OBJECTIVES: Environmental, social and personal factors influence eating patterns. This study aimed to investigate the relationship between unhealthy food outlets within a residential area and obesity using nationally representative Korean survey data and data from the Census on Establishments. METHODS: Data on the food intakes and socioeconomic variables of a total of 9,978 adults aged ≥ 19 years were obtained from the 2013-2014 Korea National Health and Nutrition Examination Survey. Geographic locations of restaurants were obtained from the 2013 Census on Establishments in Korea. Administrative area was categorized into tertiles of count of unhealthy food outlets based on the distribution of number of unhealthy food outlets among all urban (Dong) and rural (Eup or Myun) administrative districts in Korea. Multilevel logistic regressions model were used to assess the association between the number of unhealthy food outlets and obesity. RESULTS: People living in the district with the highest count of unhealthy food outlets had higher intakes of fat (45.8 vs. 44.4 g/day), sodium (4,142.6 vs. 3,949.8 mg/day), and vitamin A (753.7 vs. 631.6 µgRE/day) compared to those living in the district with the lowest count of unhealthy food outlets. A higher count of unhealthy food outlets was positively associated with frequent consumption of instant noodles, pizza, hamburgers and sandwiches, sweets and sour pork or pork cutlets, fried chicken, snacks, and cookies. Higher exposure to unhealthy food outlets was associated with increased odds of obesity (1st vs. 3rd tertile; OR 1.689; 95% CI 1.098-2.599). CONCLUSIONS: A high count of unhealthy food outlets within a residential area is positively associated with the prevalence of obesity in Korea. The results suggest that food environmental factors affects the health outcomes and interventions aiming to restrict the availability of unhealthy food outlets in local neighborhoods may be a useful obesity prevention strategy.
Adult ; Censuses* ; Chickens ; Eating ; Geographic Locations ; Humans ; Korea* ; Logistic Models ; Nutrition Surveys* ; Obesity* ; Prevalence ; Red Meat ; Residence Characteristics ; Restaurants ; Snacks ; Sodium ; Vitamin A

PURPOSE: The purpose of this study was to assess the effects of a medication management program on oral chemotherapy patients. METHODS: A nonequivalent control group ppretest-posttest design was used. Participants were 60 cancer patients (intervention group: 30, control group: 30). The medication management program was provided for 6 weeks. Collected data were analyzed using the SPSS/WIN 21.0 program. RESULTS: Although there were no statistically significant differences, scores of self-efficacy (t=−0.12, p=.902), knowledge (t=0.62, p=.537), medication adherence (t=0.51, p=.610), and staff satisfaction (t=1.44, p=.156) were higher in the experimental group than in the control group. CONCLUSION: There was no significant difference in self-efficacy, knowledge, symptom experience, medication adherence and staff satisfaction. This can be explained by both groups having already received initial instruction concerning basic care when they started to receive chemotherapy. Considering the positive outcome of the medication management program, a specialist nursing effort is needed to improve symptoms and medication adherence. Furthermore, a medication counseling hotline is needed to support the medical staff.
Counseling ; Drug Therapy* ; Hotlines ; Humans ; Medical Staff ; Medication Adherence ; Medication Therapy Management ; Mouth ; Nursing ; Specialization

This randomized controlled trial study aimed to investigate the effects of a lifestyle intervention on metabolic syndrome (MetS) among middle-aged Koreans. A total of 243 middle-aged Koreans with MetS were randomly assigned to either of 2 types of lifestyle intervention for MetS and followed for 12 months. Health examinations and interventions were implemented at 16 regional branch facilities of a Korean medical institution from 2010, following the NCEP-ATP III criteria and recommendations. Lifestyle intervention (LI) group (n = 137) participated in a 12-week multi-component intervention including individual counseling, group sessions, and self-help materials. Basic usual intervention (BI) group (n = 106) was provided with one-page health information sheet on MetS and MetS management at baseline. Prevalence of MetS and each of MetS components, except for low HDL-cholesterol, in both groups were significantly reduced and maintained after the intervention. Notably, prevalence of hypertension and abdominal obesity continued to improve during the follow-up period. Between-group differences in results were not found. Both interventions were effective when they were accompanied with repeated check-ups and notification of MetS status. It is recommended to design clear guidelines for the notification of MetS after MetS screening and to encourage checking MetS status periodically for effective MetS management (KCT 0000446).
Adult ; Combined Modality Therapy ; Directive Counseling/*methods ; Female ; Humans ; Male ; Mass Screening/*methods ; Metabolic Syndrome X/*diagnosis/epidemiology/*therapy ; Middle Aged ; Patient Education as Topic/methods ; *Risk Reduction Behavior ; *Self-Help Groups ; Treatment Outcome

