Purpose: To identify the childbearing intentions of young adults in South Korea and examine the factors influencing them using a social-ecological model (SEM). Methods: A descriptive cross-sectional study design was used. Unmarried employed men and women (n=181) aged 25–40 years completed an online survey. The data included socio-demographic characteristics and responses at four levels: (1) intrapersonal (perception of parenthood and fertility knowledge), (2) interpersonal (quality of family relationships), (3) institutional (work-family culture), and (4) community and public policy (adequacy of government policies and social support systems). Data were analyzed using descriptive statistics, correlations, and multiple logistic regression. Results: Approximately 77% of the participants planned to have children, and more than 60% wanted to have two or more children. Among the four levels of SEM, only intrapersonal factors, including intention to marry, fertility knowledge, and attitudes toward parenthood, were statistically significant in influencing childbearing intentions. The model explaining the intention to have a child demonstrated an explanatory power of 59.6%, incorporating factors such as marital intention, perceptions of parenthood, and fertility knowledge. Conclusion A noticeable gap exists between childbearing intentions and childbirth in South Korea. These findings provide insights into the nursing educational content needed for delivering family planning education to young adults. Targeted interventions such as counseling services and community education should be integrated into nursing practice. Moreover, nursing curricula should discuss factors influencing childbearing intentions to equip future nurses better to support young adults' family planning decisions.

Purpose: To identify the childbearing intentions of young adults in South Korea and examine the factors influencing them using a social-ecological model (SEM). Methods: A descriptive cross-sectional study design was used. Unmarried employed men and women (n=181) aged 25–40 years completed an online survey. The data included socio-demographic characteristics and responses at four levels: (1) intrapersonal (perception of parenthood and fertility knowledge), (2) interpersonal (quality of family relationships), (3) institutional (work-family culture), and (4) community and public policy (adequacy of government policies and social support systems). Data were analyzed using descriptive statistics, correlations, and multiple logistic regression. Results: Approximately 77% of the participants planned to have children, and more than 60% wanted to have two or more children. Among the four levels of SEM, only intrapersonal factors, including intention to marry, fertility knowledge, and attitudes toward parenthood, were statistically significant in influencing childbearing intentions. The model explaining the intention to have a child demonstrated an explanatory power of 59.6%, incorporating factors such as marital intention, perceptions of parenthood, and fertility knowledge. Conclusion A noticeable gap exists between childbearing intentions and childbirth in South Korea. These findings provide insights into the nursing educational content needed for delivering family planning education to young adults. Targeted interventions such as counseling services and community education should be integrated into nursing practice. Moreover, nursing curricula should discuss factors influencing childbearing intentions to equip future nurses better to support young adults' family planning decisions.

Purpose: To identify the childbearing intentions of young adults in South Korea and examine the factors influencing them using a social-ecological model (SEM). Methods: A descriptive cross-sectional study design was used. Unmarried employed men and women (n=181) aged 25–40 years completed an online survey. The data included socio-demographic characteristics and responses at four levels: (1) intrapersonal (perception of parenthood and fertility knowledge), (2) interpersonal (quality of family relationships), (3) institutional (work-family culture), and (4) community and public policy (adequacy of government policies and social support systems). Data were analyzed using descriptive statistics, correlations, and multiple logistic regression. Results: Approximately 77% of the participants planned to have children, and more than 60% wanted to have two or more children. Among the four levels of SEM, only intrapersonal factors, including intention to marry, fertility knowledge, and attitudes toward parenthood, were statistically significant in influencing childbearing intentions. The model explaining the intention to have a child demonstrated an explanatory power of 59.6%, incorporating factors such as marital intention, perceptions of parenthood, and fertility knowledge. Conclusion A noticeable gap exists between childbearing intentions and childbirth in South Korea. These findings provide insights into the nursing educational content needed for delivering family planning education to young adults. Targeted interventions such as counseling services and community education should be integrated into nursing practice. Moreover, nursing curricula should discuss factors influencing childbearing intentions to equip future nurses better to support young adults' family planning decisions.

Objective: This study evaluated the clinical effectiveness of Minds.NAVI, a depression screening kit combining psychometric measures and stress hormone biomarkers, in a prospective clinical trial. The objective was to assess its potential as a depression screening tool and investigate the associations between psychological assessments, salivary hormone staging, and depression severity. Methods: Thirty-five participants with major depressive disorder and 12 healthy controls (HCs) were included. The Minds.NAVI software, utilizing the PROtective and Vulnerable factors battEry Test (PROVE) and salivary cortisol/dehydroepiandrosterone (DHEA) analysis, was employed. The PROVE test is a comprehensive self-report questionnaire that assesses depressive symptoms, suicide risk, attachment style, adverse childhood experiences, mentalization capacity, and resilience. In addition, salivary cortisol and DHEA levels were measured to evaluate the functional stage of the hypothalamic–pituitary–adrenal (HPA) axis. Results: Minds.NAVI exhibited 100% sensitivity, 91.7% specificity, and 97.9% accuracy in distinguishing depression from HCs within an exploratory small group. Salivary stress hormone phases showed changes with depression stage (p=0.030), and the proportion of patients with “adrenal exhaustion stage” was higher in the moderate/severe depression group (p=0.038). Protective/vulnerable factors differed significantly between controls and depressed groups (p<0.001). Cortisol awakening response inversely correlated with depressive symptom severity (r=-0.31, p=0.034). Conclusion This study suggested possible clinical effectiveness of Minds.NAVI, a depression screening tool that integrates psychometric measures and stress hormone biomarkers. The findings support the potential association between depression, chronic stress, and HPA axis hyporesponsiveness.

