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: 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

OBJECTIVE: Removal of blood from subarachnoid space with a lumbar drainage (LD) may decrease development of cerebral vasospasm. We evaluated the effectiveness of a LD for a clinical vasospasm and outcomes after clipping of aneurysmal subarachnoid hemorrhage (SAH). METHODS: Between July 2008 and July 2013, 234 patients were included in this study. The LD group consisted of 126 patients, 108 patients in the non LD group. We investigated outcomes as follow : 1) clinical vasospasm, 2) angioplasty, 3) cerebral infarction, 4) Glasgow outcome scale (GOS) score at discharge, 5) GOS score at 6-month follow-up, and 6) mortality. RESULTS: Clinical vasospasm occurred in 19% of the LD group and 42% of the non LD group (p<0.001). Angioplasty was performed in 17% of the LD group and 38% of the non LD group (p=0.001). Cerebral infarctions were detected in 29% and 54% of each group respectively (p<0.001). The proportion of GOS score 5 at 6 month follow-up in the LD group was 69%, and it was 58% in the non LD group (p=0.001). Mortality rate showed 5% and 10% in each group respectively. But, there was no difference in shunt between the two groups. CONCLUSION: LD after aneurysmal SAH shows marked reduction of clinical vasospasm and need for angioplasty. With this technique we have shown favorable GOS score at 6 month follow-up.
Aneurysm ; Angioplasty ; Cerebral Infarction ; Cerebrospinal Fluid* ; Drainage* ; Follow-Up Studies ; Glasgow Outcome Scale ; Humans ; Mortality ; Subarachnoid Hemorrhage* ; Subarachnoid Space ; Surgical Instruments* ; Vasospasm, Intracranial*

OBJECTIVES: The current survey environment is changing and participation rates in national nutrition surveys are decreasing. Therefore, the purpose of this study was to develop strategies for improving the nutrition survey system in the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: To develop an alternative system for conducting the KNHANES nutritional survey, we conducted focus group interviews with stakeholders of the survey, SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, and expert reviews. In addition, spatial analysis of potential sites for conducting surveys instead of relying on household visits was performed, and the perception of nutritional surveys in the population eligible for KNHANES was evaluated. RESULTS: Based on the results of the focus group interviews, SWOT analysis, and expert reviews, we propose two options for survey sites: vehicles specifically prepared for nutritional surveys and public facilities such as community service centers or public health centers. Among public facilities, community service centers were found to be more appropriate sites than public health centers because they were considered more accessible. About 90% of respondents would participate in the survey in public facilities and about 74% would in vehicles. CONCLUSIONS: Conducting national nutrition surveys in specially designed vehicles and public facilities could be a viable alternative to home visits. Next, the validity of these newly proposed nutrition survey methods needs to be compared to the results of the current national nutrition survey.
Family Characteristics ; Focus Groups ; House Calls ; Korea ; Nutrition Surveys ; Public Facilities ; Public Health ; Social Welfare ; Spatial Analysis ; Surveys and Questionnaires

OBJECTIVES: The current survey environment is changing and participation rates in national nutrition surveys are decreasing. Therefore, the purpose of this study was to develop strategies for improving the nutrition survey system in the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: To develop an alternative system for conducting the KNHANES nutritional survey, we conducted focus group interviews with stakeholders of the survey, SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, and expert reviews. In addition, spatial analysis of potential sites for conducting surveys instead of relying on household visits was performed, and the perception of nutritional surveys in the population eligible for KNHANES was evaluated. RESULTS: Based on the results of the focus group interviews, SWOT analysis, and expert reviews, we propose two options for survey sites: vehicles specifically prepared for nutritional surveys and public facilities such as community service centers or public health centers. Among public facilities, community service centers were found to be more appropriate sites than public health centers because they were considered more accessible. About 90% of respondents would participate in the survey in public facilities and about 74% would in vehicles. CONCLUSIONS: Conducting national nutrition surveys in specially designed vehicles and public facilities could be a viable alternative to home visits. Next, the validity of these newly proposed nutrition survey methods needs to be compared to the results of the current national nutrition survey.
Family Characteristics ; Focus Groups ; House Calls ; Korea ; Nutrition Surveys ; Public Facilities ; Public Health ; Social Welfare ; Spatial Analysis ; Surveys and Questionnaires

Purpose: This study was conducted to assess the effects of a personalized nutritional intervention program on food security and health and nutritional status of elderly people in the city of Seoul. Methods: A total of 372 elderly adults aged 65 years or above who resided in Seoul were enrolled in this study. Personalized supplementary food supply and nutritional education based on chronic disease status, disability and cooking ability were implemented for 4 months. To evaluate the effectiveness of the program, nutrient intake, food security status, anemia status, chronic disease management, and frailty status, and prevalence of malnutrition (Mini Nutritional Assessment) were examined. Results: After the program, all subjects displayed significantly increased nutrient intake.Before the intervention, all subjects were in a state of food insecurity; however, after the intervention, 37.1% of the subjects were food secure. Moreover, the rates of being at risk of malnutrition and malnutrition in subjects were decreased and instead rate of those who improved to normal increased to 29.8% from 0% of normal rate before the prevention. The rate of subjects without anemia increased from 18.7% to 28.5% after the intervention. In addition, the rate of subjects with intensive or periodic management of chronic diseases decreased, while those with occasional management of chronic diseases increased from 0% to 4.6%. Furthermore, the rates of being at risk of frailty and frailty were decreased and the normal rate increased from 0% to 9.7% instead. Age group-based analysis showed that elderly people over 80 years showed less improvement in the management of the chronic disease status and the frailty status. Conclusion Personalized supplementary food supplies and nutritional education improved not only the nutritional status but also disease status in vulnerable older adults, and the effects were more significant in adults aged less than 80 years.

