PURPOSE: This study evaluated the acquisition and retention effects on diabetes knowledge and academic self-efficacy of patient simulation-based hypoglycemia scenario using a high-fidelity simulator. METHODS: A nonequivalent control group pretest/posttest repeated measures quasi-experimental design determined if nursing simulation using a high-fidelity simulator helps students acquire and retain diabetes knowledge and academic self-efficacy. A total of 101 nursing students from two universities participated in this study, comprising the experimental and control groups. The experimental group (n=52) at a university in S city comprised participants in an adult nursing class, nursing practicum, and simulation education. The control group (n=49) at a university in C city participated in an adult nursing class and nursing practicum without simulation education. RESULTS: The experimental group had statistically significant group-time interaction effects on diabetes knowledge (p=.044) and self-confidence (p<.001) of academic self-efficacy compared to the control group. CONCLUSION: The results indicated that the patient simulation-based hypoglycemia scenario using a high-fidelity simulator applied to nursing education is useful in encouraging nursing students to engage in strategies with acquisition and retention effects, enhancing their diabetes knowledge and self-confidence of academic self-efficacy. Therefore, educators should use simulation programs effectively with nursing classes and practicum to enhance the effects of nursing competencies.
Adult ; Education ; Education, Nursing ; Humans ; Hypoglycemia* ; Nursing* ; Patient Simulation ; Self Efficacy ; Students, Nursing*

PURPOSE: DIR image is relatively free from susceptibility artifacts therefore, DIR image can make it possible to reliably measure cortical thickness/volume. One drawback of the DIR acquisition is the long scan time to acquire the fully sampled 3D data set. To solve this problem, we applied a parallel imaging method (GRAPPA) and verify the reliability of using the volumetric study. MATERIALS AND METHODS: Six healthy volunteers (3 males and 3 females; age 25.33+/-2.25 years) underwent MRI using the 3D DIR sequence at a 3.0T Siemens Tim Trio MRI scanner. GRAPPA simulation was performed from the fully sampled data set for reduction factor 2. Data reconstruction was performed using MATLAB R2009b. Freesurfer v.4.3.0 was used to evaluate the cortical thickness of the entire brain, and to extract white matter information from the DIR image, Analyze 9.0 was used. The global cortical thickness estimated from the reconstructed image was compared with reference image by using a T-test in SPSS. RESULTS: Although reduced SNR and blurring are observed from the reconstructed image, in terms of segmentation the effect was not so significant. The volumetric result was validated that there were no significant differences in many cortical regions. CONCLUSION: This study was performed with DIR image for a volumetric MRI study. To solve the long scan time of 3D DIR imaging, we applied GRAPPA algorithm. According to the results, fast imaging can be done with reduction factor 2 with little loss of image quality at 3.0T.
Artifacts ; Brain ; Humans ; Male

PURPOSE: DIR image is relatively free from susceptibility artifacts therefore, DIR image can make it possible to reliably measure cortical thickness/volume. One drawback of the DIR acquisition is the long scan time to acquire the fully sampled 3D data set. To solve this problem, we applied a parallel imaging method (GRAPPA) and verify the reliability of using the volumetric study. MATERIALS AND METHODS: Six healthy volunteers (3 males and 3 females; age 25.33+/-2.25 years) underwent MRI using the 3D DIR sequence at a 3.0T Siemens Tim Trio MRI scanner. GRAPPA simulation was performed from the fully sampled data set for reduction factor 2. Data reconstruction was performed using MATLAB R2009b. Freesurfer v.4.3.0 was used to evaluate the cortical thickness of the entire brain, and to extract white matter information from the DIR image, Analyze 9.0 was used. The global cortical thickness estimated from the reconstructed image was compared with reference image by using a T-test in SPSS. RESULTS: Although reduced SNR and blurring are observed from the reconstructed image, in terms of segmentation the effect was not so significant. The volumetric result was validated that there were no significant differences in many cortical regions. CONCLUSION: This study was performed with DIR image for a volumetric MRI study. To solve the long scan time of 3D DIR imaging, we applied GRAPPA algorithm. According to the results, fast imaging can be done with reduction factor 2 with little loss of image quality at 3.0T.
Artifacts ; Brain ; Humans ; Male

Objectives: This study explored the community food environmental factors affecting food purchasing using a qualitative research methodology for the elderly as well as the various food environments under their socioeconomic diversity. Methods: For the qualitative data collection, this study interviewed 20 elderly people aged 65 years or more, who participated in a public health program or lunch services operated by the senior welfare center in Seoul. Five dimensions, such as availability, physical accessibility, affordability, acceptability, and accommodation suggested in previous studies, were used to identify the community food environmental factors. Results: The elderly participants showed overall similarities to the concepts derived from existing studies on the five dimensions of food accessibility environment. In addition, other important food accessibility environmental factors that were not present in previous studies, such as acceptability for a product of domestic origin, delivery service to home, and small-packaged food sales, were derived. On the other hand, the concept of some subjects differed depending on the household income and specifically for the physical accessibility concept. This showed that the close distance factor from a grocery store at home might not apply to older adults in low-income households in Korea. Conclusions This study found that five dimensions of the food environment suggested by previous studies could also be applied to vulnerable older adults in Korea. On the other hand, the socioeconomic characteristics of individuals and households would affect the perspectives of their local food environments differently. The findings of this study could help in the development of tools for evaluating the community food environment.

