Purpose: We aimed to compare broad-spectrum antibiotic use between hospice and nonhospice patients with cancer at the end of life using nationwide data from Korea. Methods: In this retrospective cohort study, we analyzed the Korean National Health Insurance Service data of adult patients with cancer who died between 2018 and 2021. Hospice users were defined as patients who received inpatient, home-based, or consultation-based hospice care before death. We applied propensity score matching (1:2) to balance the baseline characteristics of the hospice and non-hospice groups. Broad-spectrum antibiotic use, including anti-pseudomonal penicillins, anti-pseudomonal cephalosporins, carbapenems, and glycopeptides, was assessed during the last 3 months of life using prescription proportions and days of therapy per 1,000 patient-days. Results: After matching, 38,102 hospice and 75,736 non-hospice users were analyzed. During the last 3 months of life, 74.6% of hospiceand 79.0% of non-hospice users received at least one broad-spectrum antibiotic (P＜0.001).The proportion of patients receiving broad-spectrum antibiotics was generally lower amonghospice users across all time intervals (P＜0.001), and the number of days of therapy wasalso lower, with the largest differences observed during the final week and last 3 days of life.Subgroup analyses showed the highest antibiotic exposure among patients with hematologic and pancreatobiliary cancers, particularly in the non-hospice group. Conclusion Hospice involvement was associated with lower use and reduced exposure to broad-spectrum antibiotics among patients with cancer near the end of life. These findings support the alignment of end-of-life treatment decisions with the comfort-oriented goals of hospice care.

BACKGROUND/OBJECTIVES: As awareness of climate change increases, the relevance of environmental education in dietary choices gains prominence. Although diversely defined, food literacy (FL) is increasingly recognized as the ability to make food choices with an awareness of environmental sustainability. This study aims to conduct a pilot implementation and assess the effectiveness of a program developed to improve FL among university students. SUBJECTS/METHODS: The study spanned from August 2022 to February 2023, involving 92 participants (42 in the intervention group and 50 in the control group). Over 11 weeks, the program included cooking classes, local farm visits, and environmental impact lectures developed through extensive literature reviews and interviews with students and experts. FL was measured using a 33-item survey along with basic sociodemographic factors. After the intervention, both groups participated in qualitative interviews. All statistical analyses were carried out in Stata/SE version 17.0, and interview data were analyzed in Microsoft Excel using the framework analysis method. RESULTS: The FL scores of the intervention group improved significantly from an average of 65.8 to 69.6 points (P = 0.015), with notable gains in the socio-ecological domain in FL from 65.3 to 71.5 points (P < 0.001). A linear regression analysis comparing FL between the intervention and control groups found that only the knowledge items were marginally significant (P = 0.054), with no statistically significant difference in the practice aspect before and after the intervention (P = 0.657). The interviews revealed that the intervention group experienced broadened perspectives and heightened environmental consciousness, although translating these into practice was challenged by unchanged daily routines. CONCLUSION This pilot program effectively enhanced some aspects of FL-related knowledge of participants. High satisfaction among participants and no dropouts indicated its potential for scaling. Future programs will benefit from strategies that facilitate the transition from educational improvement to practical application.

BACKGROUND/OBJECTIVES: As awareness of climate change increases, the relevance of environmental education in dietary choices gains prominence. Although diversely defined, food literacy (FL) is increasingly recognized as the ability to make food choices with an awareness of environmental sustainability. This study aims to conduct a pilot implementation and assess the effectiveness of a program developed to improve FL among university students. SUBJECTS/METHODS: The study spanned from August 2022 to February 2023, involving 92 participants (42 in the intervention group and 50 in the control group). Over 11 weeks, the program included cooking classes, local farm visits, and environmental impact lectures developed through extensive literature reviews and interviews with students and experts. FL was measured using a 33-item survey along with basic sociodemographic factors. After the intervention, both groups participated in qualitative interviews. All statistical analyses were carried out in Stata/SE version 17.0, and interview data were analyzed in Microsoft Excel using the framework analysis method. RESULTS: The FL scores of the intervention group improved significantly from an average of 65.8 to 69.6 points (P = 0.015), with notable gains in the socio-ecological domain in FL from 65.3 to 71.5 points (P < 0.001). A linear regression analysis comparing FL between the intervention and control groups found that only the knowledge items were marginally significant (P = 0.054), with no statistically significant difference in the practice aspect before and after the intervention (P = 0.657). The interviews revealed that the intervention group experienced broadened perspectives and heightened environmental consciousness, although translating these into practice was challenged by unchanged daily routines. CONCLUSION This pilot program effectively enhanced some aspects of FL-related knowledge of participants. High satisfaction among participants and no dropouts indicated its potential for scaling. Future programs will benefit from strategies that facilitate the transition from educational improvement to practical application.

