited a health examination center at a tertiary care hospital in 2006. The data were studied cross-sectionally. MetS was identified using the modified criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). CKD was defined as an estimated GFR < 60 ml/min per 1.73 m2. The multivariable-adjusted (adjustment for age, education, body mass index (BMI), alcohol drinking, smoking, previous coronary heart disease, menopauses and physical inactivity) odds ratio of CKD (95% CI) associated with each component of the metabolic syndrome was calculated using the logistic regression models. RESULTS: A total of 1,039 participants have MetS. The multivariable-adjusted odds ratios (OR) of CKD in participants with MetS, hypertriglyceridemia and high blood pressure compared with participants without such factors were 2.68 (95% CI, 1.77-4.06), 1.96 (95% CI, 1.34-2.88), and 2.00 (95% CI, 1.38-2.89). Compared with the participants with no MetS traits, those with one, two, equal to or more than three traits of MetS had OR of CKD of 1.24 (95% CI, 0.75-2.06), 1.56 (95% CI, 0.89-2.75), and 2.18 (95% CI, 1.21-3.93), respectively. CONCLUSION: We found that Korean women with MetS had an increased risk for developing CKD. Finally, earlier identification and management of MetS might improve patient health and prevent progression of CKD.
Adult ; Aged ; Alcohol Drinking ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Coronary Disease ; Fasting ; Female ; Glomerular Filtration Rate ; Glucose ; Humans ; Hypertension ; Hypertriglyceridemia ; Lipoproteins ; Logistic Models ; Obesity, Abdominal ; Odds Ratio ; Renal Insufficiency, Chronic ; Risk Factors ; Smoke ; Smoking ; Tertiary Healthcare

The goal of this research was to determine the relationship between the stage of chronic periodontitis and the presence of six bacterial pathogens (Aggregatibacter actinomycetemcomitans: AA, Fusobacterium nucleatum: FN, Porphyromonas gingivalis: PG, Prevotella intermedia: PI, Enterococcus faecalis: EF, and Parvimonas micra: PM). Forty-six chronic periodontitis patients visiting a dental hospital were included in this investigation. They were classified into four chronic periodontitis stages based on the sulcus bleeding index value and the probing depth. The tissue samples from the periodontal surgery were used for a direct PCR detection assay. A total of 49 samples from 46 patients were collected and classified into four chronic periodontitis groups (N: 6, P1: 13, P2: 18, P3: 12). The PCR assay showed that FN, PI, and PM were involved from the beginning of chronic periodontitis (P1), while AA and PG existed regardless of the disease stages. EF was strongly linked to the P3 stage of the disease. In order to assess the effect of dental treatments on patients with chronic periodontitis, EF should be a critical marker for P3 patients, while FN, PI, and PM would be good indicators for chronic periodontitis.
Chronic Periodontitis* ; Enterococcus faecalis ; Fusobacterium nucleatum ; Hemorrhage ; Humans ; Polymerase Chain Reaction ; Porphyromonas gingivalis ; Prevotella intermedia

BACKGROUND: C-reactive protein (hereinafter CRP) is a substance that is elevated in large quantities when there is an abnormal metabolic reaction or an inflammatory condition. Many researches have identified the substance as a prognostic and an independent risk factor responsible for cardiovascular disease. More recently, many studies have shown that obesity is associated with low-grade systemic inflammation. This study was attempted to illustrate the relationship between obesity and CRP regarding Korean men who were applied by different standards of obesity. METHODS: The subjects included 15,353 men who had visited one health promotion center from May, 2001 to December, 2001, were randomly selected as the total addressable population. We excluded 389 men who were observed to have inflammatory conditions, according to the results of the general chemical and physical diagnosis. Among 15,353 Korean men 14,964 were examined. CRP was quantitatively analyzed by the method of Nephelometry as high sensitivity-CRP. CRP values in relation to age, BMI, clustering of metabolic risk factors were studied, and multiple logistic regression analysis was conducted to identify correlation between obesity and CRP value. RESULTS: We compared the median values of CRP of each group divided by age, BMI, and clustering of metabolic risk factors. As a matter of the fact, the more age, BMI, and clustering of metabolic risk factors increased, the more the value of CRP significantly increased (P<0.0001). We operationally defined incremented CRP value as CRP of 0.22 mg/dl or more, and conducted multiple logistic regression analysis with the parameters of age, BMI, and obesity related diseases. Consequently, when fasting blood glucose and total cholesterol were high or HDL was low, the risk of CRP increasing was significantly high. Also, when the age was more than 60 or BMI was greater than 25 kg/m2, which was categorized as obese, the risk regarding increase in CRP was significantly high. CONCLUSION: Obesity is independently related to increase in CRP in Korean men. Which suggests that low-grade systemic inflammation exists in obese people. Furthermore, our study showed that old age, high level of blood glucose, high level of cholesterol, and low level of HDL have correlation with increase in CRP.
Blood Glucose ; C-Reactive Protein* ; Cardiovascular Diseases ; Cholesterol ; Diagnosis ; Fasting ; Health Promotion ; Humans ; Inflammation ; Logistic Models ; Male ; Nephelometry and Turbidimetry ; Obesity* ; Risk Factors

BACKGROUND: Korea's population is aging rapidly. Aged people who lead a solitary life are in a state of social isolation and face a greater risk of lower quality of life. The purpose of this study was to analyze the health behaviors and lifestyle patterns of aged people who lead a solitary life in Korea.METHODS: We analyzed 4,471 subjects (1,933 men and 2,538 women)-aged people aged 65 or above-based on data from the Korea National Health and Nutrition Examination Survey VI (2013–2015). The odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed using multivariate logistic regression analysis adjusted with age, household income level, occupational status, and geographical region.RESULTS: Socioeconomic status was lower in aged people who lead a solitary life than in those living with family. The ORs for frequent eating out alone (OR=2.93; 95% CI 1.83–4.38), daily eating out alone (OR=2.40; 95% CI 1.25–4.60), smoking (OR=1.57; 95% CI 1.06–2.32), feeling sick or uncomfortable (OR=1.59; 95% CI 1.08–2.36), feeling depressed (OR=4.10; 95% CI 2.53–6.65), and suicide ideation (OR=2.06; 95% CI 1.21–3.51) were significantly higher in male subjects who lead a solitary life. The ORs for frequent eating out alone (OR=1.57; 95% CI 1.10–2.24) and inadequate sleep duration (OR=1.29; 95% CI 1.03–1.61) were significantly higher in female subjects who lead a solitary life.CONCLUSION: Aged people who lead a solitary life exhibited unhealthy behaviors and poor mental health. The elderly men who lead a solitary life faced higher risk of poor health than the women. Integrated management of lifestyle behaviors is required to improve the quality of health in aged people who lead a solitary life.
Aged ; Aging ; Eating ; Employment ; Family Characteristics ; Female ; Health Behavior ; Humans ; Korea ; Life Style ; Logistic Models ; Male ; Mental Health ; Nutrition Surveys ; Nutritional Status ; Odds Ratio ; Quality of Life ; Smoke ; Smoking ; Social Class ; Social Isolation ; Suicide