BACKGROUND: Hemolytic specimens contain components that interfere with clinical laboratory results. We evaluated previously published hemolysis indices (HI) and developed an algorithm for differentiating between mechanical hemolysis and immune-mediated hemolysis based on complete blood count (CBC). METHODS: Sixty-three residual EDTA (ethylenediamine tetraacetic acid)-anticoagulated blood specimens were obtained during regular health check-ups, and each specimen was divided into 3 aliquots (A control, B, and C group). Aliquots B and C were mechanically hemolysed by 2 and 5 aspirations, respectively, using a 25-gauge needle before testing; aliquot A was analysed immediately without hemolysis. Additionally, we collected 36 specimens from patients suspected of having immune-mediated hemolysis after thorough reviewing their various laboratory results including direct antiglobulin test. We compared CBC parameters between the groups (A, B, C, D [B+C], and E [immune-mediated hemolysis group]). RESULTS: Our HI scoring system using the sum of red blood cell ghosts, measured hemoglobin-calculated hemoglobin, mean corpuscular hemoglobin concentration-corpuscular hemoglobin concentration mean, and mean platelet volume rather than mean corpuscular hemoglobin, effectively identified mechanical hemolysis; the results were similar to those of previous studies. Furthermore, the HI score using the sum of mean corpuscular volume, red cell distribution width, hemoglobin distribution width, polymorphonuclear %, and neutrophil % differentiated mechanical hemolysis from immune-mediated hemolysis (cut-off, 9; sensitivity, 91.7%; specificity, 92.9%; area under the receiver operating characteristic curve, 0.965 [95% confidence interval, 0.924–0.988]). CONCLUSIONS: The newly developed algorithm may provide effective screening for detecting hemolysis and differential diagnosis of mechanical hemolysis and immune-mediated hemolysis based on CBC results.
Aspirations (Psychology) ; Blood Cell Count ; Coombs Test ; Diagnosis, Differential* ; Edetic Acid ; Erythrocyte Indices ; Erythrocytes ; Hemolysis* ; Humans ; In Vitro Techniques* ; Mass Screening ; Mean Platelet Volume ; Needles ; Neutrophils ; ROC Curve ; Sensitivity and Specificity

The purpose of this study was to determine the characteristics of infants' temperaments and eating behaviors, mothers' eating behaviors and feeding practices in poor eating infants. The participants were 80 infants of 12 - 24 months (27 poor eaters and 53 matched normal controls) from a hospital and a public health center. Mothers were questioned about their eating behaviors and feeding practices, and infants' temperaments, eating behaviors, and nutrient intakes by one day food recall. Subjects were divided by mean nutrient adequacy ratio (MAR, < 0.75; poor eater). Intakes of Ca, P, Fe, Zn, thiamin, riboflavin, niacin, vitamin C, E, folate were below 75% RDA in poor eaters, whereas protein, thiamin, riboflavin, vitamin B6, C, folate exceeded 125% RDA in good eaters. Rhythmicity of infants' temperaments and eating behaviors, restriction of mothers' eating behaviors and feeding practices were significantly lower, whereas activity levels of infants' temperaments were higher than good eaters. In multiple logistic regression model of poor eaters, activity of infants' temperaments (T, OR: 1.19, CI: 1.05 - 1.35) and attention spans of infants' eating behaviors (A, OR: 1.18, CI: 1.03 - 1.35) were significantly positive, whereas rhythmicity of infants' eating behaviors (R, OR: 0.79, CI: 0.67 - 0.94) was significantly negative [E (the logit) = -6.8644 + 0.1712 x T - 0.2337 x R + 0.1641 x A]. Our findings suggest that examination of eating behaviors, feeding practices, and temperaments will help target interventions to improve infants' food intakes, and these variables should be examined at the time of nutrition counseling.
Ascorbic Acid ; Counseling ; Eating* ; Feeding Behavior* ; Folic Acid ; Humans ; Infant* ; Logistic Models ; Mothers ; Niacin ; Periodicity ; Public Health ; Riboflavin ; Temperament* ; Vitamin B 6