BACKGROUND/OBJECTIVES: As awareness of climate change increases, the relevance of environmental education in dietary choices gains prominence. Although diversely defined, food literacy (FL) is increasingly recognized as the ability to make food choices with an awareness of environmental sustainability. This study aims to conduct a pilot implementation and assess the effectiveness of a program developed to improve FL among university students. SUBJECTS/METHODS: The study spanned from August 2022 to February 2023, involving 92 participants (42 in the intervention group and 50 in the control group). Over 11 weeks, the program included cooking classes, local farm visits, and environmental impact lectures developed through extensive literature reviews and interviews with students and experts. FL was measured using a 33-item survey along with basic sociodemographic factors. After the intervention, both groups participated in qualitative interviews. All statistical analyses were carried out in Stata/SE version 17.0, and interview data were analyzed in Microsoft Excel using the framework analysis method. RESULTS: The FL scores of the intervention group improved significantly from an average of 65.8 to 69.6 points (P = 0.015), with notable gains in the socio-ecological domain in FL from 65.3 to 71.5 points (P < 0.001). A linear regression analysis comparing FL between the intervention and control groups found that only the knowledge items were marginally significant (P = 0.054), with no statistically significant difference in the practice aspect before and after the intervention (P = 0.657). The interviews revealed that the intervention group experienced broadened perspectives and heightened environmental consciousness, although translating these into practice was challenged by unchanged daily routines. CONCLUSION This pilot program effectively enhanced some aspects of FL-related knowledge of participants. High satisfaction among participants and no dropouts indicated its potential for scaling. Future programs will benefit from strategies that facilitate the transition from educational improvement to practical application.

Objective: Cognitive reserve has emerged as a concept to explain the variable expression of clinical symptoms in the pathology of Alzheimer’s disease (AD). The association between years of education, a proxy of cognitive reserve, and resting-state functional connectivity (rFC), a representative intermediate phenotype, has not been explored in the preclinical phase, considering risk factors for AD. We aimed to evaluate whether the relationship between years of education and rFC in cognitively preserved older adults differs depending on amyloid-beta deposition and APOE ε4 carrier status as effect modifiers. Methods: A total of 121 participants underwent functional magnetic resonance imaging, [ 18F] flutemetamol positron emission tomography-computed tomography, APOE genotyping, and a neuropsychological battery. Potential interactions between years of education and AD risk factors for rFC of AD-vulnerable neural networks were assessed with wholebrain voxel-wise analysis. Results: We found a significant education years-by-APOE ε4 carrier status interaction for the rFC from the seed region of the central executive (CEN) and dorsal attention networks. Moreover, there was a significant interaction of rFC between right superior occipital gyrus and the CEN seed region by APOE ε4 carrier status for memory performances and overall cognitive function. Conclusion In preclinical APOE ε4 carriers, higher years of education were associated with higher rFC of the AD vulnerable network, but this contributed to lower cognitive function. These results contribute to a deeper understanding of the impact of cognitive reserve on sensitive functional intermediate phenotypic markers in the preclinical phase of AD.

BACKGROUND/OBJECTIVES: Happiness is an important factor in life, and food literacy (FL) has been emphasized as a core concept for a happy and healthy life. This study examined the level of happiness of Seoul citizens according to their sociodemographic factors and their association with FL. SUBJECTS/METHODS: This study used the data from the Seoul Food Survey, a cross-sectional study conducted on 4,039 Seoul citizens from September to October 2021. FL was measured using a validated questionnaire consisting of 33 items from 3 sub-domains: 14 items in the nutrition and safety domain, 8 items in the cultural and relational domain, and 11 items in the socio-ecological domain. Statistical analysis involved descriptive statistics and multivariate regression analysis. RESULTS: Various sociodemographic factors, such as household income, subjective health status, and food insecurity, were found to be associated with the level of happiness. The level of FL was also associated with the happiness scores. After adjusting for variables associated with happiness, the participants with the highest quartile FL scores were 7.32 times more likely to respond that they were happy than those with the lowest FL score. Three FL domains and total FL showed linear increases in overall happiness after controlling for subjective health status and sociodemographic factors (P < 0.001). CONCLUSIONS After adjusting for the related covariates, higher levels of FL were associated with higher scores in happiness. Based on this study, it would be meaningful to evaluate ways to intervene in FL to improve the level of happiness among the general population.

