INTRODUCTION: Achieving low-density lipoprotein cholesterol (LDL-C) levels is key to preventing atherosclerotic cardiovascular events. However, many high-risk cardiovascular patients still experience poor LDL-C goal attainment and receive suboptimal lipid-lowering therapy (LLT) prescriptions. Herein, we evaluated LLT prescription patterns, LDL-C goal attainment and cardiovascular mortality among this population group in Singapore. METHODS: This prospective observational cohort study included 555 patients with ischaemic heart disease (IHD) admitted to the hospital in 2020. The LLT prescriptions, corresponding LDL-C levels and cardiovascular outcomes were assessed over a 24-month period. RESULTS: Most participants were male (82.3%), with 48.5% identified as Chinese. High-intensity statin prescriptions increased from 45.4% at hospital admission to 87.1% at discharge and remained stable at approximately 80% at 6, 12, and 24 months post-discharge. Combination LLT prescriptions increased from 12.3% at discharge to 33.8% by 24 months. Ezetimibe was the most commonly prescribed second-line LLT (40.8%), followed by inclisiran (1.09%) and anti-proprotein convertase subtilisin/kexin type 9 monoclonal antibody therapies (0.87%). Over 24 months, LDL-C goal attainment rates were 22.1% for LDL-C < 1.4 mmol/L and 47.2% for LDL-C < 1.8 mmol/L. Multivariable Cox proportional hazards regression indicated that achieving LDL-C < 1.8 mmol/L goal was associated with a reduction in all-cause mortality at 24 months (hazard ratio 0.53, 95% confidence interval 0.30-0.94, P = 0.030). CONCLUSION Treatment gaps in lipid management persist in 80% of the study population, indicating that statin monotherapy alone is insufficient to achieve LDL-C goals. Greater efforts to improve LDL-C goal attainment rates in high-risk cardiovascular patients are imperative.
Humans ; Male ; Cholesterol, LDL/blood* ; Female ; Myocardial Ischemia/drug therapy* ; Middle Aged ; Prospective Studies ; Aged ; Singapore/epidemiology* ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use* ; Ezetimibe/therapeutic use* ; Anticholesteremic Agents/therapeutic use* ; Treatment Outcome

In diabetes camps, medical social workers interact with individuals and groups of participants to help them learn to adapt psychologically and emotionally to the stress from diabetes and to improve their ability to cope with interpersonal relationships. The change stage model (transtheoretical model) is applied to change the behavior of diabetics. Social worker intervention programs in diabetes camps provide opportunities for patients to manage their diabetes healthily by increasing self-esteem, participating in motivational counseling, and developing stress management, fear and conflict resolution. In particular, in the 2030 diabetes camp program, young diabetics can learn the personal importance of medical social workers through the ‘post-camp’ talk.
Camping ; Counseling ; Diabetes Mellitus ; Health Behavior ; Humans ; Motivation ; Negotiating ; Social Work* ; Social Workers*

Sexual function may be affected by diabetes complications, often resulting in marriage difficulties. This study introduced 'I-message' as a communication technique. This study is to understand Gottman's dysfunctional communication between the couple so that they do not use it. Therefore, this study aims to help married couples with diabetic partner to better understand sexual function affected by the diabetes and thereby communicate happily with each other using the 'I-message' technique.
Diabetes Complications ; Diabetes Mellitus ; Family Characteristics* ; Marriage

PURPOSE: Prevalence of food allergy and perceptions on food allergen labeling in school foodservice among elementary, middle, and high school students were investigated in Korea. METHODS: A total of 1,000 elementary, middle, and high schools were selected in 16 cities and provinces of Korea and students attending the schools were surveyed using a questionnaire modified from the Korean International Study of Asthma and Allergies in Childhood questionnaire in July 2012. Responses from 27,679 students were used for data analysis. RESULTS: The ratio of the students who had experienced food allergy was 12.6%; 7.6% of the responding students had food allergy reactions last 12 months and 6.8% of the students had been diagnosed for food allergy by doctors. Eggs, milk, peach, and crabs were the most frequent allergenic foods for the elementary school 1st graders, 5th graders, middle, and high school students, respectively, who had experienced food allergy last 12 months. The students with food allergy read menus more frequently and were more interest in food allergen labeling in school foodservice than their counterparts. Both of the student groups with and without food allergy perceived food allergen labeling important for the students with food allergy and their parents. CONCLUSION: The prevalence of food allergy and major allergenic foods varied by school years. The Korean students had positive perception on allergic food labeling in school foodservice. An effective food allergen labeling system for school foodservice should be developed and implemented that reflects prevalence, symptoms, and food allergens among Korean students.
Allergens ; Asthma ; Eggs ; Food Hypersensitivity ; Food Labeling ; Humans ; Hypersensitivity ; Korea ; Milk ; Ovum ; Prevalence ; Prunus persica ; Surveys and Questionnaires

