PURPOSE: The purpose of this study was to develop and evaluate the effect of a cultural competency promotion program for nurses in obstetrics-gynecology and pediatrics. METHODS: The cultural competency promotion program was developed through the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) steps. In this quasi-experimental study, 30 nurses in obstetrics-gynecology and pediatrics were assigned to the experimental group and 34 nurses were assigned to the control group. The experimental group received this program once a week for four weeks and each class lasted one hour. Data were analyzed using descriptive statistics, t-test, chi2-test and Fisher's exact test with the IBM SPSS Statistics version 21.0 program. RESULTS: After attending the program, cultural competency (t=8.30, p<.001) increased significantly in the experimental group compared to the control group. There were also significant differences between two groups in cultural awareness (t=7.53, p<.001), cultural attitude (t=6.41, p<.001), and cultural knowledge & skills (t=7.79, p<.001) as components of cultural competency. CONCLUSION: The results of this study indicate that this cultural competency program is effective and efficient for nurses in obstetrics-gynecology and pediatrics and can help nurses provide appropriate multicultural nursing care in multicultural society.
Cultural Competency* ; Nursing Care ; Pediatrics* ; Program Development

PURPOSE: This study was to evaluate the quality of online health information related to infants and preschoolers accessible through mobile applications and websites. METHODS: Using combinations of the terms 'infant', 'preschooler', and 'health' as the main keyword or categories, the researchers searched relevant mobile applications and websites in Korean application markets and popular search engines. Twelve mobile application and 14 websites were finally selected according to our inclusion criteria and evaluated using DISCERN instrument. RESULTS: The overall quality score of online health information available through mobile applications was 2.00 of 5 points, the reliability score was 2.15, and the quality score was 1.76. The overall quality score of online health information available through websites was 2.29, the reliability score was 2.40, and the quality score was 1.82. CONCLUSION: The quality of online health information related to young children was found to be low and to have potentially significant drawbacks according to DISCERN criteria. Therefore, it is necessary to establish a system to evaluate and regulate the quality of online health information. Additionally, factors that readers can use to judge the quality of health information, such as references and the benefit versus risks of the information, should be provided.
Child ; Consumer Health Information ; Humans ; Infant ; Internet ; Mobile Applications ; Search Engine

PURPOSE: This study aims to investigate if 2D analysis method is applicable to analysis of CBCT by comparing measuring points of CBCT with those of Adjusted 2D Lateral Cephalogram (Adj-Ceph) with magnification adjusted to 100% and finding out at which landmarks the difference in position appear. MATERIALS AND METHODS: CBCT data and Adj-Ceph (100% magnification) data from 50 adult patients have been extracted as research objects, and the horizontal (Y axis) and vertical (Z axis) coordinates of landmarks were compared. Landmarks have been categorized into 4 groups by the position and whether they are bilaterally overlapped. Paired t-test was used to compare differences between Adj-Ceph and CBCT. RESULTS: Significant difference was found at 11 landmarks including Group B (S, Ar, Ba, PNS), Group C (Po, Or, Hinge axis, Go) and Group D (U1RP, U6CP, L6CP) in the horizontal (Y) axis while all the landmarks in vertical (Z) axis showed significant difference (P<.05). As a result of landmark difference analysis, a meaningful difference with more than 1 mm at 13 landmarks were indentifed in the horizontal axis. In the vertical axis, significant difference over 1 mm was detected from every landmark except Sella. CONCLUSION: Using the conventional lateral cephalometric measurements on CBCT is insufficient. A new 3D analysis or a modified 2D analysis adjusted on 19 landmarks of the vertical axis and 13 of the horizontal axis are needed when implementing CBCT diagnosis.
Adult ; Axis, Cervical Vertebra ; Diagnosis ; Humans