BACKGROUND: Androgenic alopecia (AGA) is the most common type of hair loss. It is likely inherited genetically and is promoted by dihydrotestosterone. 5α-reductase has been proven a good target through finasteride use. However, the pathogenesis of AGA cannot be fully explained based only on dihydrotestosterone levels. OBJECTIVE: To identify similar hairloss inhibition activity of RE-ORGA with mode of action other than finasteride. METHODS: We prepared RE-ORGA from Korean herb mixtures. We performed MTT assays for cytotoxicity, Cell Counting Kit-8 assays for cell proliferation, and western blot to identify expression levels of 5α-reductase and Bax. RNA-sequencing was performed for the expression patterns of genes in dihydrotestosterone-activated pathways. Anti-inflammatory activity was also assessed by the expression levels of tumor necrosis factor-alpha (TNF-α) and interleukin 6. RESULTS: REORGA could promote the proliferation of human dermal papilla cells and showed low cytotoxicity. It also inhibited the expression of 5α-reductases and Bax in the cells. RNA-sequencing results verified that the mRNA expressions of SRD5A1, Bax, transforming growth factor-beta 1 (TGF-β1), and TGF-β1 induced transcript 1 (TGFβ1I1) were decreased, whereas expression of protein tyrosine kinase 2 beta (PTK2β) was more elevated. REORGA also showed anti-inflammatory activity through decreased mRNA levels of TNF-α. CONCLUSION: Transcriptionally, up-regulation of PTK2β and concomitant down-regulation of TGFβ1I1 imply that RE-ORGA can modulate androgen receptor sensitivity, decreasing the expression of 5α-reductase type II and Bax together with TGF-β1 transcripts; RE-ORGA also showed partial anti-inflammatory activity. Overall, RE-ORGA is expected to alleviate hair loss by regulating 5α-reductase activity and the receptor's androgen sensitivity.
Alopecia ; Blotting, Western ; Cell Count ; Cell Proliferation ; Cholestenone 5 alpha-Reductase ; Dihydrotestosterone ; Down-Regulation ; Finasteride ; Hair ; Humans ; Interleukin-6 ; Protein-Tyrosine Kinases ; Receptors, Androgen ; RNA, Messenger ; Tumor Necrosis Factor-alpha ; Up-Regulation

The purpose of this study was to develop and validate a competency tool for new nurses and to pilot-test it with new nurses. A Delphi survey was conducted to develop a competency tool, and a self-evaluation was conducted among new nurses who pilot-tested the finally derived competencies. The Delphi survey panel consisted of 18 people, including adjunct professors at the College of Nursing, nursing managers, and nurses with master’s degrees. The Delphi survey asked about the validity of the competencies constructed in two rounds. After analyzing the Delphi results with mean, standard deviation, content validity ratio, degrees of convergence, and degrees of consensus, 12 core competencies and 36 enabling competencies were finally derived. The competencies consisted of clinical judgment and management (nine items), task competence (four items), patient orientation (five items), moral value orientation (three items), cooperation (two items), supply management (two items), professional development (three items), confidence (one item), self-control (two items), flexibility (two items), influence (one item), and nurturing others (two items). The finally derived competencies were pilot-tested with 229 new nurses who had worked for 2–12 months. The self-evaluation scores of new nurses were distributed differently according to their working period. In this study, the competencies required for new nurses were identified and the corresponding enabling competencies were identified. In the future, it is expected that a competency-based education program will be prepared based on these findings, and furthermore, it will be possible to provide high-quality medical and nursing services that meet patients’ needs by improving the competency of new nurses and lowering the turnover rate.