PURPOSE: The purpose of this study is to identify the dietary habits of Korean adolescents and to investigate their effects on sleep duration. METHODS: This study is a secondary analysis drawn from the 2016 Korean Youth Risk Behavior Web-Based Survey (N=65,528). ANCOVA was used to determine the relationship between dietary habits and sleep duration. Ordinal logistic regression was used to find out the effects of dietary habits on sleep duration adjusted for general characteristics and behavioral characteristics. RESULTS: The group that consumed no breakfast (AOR=0.89, p < .001) had less sufficient sleep duration than those who had breakfast 7 times per week. The group that had drunk no milk (AOR=0.88, p < .001) had less sufficient sleep duration than those who enjoyed it 5 times per week. On the contrary, the groups that had no soda drinks (AOR=1.18, p=.015), caffeine drinks (AOR=1.77, p < .001), and sweet drinks (AOR=1.25, p < .001) were more likely to have sufficient sleep duration than the groups that consumed those beverages 5 times per week. CONCLUSION: It is important to educate adolescents about healthy eating habits including drinks and optimal sufficient sleep duration through a multidisciplinary approach.
Adolescent ; Beverages ; Breakfast ; Caffeine ; Diet ; Eating ; Food Habits ; Humans ; Logistic Models ; Milk ; Risk-Taking

BACKGROUND/OBJECTIVES: Recent studies have reported chocolate consumption has beneficial effects on blood pressure, obesity, and dyslipidemia, which are components of metabolic syndrome (MetS). However, evidence regarding these relationships in Asia is limited. The aim of this study was to investigate relations between chocolate consumption and MetS in Korea. SUBJECTS/METHODS: Study subjects were 6,982 adults aged 19-64 years free of major chronic diseases that participated in the 2014–2016 Korea National Health and Nutrition Examination Survey. Information on chocolate consumption was obtained using food frequency questionnaires. For primary analysis, subjects were divided into two groups:non-consumer (n = 3,741, 53.6%); consumer (n = 3,241, 46.4%). In order to investigate doseresponse effects on MetS, chocolate consumers were divided into quartiles based on amounts consumed: Q1 (n = 789, 24.3%); Q2 (n = 837, 25.8%); Q3 (n = 863, 26.6%); Q4 (n = 752, 23.2%) in second analysis. RESULTS: Chocolate consumers; 1) were more physically active(P < 0.0001); 2) less likely to smoke(P < 0.0001); 3) paid more attention to food nutrition labels (P < 0.0001), and 4) had healthier dietary patterns, that is, they consumed vegetables, fruits, and dairy products more frequently(P < 0.0001) than non-consumers. Furthermore, chocolate consumers had a 30% lower risk of MetS (odds ratio, 0.70; 95% confidence interval, 0.58–0.86; P = 0.0005).However, dose-response effects between chocolate intake and MetS was not found by secondary analysis after excluding non-consumers. CONCLUSIONS In conclusion, chocolate consumers had healthier lifestyles and dietary patterns and a lower prevalence of MetS than non-consumers, as determined by our primary analysis. Although dose-response effects were not found to be significant among chocolate consumers during secondary analysis, the patterns were partially similar. This cross-sectional finding shows chocolate consumption does not increase the risk of MetS. The prospective studies and intervention trials in Korea are needed to confirm this cross-sectional finding.

Purpose: This study examined the factors affecting mortality and clinical severity score (CSS) of male and female patients with Coronavirus Disease 2019 (COVID-19) using clinical epidemiological information provided by the Korea Disease Control and Prevention Agency. Methods: This is a retrospective, observational cohort study. From January 21 to April 30, 2020, a total of 5624 patients who were released from quarantine or died were analyzed. Results: The factors influencing release or death that differed by sex were high heart rate and malignancy in males and chronic kidney disease in females. In addition, the factors influencing progression to severe CSS were high BMI (severe obesity) and rheumatic disease in males and high temperature, sputum production, absence of sore throat and headache, chronic kidney disease, malignancy, and chronic liver disease in females. Older age, low lymphocyte count and platelets, dyspnea, diabetes mellitus, dementia, and intensive care unit (ICU) admission affected mortality in all the patients, and older age, low lymphocyte count and platelets, fever, dyspnea, diabetes mellitus, dementia, and ICU admission affected progression to severe stage of CSS. Conclusions This study is expected to contribute to the general results by analyzing nationally representative data. The results of this study present an important basis for development of differentiated nursing and medical management strategies in consideration of factors that influence treatment effects and outcomes according to sex of patients with COVID-19.

