BACKGROUND/OBJECTIVES: Vitamin K (VK) plays a key role in regulating calcium homeostasis in bone and soft tissues and may be associated with physical function (PF), handgrip strength (HGS), and mortality; however, nationally-representative studies are scarce. SUBJECTS/METHODS: In this cross-sectional study, we assessed the association of VK intake with PF, HGS, and mortality in adults aged 50 and older using data from the National Health and Nutrition Examination Survey 2003–2016 (n = 4,950). VK intake was assessed using two 24-h dietary recalls and dietary supplement use questionnaires and categorized as < or ≥ the Adequate Intake (AI). Self-reported PF was categorized into 5 activities (activities of daily living, instrumental activities of daily living [IADL], lower extremity mobility [LEM], general physical activities, and leisure and social activities). HGS was measured using a grip strength dynamometer. Linear models, odds ratios, and Cox proportional hazards analyses were performed. All analytical models were adjusted for potential confounders. RESULTS: VK intake meeting the AI was associated with a 0.60-fold (95% confidence interval [CI], 0.43–0.84) and 0.64-fold (95% CI, 0.47–0.89) decrease in the odds of IADL and LEM difficulty, respectively. When stratified by sex, these associations were significant only in males. However, VK intake was not associated with HGS or mortality. CONCLUSION VK intake meeting the AI is associated with lower odds of impaired IADL and LEM, especially in males.

Objectives: Although diet quality is known to be associated with environment and individuals’ characteristics, these have not been studied together. We determined the association of diet quality with regional factors stratified by individuals’ sociodemographic characteristics. Methods: This study used nationally representative survey data on regional factors (2010–2020) and the Korea National Health and Nutrition Examination Survey data on individuals’ sociodemographic characteristics (2013–2018). Community-dwelling Koreans aged ≥ 20 were included (n = 26,853). Regions were categorized into metropolitan cities or provinces and subsequently according to regional factors (level of educational attainment, income per capita, food security status, physical activity facilities, time to the nearest large retailer, and internet use of the region). Individuals’ sociodemographic characteristics included age, education status, income, and number of household members. Diet quality was assessed using the Korean Healthy Eating Index (KHEI). Results: In the entire population, education status of metropolitan cities was positively associated with the KHEI. Shorter time to retailers and higher internet use were positively associated with the KHEI in metropolitan residents with higher income levels but negatively associated with the KHEI in those with lower income status. Among provincial residents with a low education status or income, regional physical activity facilities were positively associated with the KHEI. Conclusion The association between diet quality and regional factors varied depending on the resident’s sociodemographic characteristics. Both regional and individual sociodemographic factors must be considered to address gaps in nutritional equity.

Background: The association between diet quality (DQ) and osteoarthritis (OA) among the Asian population is unclear. Even within this population, the associations between DQ and OA may differ by region. We examined the relationship between DQ and radiologic knee OA (RKOA) among Koreans, stratifying participants by residential area. Methods: This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey conducted in 2013. A total of 2,222 participants aged 50 years old and older with available data on RKOA and DQ were analyzed. DQ was evaluated using the Korean Healthy Eating Index (KHEI). RKOA was diagnosed via radiography and defined as having a Kellgren-Lawrence grade ≥2 in the knee. Participants were categorized by residential region: metropolitan cities, small to medium-sized cities, or rural areas. The odds ratios for RKOA across the three regions were analyzed using multiple logistic regression, adjusting for confounding factors. Results: High KHEI scores were associated with lower odds of RKOA (P for trend=0.03). This association was primarily observed in residents of metropolitan cities, particularly among men (P for trend=0.02). Conclusions Better DQ is associated with reduced odds of RKOA in older Korean adults living in metropolitan areas.