Purpose: Our study aimed to delve beyond a surface-level understanding and explore the various dimensions of the global health curriculum from the perspective of both learners and educators using the Context, Input, Process, and Product (CIPP) model. Methods: From 2020 to 2021, interviews were conducted with a total of 10 individuals, including five students who had taken at least one elective course and at least one elective research course, three teaching assistants (TA), and two faculty members who had taken more than four global health courses in multiple phases in the global health curriculum. Semi-structured interview questions based on the CIPP model were used and qualitative data were analyzed through content analysis. Results: The study identified 12 sub-themes. Students held idealized views of global health careers and sought to bridge the gap through global health classes. They desired early exposure to global health courses, emphasizing both pre-medical and clinical phases. Challenges in adjusting course difficulty and recruiting faculty were identified, along with a preference for interactive teaching methods and offline discussions. The curriculum promoted reflection on medicine’s essence, expanded career perspectives, and emphasized competencies like altruism, communication skills, and crisis management in the evolving global health landscape. Conclusion This study showed that a comprehensive approach is possible from the perspective of learners and educators by identifying strengths, weaknesses, and the value of the curriculum’s goals, plans, implementations, and results through the CIPP model. For optimal curriculum design, a sequential approach from basic to advanced courses is essential, promoting hands-on global health experiences for students.

Depressive disorder is a common mental illness and remains a major cause of morbidity worldwide. The present study, a cross-sectional, nationwide, population-based survey assessed the prevalence of depression in the general population of Korea through a random sampling of the non-institutionalized population for the Korea National Health and Nutrition Examination Survey (KNHANES) VI. The Patient Health Questionnaire (PHQ)-9 was first introduced into the KNHANES to detect depression. The point prevalence of depression (PHQ score of 10 or higher) was 6.7% (95% confidence interval [CI], 5.7–7.6) in 4,949 subjects. Based on the analysis using the diagnostic algorithm of the PHQ-9, the prevalence of major depressive disorder was 2.7% (95% CI, 2.2–3.3). Multiple logistic regression analysis, after adjusting the sociodemographic variables, also showed that the factors associated with depression were perceived stress and health status. This study reported for the first time that the point prevalence of depression screened using the PHQ-9 in this nationwide survey of the Korean population was similar to that of the western countries. As the KNHANES to detect depression is conducted biennially, further studies on the accumulated data are expected in the future.
Depression* ; Depressive Disorder ; Depressive Disorder, Major ; Humans ; Korea* ; Logistic Models ; Nutrition Surveys* ; Prevalence*

BACKGROUND: Health maintenance and monitoring of transplant candidates, the great majority of whom are undergoing chronic dialysis, can be a determinant of post-transplant prognosis. New issues such as malignancy, inflammation, cardiovascular disease, and psychosocial problems might arise among potential recipients, which may lead to cancellation of the transplantation. METHODS: A questionnaire, including questions regarding follow-up monitoring, was sent to 66 transplant centers, and responses to the survey were obtained from 35 centers (53%). A similar questionnaire was sent to 217 wait-listed patients, and 164 (76%) responded. RESULTS: Regular contact between the transplant center and patients was maintained by only 37% of the centers. No consistent pattern of contact was observed for 11%. Sixty percent of the centers monitored patients by telephone. Three-fourths of the transplant centers monitored their patients annually or every 6 months. A cancer screening program was run by only 17% of the centers, and 29% did not routinely request cardiac screening. Most centers (83%) informed their patients of the features of marginal kidneys. However, many patients (69%) reported not hearing about marginal kidneys, and 43% indicated that a cadaver transplant was cancelled because of a cadaver donor problem. CONCLUSIONS: Our survey indicates that the necessity for routine follow-up monitoring is broadly recognized by 86% of transplant centers and 78% of wait-listed patients However, no formal monitoring guidelines currently exist for wait-listed patients in Korea. Therefore, guidelines are absolutely necessary for improving the quality of post-transplant life.
Cadaver ; Cardiovascular Diseases ; Dialysis ; Early Detection of Cancer ; Follow-Up Studies ; Hearing ; Humans ; Inflammation ; Kidney ; Kidney Transplantation ; Korea ; Mass Screening ; Prognosis ; Surveys and Questionnaires ; Telephone ; Tissue Donors ; Transplants ; Waiting Lists