PURPOSE: The purpose of this study was to evaluate the effects of a communication course with lecture, small group activity and music therapy for nursing students, compared to a conventional lecture course. METHODS: The design of this study was a nonequivalent control group with a pre-post test. Data were collected by questionnaires from 166 nursing students from Y University, Seoul, Korea, with 92 in the experimental group and 74 in the control group. A 13 session program with lecture, small group activity and music therapy was given to the experimental group in 2008, while a conventional lecture course was given to the control group in 2007. The data were analyzed using descriptive statistics, and independent/paired t-tests. RESULTS: There were no significant differences in interpersonal communications or relationships change between the experimental and control group. We found that which area in interpersonal communication and relationships had a positive effect in each course. CONCLUSION: The results indicate a need to consider the characteristics of students and thoroughly prepare for operational difficulties in advance of effectively administering various instructional methods in communication courses for nursing students in the second year.
Evaluation Studies as Topic ; Humans ; Interpersonal Relations ; Korea ; Music Therapy ; Music* ; Surveys and Questionnaires ; Seoul ; Students, Nursing

PURPOSE: To investigate the effect of cardiac knowledge and cardiac self-efficacy on health behaviors after controlling for influences from associating factors of health behaviors in patients with coronary artery diseases (CADs). METHODS: A descriptive correlational and cross-sectional design was used. Subjects with CADs were recruited from outpatient clinics of three academic medical centers. The cardiac knowledge, cardiac self-efficacy, and health behaviors were measured by Coronary Heart Disease Awareness and Knowledge Questionnaire, Cardiac Self-Efficacy Scale, and Health-Promoting Lifestyle Profile II respectively. The data collected were statistically analyzed by descriptive statistics, t test, Kruskal-Wallis test, analysis of variance, Pearson's correlation analysis, and the hierarchical multiple regression analysis. RESULTS: A total of 157 subjects were recruited for this study. The mean age of subjects was 59.38 +/- 10.04 years, and three-fourths (75.2%) were male. Subjects showed relatively low cardiac knowledge, moderately high cardiac self-efficacy, and moderate level of health behaviors. The overall model significantly explained 48% of variance in health behaviors (F = 14.52, p < .001). Among predictors, age, education, smoking status, experience of receiving patient education, and cardiac self-efficacy significantly affected health behaviors, and cardiac self-efficacy had the greatest effect on health behaviors (beta = .39). However, cardiac knowledge had no statistically significant influence on health behaviors after controlling for the other factors. CONCLUSION: The findings suggested that cardiac self-efficacy was shown to be the most influencing factor on health behaviors but cardiac knowledge had no influence on health behaviors. The nursing interventions tailored on the patient characteristics should be developed in order to improve the health behaviors of patients with CADs.
Academic Medical Centers ; Ambulatory Care Facilities ; Coronary Artery Disease ; Coronary Disease ; Coronary Vessels ; Health Behavior ; Health Status ; Humans ; Life Style ; Male ; Patient Education as Topic ; Smoke ; Smoking ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to investigate the effects of simulation in nursing education based on caring for elderly cognition disorder patients. The education consisted of a caring program for patients that included a process of assessment of a patient's mental status, diagnosis of the patient's health condition, and intervention to address the problems by using therapeutic communication. METHODS: A nonequivalent control group pretest-posttest design was used. A total of 69 subjects (undergraduate students) participated in the education and they were assigned to two groups: the experimental group (n=32) and the control group (n=37). Data-gathering structured questionnaires that included communication competence, academic self-efficacy, and attitudes about the elderly. The data were collected from October 2013 to December 2013, and statistical analyses were conducted with-test and t-test using the SPSS 21.0 program. RESULTS: With respect to education, there was significant improvement in communication competence in the experiment group (t=2.41, p=.022) compared with in the control group (t=.69, p=.494). However, there was no statistically significant difference in academic self-efficacy and attitude about the elderly. CONCLUSION: Simulation-based education should continue to be developed further for better elderly-patient care. Integrated education in particular using a high-fidelity simulator will contribute to improvements in nursing competence in this area.
Aged* ; Cognition ; Cognition Disorders ; Diagnosis ; Education* ; Education, Nursing ; Humans ; Learning* ; Mental Competency* ; Nursing ; Patient Simulation ; Surveys and Questionnaires ; Students, Nursing*