Pilar leiomyoma or piloleiomyoma is a benign neoplasm of the smooth muscle arising from the arrector pili muscle. It manifests as brown to red firm papulonodules with sites of predilection being the face, trunk, and extensor surfaces of the extremities. Histologically, the lesions exhibit ill-defined dermal tumors with interlacing fascicles of spindle cells. Some genodermatoses are characterized by the development of visceral tumors and cutaneous leiomyomatosis such as Reed’s syndrome, and hereditary leiomyomatosis and renal cell cancer (HLRCC). A 55-year-old male presented with reddish-brown papules and nodules on the face and upper back, accompanied by sharp episodic pain on the face. He had undergone nephrectomy for renal cancer 9 years ago, and his younger brother had similar cutaneous manifestation. Histopathologic findings were consistent with pilar leiomyoma, showing bundles of smooth muscle tumors in the dermis. Based on the clinical information including clinical features, past medical history, and family history, HLRCC was highly suspected.To confirm the diagnosis, whole exome sequencing was performed using peripheral blood, which revealed a novel point mutation (c.739G>A, p.Glu247Lys) in the fumarate hydratase (FH) gene. We describe a confirmed case of HLRCC, which is a genetic disorder with a potential to cause visceral cancers, which dermatologists might overlook as a benign condition.

Objective: To assess pre-biologic treatments with conventional synthetic disease-modifying drugs (csDMARDs) prior to biologics initiation among patients with rheumatoid arthritis (RA). Methods: Using Korea National Health Insurance database, we examined pre-biologic treatments of RA patients on the following four items: whether 1) initial methotrexate (MTX) therapy was given, 2) MTX dose was escalated up to ≥15 mg/week within 1-year post-diagnosis, 3) prednisone-equivalent glucocorticoid was used at a dose of ≤7.5 mg/day, and 4) glucocorticoid was discontinued within 6 months of treatment. Multivariable logistic regressions identified predictors of items 2) and 4) fulfillment. Results: Among 6,986 biologics initiators with RA, 54.9% used MTX as the 1st csDMARD. Within 1-year post-diagnosis, 85.2% used MTX with half of them achieving a dose of ≥15 mg/week. The majority (75.2%) of patients used glucocorticoids initially and 64.5% were still on glucocorticoids at 6 months, mostly at a dose of ≤7.5 mg/day. csDMARD combination was observed in 85.7%. Item 2) fulfillment was associated with males, younger age, glucocorticoid, combination therapy, cyclo-oxygenase-2 inhibitors, and viral hepatitis. Item 4) fulfillment was associated with males, MTX dose of ≥15 mg/week, combination therapy, viral hepatitis, and hospitalizations. Conclusion RA patients in Korea were predominantly treated with MTX-based csDMARD combination plus glucocorticoids before initiating biologics, without sufficient MTX dose escalation or glucocorticoid discontinuation. Items 2) and 4) fulfillments were associated with patient age and gender, concomitant treatments, and comorbidities.

INTRODUCTION: Chest physiotherapy (CPT) may benefit children aged below five years who suffer from lower respiratory tract infection (LRTI). However, its effects depend on the technique used. This study aimed to determine whether mechanical CPT using the LEGA-Kid® mechanical percussion device is superior to manual CPT in children with LRTI. METHODS: Children aged five months to five years who were admitted and referred for CPT from January to April 2017 were randomised to either manual CPT or mechanical CPT with LEGA-Kid. Outcomes measured before intervention and two hours after intervention were respiratory rate (RR), oxygen saturation and modified Respiratory Distress Assessment Instrument (mRDAI) score. RESULTS: All 30 enrolled patients showed significant reduction in post-intervention RR and mRDAI scores. There was an 8% reduction in RR for the manual CPT group (p = 0.002) and a 16.5% reduction in the mechanical CPT group (p = 0.0001), with a significantly greater reduction in the latter (p = 0.024). mRDAI scores decreased by 2.96 in the manual group (p = 0.0001) and 3.62 in the mechanical group (p = 0.002), with no significant difference between the groups. There was no significant improvement in oxygen saturation, and no adverse events were observed after CPT. CONCLUSION Children receiving both manual and mechanical CPT showed improvements in respiratory distress symptoms, with no adverse effects. A combined strategy of nebulised hypertonic saline followed by CPT for LRTI removes airway secretions and results in improvements in moderately severe respiratory distress. The LEGA-Kid mechanical CPT method is superior to manual CPT in reducing the RR.
Child ; Humans ; Percussion/methods* ; Physical Therapy Modalities ; Respiratory Distress Syndrome ; Respiratory Therapy/methods* ; Respiratory Tract Infections ; Single-Blind Method