Purpose: To investigate the effects of honey-based oral care on the oral health of patients with stroke undergoing rehabilitation. Methods: In this randomized controlled trial, 44 stroke patients from a tertiary hospital’s rehabilitation ward were assigned to receive either honey-based oral care or normal saline, with treatments administered twice daily for 2 weeks. The study, conducted from November 2021 to August 2022, employed a double-blind method, blinding both participants and evaluators to treatment allocations. The key outcomes measured included oral status, dental plaque index (DPI), and xerostomia. The final analysis included 13 patients in the experimental group and 16 in the control group. Results: The intervention significantly changed the oral status, DPI, and xerostomia between the groups. The experimental group showed significantly improved oral status (Z = −4.63, p < .001), DPI (Z = −4.58, p < .001), and xerostomia (t = −6.33, p < .001) compared with the control group. The experimental group showed significant improvements in oral status (Z = −3.27, p = .001), DPI (Z = −3.19, p = .001), and xerostomia (t = 7.37, p < .001) after the intervention, confirming the efficacy of honey-based oral care. Conclusions Honey-based oral care effectively improves oral status and xerostomia, and reduces DPI in patients with stroke.

Purpose: To investigate the effects of honey-based oral care on the oral health of patients with stroke undergoing rehabilitation. Methods: In this randomized controlled trial, 44 stroke patients from a tertiary hospital’s rehabilitation ward were assigned to receive either honey-based oral care or normal saline, with treatments administered twice daily for 2 weeks. The study, conducted from November 2021 to August 2022, employed a double-blind method, blinding both participants and evaluators to treatment allocations. The key outcomes measured included oral status, dental plaque index (DPI), and xerostomia. The final analysis included 13 patients in the experimental group and 16 in the control group. Results: The intervention significantly changed the oral status, DPI, and xerostomia between the groups. The experimental group showed significantly improved oral status (Z = −4.63, p < .001), DPI (Z = −4.58, p < .001), and xerostomia (t = −6.33, p < .001) compared with the control group. The experimental group showed significant improvements in oral status (Z = −3.27, p = .001), DPI (Z = −3.19, p = .001), and xerostomia (t = 7.37, p < .001) after the intervention, confirming the efficacy of honey-based oral care. Conclusions Honey-based oral care effectively improves oral status and xerostomia, and reduces DPI in patients with stroke.

Purpose: To investigate the effects of honey-based oral care on the oral health of patients with stroke undergoing rehabilitation. Methods: In this randomized controlled trial, 44 stroke patients from a tertiary hospital’s rehabilitation ward were assigned to receive either honey-based oral care or normal saline, with treatments administered twice daily for 2 weeks. The study, conducted from November 2021 to August 2022, employed a double-blind method, blinding both participants and evaluators to treatment allocations. The key outcomes measured included oral status, dental plaque index (DPI), and xerostomia. The final analysis included 13 patients in the experimental group and 16 in the control group. Results: The intervention significantly changed the oral status, DPI, and xerostomia between the groups. The experimental group showed significantly improved oral status (Z = −4.63, p < .001), DPI (Z = −4.58, p < .001), and xerostomia (t = −6.33, p < .001) compared with the control group. The experimental group showed significant improvements in oral status (Z = −3.27, p = .001), DPI (Z = −3.19, p = .001), and xerostomia (t = 7.37, p < .001) after the intervention, confirming the efficacy of honey-based oral care. Conclusions Honey-based oral care effectively improves oral status and xerostomia, and reduces DPI in patients with stroke.

Purpose: This study aimed to identify the etiology and risk factors of community-acquired pneumonia (CAP) requiring hospitalization in Korean children during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Clinical information of children admitted with CAP to Seoul National University Children’s Hospital (SNUCH) between January 1, 2021, and February 28, 2022, was retrospectively collected and analyzed. In addition, the etiologic diagnosis and demographic data of children with CAP who were discharged at the other seven hospitals between January and February 2022 were collected. Pneumonia was diagnosed using strict criteria comprising clinical symptoms, physical examination findings, and chest radiographic findings. Results: Among 91 children hospitalized with CAP at SNUCH during the 14-month period, 68.4% were aged <5 years and 79.1% had underlying diseases. Among the 95 CAP cases, respiratory assistance was required in 70.5%, and the use of a ventilator was required in 20.0%.A total of five patients expired, all of whom were either immunocompromised or had underlying neurological diseases. Neurological diseases and immunosuppression were significantly correlated with respiratory assistance (P=0.003) and death (P=0.014). A total of 55% of the detected respiratory pathogens were viruses, the most common of which was rhinovirus at 35.9%. Among the 169 children hospitalized for CAP at the eight institutions, ≥1 respiratory virus was detected in 92.3%, among which respiratory syncytial virus (79.8%) was the most prevalent. Conclusions Even during the COVID-19 pandemic, Korean children were hospitalized with CAP caused by seasonal respiratory viral pathogens. Although atypical and pyogenic bacteria were not detected, continuous clinical monitoring and further prospective studies should be conducted.