PURPOSE: This study examined the effects of sagittal spinopelvic alignment on the clinical parameters, motor symptoms, and respiratory function in patients with mild to moderate Parkinson's disease (PD). METHODS: This study was a prospective assessment of treated patients (n=28, Hoehn and Yahr (H&Y) stage 2–3) in a PD center. Twenty-eight subjects (68.5±5.7 yrs) participated in this study. The clinical and demographic parameters, including age, sex, symptoms duration, treatment duration, and H&Y stage, were collected. Kinematic analysis was conducted in the upright standing posture with a motion capture system. A pulmonary function test (PFT) was performed in the sitting position using a spirometer. The motor symptoms were assessed on part III of the movement disorder society sponsored version of the unified Parkinson's disease rating scale (MDS-UPDRS). SPSS 18.0 was used to analyze the collected data. RESULTS: The exceeding 12 degrees group of the lower trunk showed significantly higher on the clinical parameters than the below 12 degrees group. In addition, the exceeding 12 degrees group of the lower trunk showed a significantly lower forced expiratory volume at one second (FEV1) / forced vital capacity (FVC) (%) and 25–75% forced mid-expiratory flow (FEF) (L/s) than in the below group. On the other hand, there was no difference in the upper trunk and the cervical pelvis between the groups. CONCLUSION: These findings suggest that the sagittal balance in the lower trunk is related to the clinical parameters and respiratory function, but not the motor symptoms in patients with mild to moderate PD.
Forced Expiratory Volume ; Hand ; Humans ; Movement Disorders ; Parkinson Disease ; Pelvis ; Posture ; Prospective Studies ; Respiratory Function Tests ; Vital Capacity

Purpose: This study aims to explore income-based disparities in breast cancer (BC) incidence and stage at presentation in a national population in South Korea, where a National Cancer Screening Program (NCSP) has been implemented. Methods: In 2007, new patients with BC were identified using the Korea Central Cancer Registry database. We calculated adjusted odds ratios (aORs) to evaluate the association between individual income level and the risk of distant stage BC at presentation, adjusting for women’s age, body mass index, disability registration, employment, region of residence, and year of diagnosis. Results: The cumulative age-standardized incidence of BC in the 11 years was highest among women in the richest quintile (2,040 per 100,000 women for 11 years), whereas the proportion of distant stage at presentation was the highest (10.2%) among the medical aid beneficiaries. The aOR of distant stage diagnosis at presentation was higher for lowerincome quintiles, and the risk was the highest in the medical aid beneficiaries (aOR, 2.25;95% confidence interval, 1.97–2.58) than in the richest quintile. The income-based gradient in aORs for distant stage did not differ between younger (< 40 years) and older patients. Conclusion A higher risk of distant stage BC at presentation among the lower-income and medical aid groups in the context of a NCSP was observed. A more focused approach toward women in lower-income groups is necessary to alleviate the disparity in the risk of advanced BC.

OBJECTIVES: To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes.METHODS: Data from the Korea National Health and Nutrition Examination Survey (2007–2009) were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes.RESULTS: Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, p<0.001 for gastric cancer; 60.5 vs. 71.5%, p<0.001 for breast cancer; and 49.1 vs. 59.6%, p<0.001 for cervical cancer). Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, p<0.001), breast cancer (38.8 vs. 44.6%, p<0.001), and cervical cancer (35.1 vs. 51.2%, p<0.001). In subgroup analyses according to socioeconomic factors, the lifetime and recommended screening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9), and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9).CONCLUSIONS: The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.
Breast ; Breast Neoplasms ; Diabetes Mellitus ; Early Detection of Cancer ; Female ; Humans ; Korea ; Male ; Mass Screening ; Multivariate Analysis ; Nutrition Surveys ; Socioeconomic Factors ; Stomach Neoplasms ; Uterine Cervical Neoplasms

OBJECTIVE: The aim of this study was to investigate the prevalence of abnormal vaginal microorganisms in pregnant women according to trimester, and to determine whether the presence of abnormal vaginal colonization is associated with higher risk of miscarriage or preterm delivery. Furthermore, we analyzed delivery outcomes according to individual microorganism species. METHODS: We included pregnant women who underwent vaginal culture during routine prenatal check-up between January 2011 and June 2016. We compared delivery outcomes according to the presence or absence of abnormal vaginal flora grouped by trimester. RESULTS: This study included 593 singleton pregnancies. We classified participants into 3 groups, according to the trimester in which vaginal culture was performed; 1st trimester (n=221), 2nd trimester (n=138), and 3rd trimester (n=234). Abnormal vaginal colonization rate significantly decreased with advancing trimester of pregnancy (21.7% for 1st, 21.0% for 2nd, 14.5% for 3rd; P=0.048). Abnormal vaginal colonization detected in the 2nd trimester but not in 1st trimester was associated with a significant increase in preterm delivery before 28 weeks of gestation (6.9% vs. 0%; P=0.006). Among abnormal vaginal flora isolated in the 2nd trimester, the presence of Klebsiella pneumonia was identified as significant microorganism associated with preterm delivery before 28 weeks of gestation (50% vs. 0.7% for K. pneumonia; P=0.029). CONCLUSION: There is an association between abnormal vaginal colonization detected in the 2nd trimester and preterm delivery before 28 weeks. K. pneumonia has been identified as the likely causative microorganisms.
Abortion, Spontaneous ; Colon ; Female ; Humans ; Klebsiella ; Microbiota ; Pneumonia ; Pregnancy ; Pregnant Women ; Premature Birth ; Prevalence