This research was performed to evaluate the effects of nutrition education on food waste reduction at school food service. A dietitian conducted nutrition education on environmental protection and proper eating attitude and poor eating habits for 3rd and 5th graders at an elementary school in Seoul. The effectiveness of the education was evaluated by surveying the students before and after the education; 375 responses were analyzed. A questionnaire was designed to compare changes of the students' attitudes and plate waste before and after education. Plate wastes of boiled black rice(p<0.05), potato soup(p<0.05), amaranthus herb salad(p<0.01), and cabbage kimchi(p<0.05) decreased significantly after education. Students' eating attitudes improved significantly(t= -6.22, p<0.01) after nutrition education. Major reasons the students did not eat all foods they were served were large portion sizes (30.59%), low menu preference (29.79%), and tastes (17.82%). The menus with high plate waste rates were cooked vegetable items (35.64%) and soup items (26.6%). After education, students' attitudes on 'food waste pollutes the Earth(p=0.013)', 'food preparation for birthday parties(p<0.01)', and 'restaurant selection for eating out (p<0.01)' changed significantly. After education, plate waste and portion sizes that the students perceived were not negatively correlated. In conclusion, nutrition education on proper eating habits and source reduction is an effective method to reduce food waste generation and to improve students' eating attitudes and awareness on environment.
Amaranthus ; Brassica ; Natural Resources ; Eating ; Education* ; Food Services ; Humans ; Nutritionists ; Portion Size ; Surveys and Questionnaires ; Seoul ; Solanum tuberosum ; Vegetables

The study was designed to investigate food waste management practices and to identify factors affecting food waste generation at school food services. A total of 202 dietitians employed at elementary schools participated in the survey. The mean food waste weight per school was 77.54 kg, forty percent of the schools generated food waste of 50~100 kg every day and 53% generated plate waste less than 50 kg. Three quarters of the dietitians perceived plate waste as a major component of the food waste and vegetable dishes were a major source of the plate waste. Half of the dietitians used a food waste pick-up service for waste disposal, which was the most preferred waste disposal method. Approximately 90% of the dietitians conducted education on plate waste reduction for students but their perceptions on the effectiveness of the education was inconsistent. The contents were environmental issues (70.3%) and unbalanced food choice (56.7%). According to factor analysis based on performance score, solid waste management practices were grouped into 'information collecting and education', 'supervision of production process', 'cooperation with related groups', and 'control over production planning'. Practices appertaining to 'cooperation with related groups', 'information collecting and education' factor need to be improved. Dietitians should pay attention to 'recycle and reuse of left over' practice. Waste generation differed significantly by dietitians' ages and working experience. In order to reduce plate waste, more effective education materials and methods need to be developed and support from principals, teachers, and parents is necessary.
Education ; Food Services* ; Humans ; Nutritionists ; Parents ; Solid Waste ; Vegetables ; Waste Management*

Malignant mixed mullerian tumor of the ovary are very aggressive tumors that were usually diagnosed at an older age. They are usually at an advanced stage at the time of diagnosis, and survival after diagnosis varies by stage of disease and histological type. Despite aggressive treatment that includes surgery and chemotherapy, women with these tumors have a significantly increased risk of death giving them a very poor prognosis. The poor prognosis associated with this rare disease represents a need to new therapeutic regimens to improve patients' survival. We experienced two cases of primary malignant mixed mullerian tumor of the ovary.
Diagnosis ; Drug Therapy ; Female ; Humans ; Ovary* ; Prognosis ; Rare Diseases

Malignant mixed mullerian tumor of the ovary are very aggressive tumors that were usually diagnosed at an older age. They are usually at an advanced stage at the time of diagnosis, and survival after diagnosis varies by stage of disease and histological type. Despite aggressive treatment that includes surgery and chemotherapy, women with these tumors have a significantly increased risk of death giving them a very poor prognosis. The poor prognosis associated with this rare disease represents a need to new therapeutic regimens to improve patients' survival. We experienced two cases of primary malignant mixed mullerian tumor of the ovary.
Diagnosis ; Drug Therapy ; Female ; Humans ; Ovary* ; Prognosis ; Rare Diseases