PURPOSE: The purpose of this study is to clarify the relevance of breastfeeding and its preventive effect on maternal hypertension as well as to evaluate the theoretical mechanism behind of it through systematic evaluation of existing articles. METHODS: For systematic evaluation of literatures in recent 5 years, 5 most suitable articles were selected with the key words, (breastfeeding or breastfeed or lactation) AND (hypertension or high blood pressure or hypertensive disorders) from PubMed, EMBASE, and Cochran Library, and carefully reviewed by 2 researchers. RESULTS: Breastfeeding women have less frequently developed hypertension in their later life. Depending on the duration of breastfeeding, compared to nonbreastfeeding women, breastfeeding women's odds ratio for developing hypertension are 0.87 (95% confidence interval [CI], 0.76–0.99), 0.83 (95% CI, 0.68–1.00), and 0.79 (95% CI, 0.65–0.97) each for 0–6 months, 6–12 months, and greater than 12 months of breastfeeding. As the number of breastfeeding children increases, the incidence of maternal hypertension decreases. In addition, both partial and exclusive breastfeeding lower the risk of developing maternal hypertension. Though the mechanism of prophylactic effect of breastfeeding on hypertension is not conclusive, reset hypothesis, oxytocin release, the increase of ghrelin and protein peptide YY, as well as epigenetic programming are considered to be relevant to the etiology of the condition. CONCLUSION: Breastfeeding prevents maternal hypertension later in life. Studies show dose-response relationship of breastfeeding as the duration matters. In addition, both partial and exclusive breastfeeding have preventive effect on maternal hypertension. Numerous mechanisms are continuously being reported and further studies are needed for clarification.
Breast Feeding ; Child ; Epigenomics ; Female ; Ghrelin ; Humans ; Hypertension ; Incidence ; Odds Ratio ; Oxytocin ; Peptide YY

BACKGROUND AND OBJECTIVES: Joint National Committee guidelines attempt to vary treatment recommendations for patients based on considerations of their comorbidities. The aim of the present study is to estimate the age-standardized prevalence of common comorbidities among Korean hypertension patients. SUBJECTS AND METHODS: We analyzed the Korea National Health and Nutrition Examination Survey from 2007 to 2013. Among the 58423 participants, 30092 adults, aged ≥30 yrs who completed a health examination and interview survey, were selected. The survey procedures were used to estimate weighted prevalence and odds ratios for 8 comorbidities, including obesity, diabetes mellitus, dyslipidemia, cardiovascular disease, chronic kidney disease, and thyroid disease. RESULTS: Most chronic conditions were more prevalent in adults with hypertension than in those without hypertension. Common comorbidities were obesity (60.1%), dyslipidemia (57.6%), and impaired fasting glucose (45.1%). Hypertensive patients with two or more comorbid diseases were 42.2% and those with three or more diseases were 17.7%. The age- and sex-specific prevalence of three or more comorbid diseases among male hypertension patients was significantly higher than those patients in the 30-59 (p<0.05) age group. CONCLUSION: Comorbidity is highly prevalent in Korean patients with hypertension.
Adult ; Cardiovascular Diseases ; Chronic Disease ; Comorbidity* ; Diabetes Mellitus ; Dyslipidemias ; Epidemiology ; Fasting ; Glucose ; Humans ; Hypertension* ; Joints ; Korea* ; Male ; Nutrition Surveys* ; Obesity ; Odds Ratio ; Prevalence* ; Renal Insufficiency, Chronic ; Thyroid Diseases

Anesthetic management of pediatric liver transplantation in a patient with osteogenesis imperfecta (OI) requires tough decisions and comprehensive considerations of the cascade of effects that may arise and the required monitoring. Total intravenous anesthesia (TIVA) with propofol and remifentanil was chosen as the main anesthetic strategy. Malignant hyperthermia (MH), skeletal fragility, anhepatic phase during liver transplantation, uncertainties of TIVA in children, and propofol infusion syndrome were considered and monitored. There were no adverse events during the operation. Despite meticulous precautions with regard to the risk of MH, there was an episode of high fever (40degrees C) in the ICU a few hours after the operation, which was initially feared as MH. Fortunately, MH was ruled out as the fever subsided soon after hydration and antipyretics were given. Although the delivery of supportive care and the administration of dantrolene are the core principles in the management of MH, perioperative fever does not always mean a MH in patients at risk for MH, and other common causes of fever should also be considered.
Anesthesia, Intravenous ; Antipyretics ; Child ; Dantrolene ; Fever ; Humans ; Infant* ; Liver Transplantation* ; Malignant Hyperthermia ; Osteogenesis Imperfecta* ; Pediatrics ; Pharmacokinetics ; Propofol