Purpose: This study explored how the Korean Medical Colleges responded to the coronavirus disease 2019 (COVID-19) pandemic and the medical deans’ perspectives on what and how these adaptions influence the present and the future of medical education. Methods: An email survey combining short and open-ended questions was distributed to all 40 Korean school deans in May 2020. Thirty-seven deans out of 40 medical schools in Korea (92.5%) participated. Results: Most lectures moved online but students’ assessments were delayed and later held onsite. Clinical rotations continued except for an average of 3-week suspension during the first COVID-19 wave. The deans’ remarks on the positive influences far outweighed the negative impact of COVID-19 on medical education. Although technological adaptations caused initial hardship, the experience gained through the use of various online learning systems led to attitudinal changes on the importance of adopting new technology and a tailored and student centric curriculum in medical education. Conclusion The deans’ perspective changes has shown the possibility of the deans’ generation aligning more closely with the current Generation Z medical students. They projected further innovations in teaching and learning methods, especially applying flipped learning and highlighted the need to invest in faculty development so medical educators can be equipped and competent in diverse ICT (information and communications technology) learning platforms. Also, the need for advance preparations in medical education for future similar public health crises were stressed. Unprecedented changes brought by COVID-19 positively impacted Korean medical education in parts and the Korean deans envisioned further innovations using the experiences gained during this crisis.

Purpose: This study explored how the Korean Medical Colleges responded to the coronavirus disease 2019 (COVID-19) pandemic and the medical deans’ perspectives on what and how these adaptions influence the present and the future of medical education. Methods: An email survey combining short and open-ended questions was distributed to all 40 Korean school deans in May 2020. Thirty-seven deans out of 40 medical schools in Korea (92.5%) participated. Results: Most lectures moved online but students’ assessments were delayed and later held onsite. Clinical rotations continued except for an average of 3-week suspension during the first COVID-19 wave. The deans’ remarks on the positive influences far outweighed the negative impact of COVID-19 on medical education. Although technological adaptations caused initial hardship, the experience gained through the use of various online learning systems led to attitudinal changes on the importance of adopting new technology and a tailored and student centric curriculum in medical education. Conclusion The deans’ perspective changes has shown the possibility of the deans’ generation aligning more closely with the current Generation Z medical students. They projected further innovations in teaching and learning methods, especially applying flipped learning and highlighted the need to invest in faculty development so medical educators can be equipped and competent in diverse ICT (information and communications technology) learning platforms. Also, the need for advance preparations in medical education for future similar public health crises were stressed. Unprecedented changes brought by COVID-19 positively impacted Korean medical education in parts and the Korean deans envisioned further innovations using the experiences gained during this crisis.

Purpose: This study aimed to identify the effects of a direct breastfeeding program for premature infants in neonatal intensive care units (NICUs). Methods: This quasi-experimental study was conducted during August 2016 to April 2017. Sixty mothers of premature infants were assigned to the experimental (n = 31) or control groups (n = 29). The program was comprised of breastfeeding education and direct breastfeeding support. The experimental and control groups were provided with education and counseling on breastfeeding at the time of admission and discharge. In the experimental group, the mothers initiated oral feeding with direct breastfeeding and engaged in breastfeeding at least seven times during the NICU stay. The collected data were analyzed by the χ2 -test and repeated measures ANOVA using an SPSS program. Results: The experimental group showed a higher direct breastfeeding practice rate (χ2 = 19.29, p < .001), breastfeeding continuation rate (χ2 = 3.76, p < .001), and self-efficacy (F = 25.37, p < .001) than the control group except for maternal attachment. Conclusion The direct breastfeeding program in the NICU has significant effects on the practice and continuation rate of breastfeeding and breastfeeding self-efficacy. Therefore, this program can be applied in the NICU settings where direct breastfeeding is limited.