An accurate assessment of the recommended calcium (Ca) intake may contribute to reducing the risk of fractures and chronic diseases, ultimately improving quality of life.This review was performed to summarize key findings of Ca studies, investigate the effect of Ca intake on health outcomes, and determine the adequacy of evidence to revise the 2015 Dietary Reference Intakes for Koreans (KDRIs) for Ca in 2020. Databases were searched for intervention studies that assessed health outcomes by providing Ca in diets or as supplements. The framework of the systematic review comprised conducting literature searches, data extraction, quality assessment of the literature, and summarizing key findings relevant to set the Estimated Average Requirement (EAR) and Tolerable Upper Intake Level (UL) for Ca for the 2020 KDRI. The final search was performed in June 2019. A total of 13,309 studies were identified through databases and manual search. Sixtyfive studies were included in the final quality assessment and were summarized according to health indicators. As bone health was used as an indicator of the EAR for Ca, literature reports on bone health were further categorized by the life-cycle stage of the participants. This systematic review did not find new evidence that could be applied to the general Korean adult population, including postmenopausal women, for defining a new EAR for Ca in the 2020 KDRIs. Evidence in most of the reviewed literature was considered weak; however, some evidence was found that could improve the criteria on how the EAR for Ca was determined in children and adolescents. A review of the literature for the 2020 KDRIs for Ca did not find strong evidence in order to change the recommended values of the 2015 KDRIs. More clinical interventions are required among Koreans to strengthen the body of evidence to warrant the revision of the KDRIs.

PURPOSE: Proprotein convertase subtilisin/kexin type 9 (PCSK9) binds to the low density lipoprotein receptor (LDLR) and promotes degradation of the LDLR. Inhibition of PCSK9 either by reducing its expression or by blocking its activity results in the upregulation of the LDLR and subsequently lowers the plasma concentration of LDL-cholesterol. As a modality to inhibit PCSK9 action, we searched the chemical library for small molecules that block the binding of PCSK9 to the LDLR. MATERIALS AND METHODS: We selected 100 chemicals that bind to PCSK9 where the EGF-AB fragment of the LDLR binds via in silico screening of the ChemBridge chemical library, using the computational GOLD algorithm analysis. Effects of chemicals were evaluated using the PCSK9-LDLR binding assay, immunoblot analysis, and the LDL-cholesterol uptake assay in vitro, as well as the fast performance liquid chromatography assay for plasma lipoproteins in vivo. RESULTS: A set of chemicals were found that decreased the binding of PCSK9 to the EGF-AB fragment of the LDLR in a dose-dependent manner. They also increased the amount of the LDLR significantly and subsequently increased the uptake of fluorescence-labeled LDL in HepG2 cells. Additionally, one particular molecule lowered the plasma concentration of total cholesterol and LDL-cholesterol significantly in wild-type mice, while such an effect was not observed in Pcsk9 knockout mice. CONCLUSION: Our findings strongly suggest that in silico screening of small molecules that inhibit the protein-protein interaction between PCSK9 and the LDLR is a potential modality for developing hypercholesterolemia therapeutics.
Animals ; Cholesterol/*blood ; Cholesterol, LDL/blood ; Hep G2 Cells ; Humans ; Mice ; Mice, Knockout ; Proprotein Convertases/*metabolism ; Receptors, LDL/*metabolism ; Serine Endopeptidases/*metabolism ; *Small Molecule Libraries

Objective: Underconnectivity in the resting brain is not consistent in autism spectrum disorder (ASD). However, it is known that the functional connectivity of the default mode network is mainly decreased in childhood ASD. This study investigated the brain network topology as the changes in the connection strength and network efficiency in childhood ASD, including the early developmental stages. Methods: In this study, 31 ASD children aged 2–11 years were compared with 31 age and sex-matched children showing typical development. We explored the functional connectivity based on graph filtration by assessing the single linkage distance and global and nodal efficiencies using resting-state functional magnetic resonance imaging. The relationship between functional connectivity and clinical scores was also analyzed. Results: Underconnectivities within the posterior default mode network subregions and between the inferior parietal lobule and inferior frontal/superior temporal regions were observed in the ASD group. These areas significantly correlated with the clinical phenotypes. The global, local, and nodal network efficiencies were lower in children with ASD than in those with typical development. In the preschool-age children (2–6 years) with ASD, the anterior-posterior connectivity of the default mode network and cerebellar connectivity were reduced. Conclusion The observed topological reorganization, underconnectivity, and disrupted efficiency in the default mode network subregions and social function-related regions could be significant biomarkers of childhood ASD.