BACKGROUND/OBJECTIVES: The growing aging population has led to an increased utilization of senior daycare centers. This study was conducted to design a program to enhance the health of older adults in senior daycare centers in Chuncheon City, South Korea. SUBJECTS/METHODS: The study explored the health conditions and dietary patterns of older adults in senior daycare centers. Participants included staff and older adults from senior daycare centers in Chuncheon City. A mixed methods research design was used to obtain both qualitative and quantitative data. Qualitative insights were obtained through in-depth interviews with 26 staff members and older adults, coupled with observations made at 10 senior daycare centers. The quantitative component comprised structured questionnaires and physical measurements of 204 older adults at these centers. RESULTS: Many of the older adults relied on the meals provided by the center due to their limited cooking abilities. Dental health issues and dysphagia were common. Interviews highlighted the budgetary constraints of the centers in providing wholesome meals and the need for government support to alleviate meal expenses and enhance quality. A structured survey of older adults showed that the average age was 83.3 yrs, with an average of 2 chronic conditions per participant. Frailty analysis of the participants revealed that 56.2% were prefrail and 32.0% were frail. Almost half of the participants (47.0%) used dentures. Based on these findings, a preventive intervention program was proposed, addressing the specific needs and challenges of older adults while promoting overall well-being and preventing frailty. CONCLUSION Tailored health promotion strategies are crucial in senior daycare centers.Recommended interventions include staff nutrition education, improved dietary plans, and cost-effective strength training programs. These interventions aim to reduce frailty and enhance the quality of life of older adults in the community via interventions in daycare centers.

BACKGROUND/OBJECTIVES: Mukbang, a trend originating in South Korea and gaining global popularity, could influence children’s food choices and eating habits. This study analyzed the correlation between Mukbang viewing time in children and adolescents, their meal consumption frequency, nutrition quotient (NQ), and frequency of food intake. SUBJECTS/METHODS: From July to August 2022, this cross-sectional study investigated upper elementary students (ages 9–11 yrs) and adolescents (aged 12–18 yrs) using an online survey. The survey items included key demographic factors, Mukbang viewing frequency and duration, frequency of main meal consumption, commonly consumed foods, and the validated NQ, which was used to assess food intake quality. Multiple linear regression analysis was used to explore the link between Mukbang viewing and nutritional habits. RESULTS: Weekly Mukbang viewing time was significantly correlated with eating habits after adjusting for gender, age, physical activity frequency past week, household income, and primary caregiver’s level of education. Increased Mukbang viewing time correlated with reduced frequency of breakfast (P for trend < 0.001) and dinner (P for trend = 0.012), while the frequency of eating out (P for trend < 0.001) and late-night snacking (P for trend = 0.008) increased. Higher Mukbang viewing time notably decreased scores in the moderation domain (P for trend < 0.001), in the practice domain (P for trend = 0.031), and overall NQ (P for trend < 0.001). It also significantly elevated intake of sweets (P for trend = 0.001), Koreanstyle street food, Western-style fast food, instant noodles, sweetened beverages, caffeinated beverages, and fruit and vegetable juices (P for trend < 0.001). CONCLUSION This study identifies a negative correlation between Mukbang viewing and eating habits among Korean children and adolescents. The results indicate the importance of incorporating children and adolescents’ media usage and environmental factors on dietary education and the development of policy programs.

BACKGROUND/OBJECTIVES: As awareness of climate change increases, the relevance of environmental education in dietary choices gains prominence. Although diversely defined, food literacy (FL) is increasingly recognized as the ability to make food choices with an awareness of environmental sustainability. This study aims to conduct a pilot implementation and assess the effectiveness of a program developed to improve FL among university students. SUBJECTS/METHODS: The study spanned from August 2022 to February 2023, involving 92 participants (42 in the intervention group and 50 in the control group). Over 11 weeks, the program included cooking classes, local farm visits, and environmental impact lectures developed through extensive literature reviews and interviews with students and experts. FL was measured using a 33-item survey along with basic sociodemographic factors. After the intervention, both groups participated in qualitative interviews. All statistical analyses were carried out in Stata/SE version 17.0, and interview data were analyzed in Microsoft Excel using the framework analysis method. RESULTS: The FL scores of the intervention group improved significantly from an average of 65.8 to 69.6 points (P = 0.015), with notable gains in the socio-ecological domain in FL from 65.3 to 71.5 points (P < 0.001). A linear regression analysis comparing FL between the intervention and control groups found that only the knowledge items were marginally significant (P = 0.054), with no statistically significant difference in the practice aspect before and after the intervention (P = 0.657). The interviews revealed that the intervention group experienced broadened perspectives and heightened environmental consciousness, although translating these into practice was challenged by unchanged daily routines. CONCLUSION This pilot program effectively enhanced some aspects of FL-related knowledge of participants. High satisfaction among participants and no dropouts indicated its potential for scaling. Future programs will benefit from strategies that facilitate the transition from educational improvement to practical application.