PURPOSE: The aim of this study was to evaluate the clinical significance of inflammatory biomarkers in acute infectious diarrhea among children. METHODS: Clinical parameters including fever, bacterial and viral etiology based on stool culture and multiplex polymerase chain reaction, and nine biomarkers including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leukocytes in blood and calprotectin, lactoferrin, myeloperoxidase, polymorphonuclear elastase, leukocytes, and occult blood in feces were evaluated in children who were hospitalized due to acute diarrhea without underlying disease. RESULTS: A total of 62 patients were included. Among these patients, 33 had fever, 18 showed bacterial infections, and 40 patients were infected with 43 viruses. Of all the biomarkers, CRP was significantly correlated with fever (p<0.001). CRP, ESR, calprotectin, lactoferrin, myeloperoxidase, fecal leukocytes, and occult blood were significantly associated with infection with bacterial pathogens (p<0.001, p=0.04, p=0.03, p=0.003, p=0.02, p=0.03, p=0.002, respectively). The combination of CRP and fecal lactoferrin at their best cut-off values (13.7 mg/L and 22.8 µg/mL, respectively) yielded a sensitivity of 72.2%, and a specificity of 95.5% for bacterial etiology compared with their individual use. CONCLUSION: Blood CRP is a useful diagnostic marker for both fever and bacterial etiology in acute pediatric diarrhea. The combination of CRP and fecal lactoferrin yields better diagnostic capability for bacterial etiology than their use alone for acute diarrhea in children without underlying gastrointestinal disease.
Bacterial Infections ; Biomarkers ; Blood Sedimentation ; C-Reactive Protein ; Child ; Diarrhea ; Feces ; Fever ; Gastrointestinal Diseases ; Humans ; Lactoferrin ; Leukocyte L1 Antigen Complex ; Leukocytes ; Multiplex Polymerase Chain Reaction ; Occult Blood ; Pancreatic Elastase ; Peroxidase ; Sensitivity and Specificity

OBJECTIVES: To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes. METHODS: Data from the Korea National Health and Nutrition Examination Survey (2007–2009) were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes. RESULTS: Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, p<0.001 for gastric cancer; 60.5 vs. 71.5%, p<0.001 for breast cancer; and 49.1 vs. 59.6%, p<0.001 for cervical cancer). Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, p<0.001), breast cancer (38.8 vs. 44.6%, p<0.001), and cervical cancer (35.1 vs. 51.2%, p<0.001). In subgroup analyses according to socioeconomic factors, the lifetime and recommended screening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9), and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9). CONCLUSIONS: The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.
Breast ; Breast Neoplasms ; Diabetes Mellitus ; Early Detection of Cancer* ; Female ; Humans ; Korea* ; Male ; Mass Screening ; Multivariate Analysis ; Nutrition Surveys* ; Socioeconomic Factors ; Stomach Neoplasms ; Uterine Cervical Neoplasms

Purpose: This study aimed to evaluate the level of professional ethics awareness and medical ethics competency in order to assess the potential need for ethics items to be included on the Korean Dental Hygienist Licensing Examination. Methods: In total, 358 clinical dental hygienists and dental hygiene students completed a structured questionnaire to evaluate their level of ethical awareness and medical ethics competency. The sub-factors of medical ethics were classified into relationships with patients, medical and social relations, and individual specialized fields. Results: Only 32.1% of participants indicated that they had taken a course on professional ethics in the university curriculum, but 95.2% of respondents considered professional ethics to be important. The overall score for medical ethics competency was average (3.37 out of 5). The score for relationships with patients was 3.75 points, followed by medical and social relations (3.19 points) and individual specialized fields (3.16 points). The level of professional ethics awareness was higher among participants who had taken a course on professional ethics than among those who had not done so or who did not remember whether they had done so. Conclusion Dental hygienists were aware of the importance of professional ethics, but their medical ethics competency was moderate. Therefore, medical ethics should be treated as a required subject in the university curriculum, and medical ethics competency evaluations should be strengthened by adding ethics items to the Korean Dental Hygienist Licensing Examination.