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This study aimed to investigate the effects of a violence-prevention education program using empathy (VPEP-E) on elementary school students. This quasi-experimental design examined fifth-grade students' (a) empathy level, (b) perception of violence, and (c) permissive and negligent attitudes toward violence, using a pre- and post-test design. A total of 101 students participated: the experimental group (n = 48) received eight sessions of VPEP-E, whereas the control group (n = 53) received violence prevention education through classroom lectures. Significant differences were observed between the groups' empathy level (t = 6.81, p <.001), perception of violence (t = 2.79, p =.006), and permissive and negligent attitudes toward violence (t = -2.21, p =.030; t = -2.02, p =.046). Thus, a school-based VPEP-E may help elementary school students. Long-term studies evaluating behavioral changes from VPEP-E implementation are needed for establishing the effects on violent behavior. [ABSTRACT FROM AUTHOR]

Introduction: There are limited and conflicting data regarding the impact of hepatitis C in pregnancy on adverse birth outcomes. Methods: Using the Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET), a large surveillance cohort, we describe birth outcomes among a cohort of people with HCV in pregnancy in total and by reported substance use. Results: Among 1418 infants, 89% were born to people with reported substance use during pregnancy. The proportion born preterm was 20%, 13% were small-for-gestational age and 34% of term infants required intensive care. Conclusions: Assessments of recent changes to recommendations for HCV screening in pregnancy should evaluate the impact on maternal access to care for both HCV treatment as well as comorbidities such as substance use disorder which may contribute to adverse birth outcomes. Significance: Incidence of hepatitis C in pregnancy is increasing. Prematurity, small-for-gestational age, and intensive care unit admission were common among this surveillance cohort of infants born to people with hepatitis C in pregnancy with high frequency of substance use. Assessments of recent changes to recommendations for HCV screening in pregnancy should evaluate the impact on maternal access to care for both HCV treatment as well as comorbidities such as substance use disorder which may contribute to adverse birth outcomes. [ABSTRACT FROM AUTHOR]

Background: Time elapsed since pain onset might affect the likelihood of neuropathic component in low back pain. The aim of this study was to investigate the relationship between neuropathic pain component and pain duration in patients with low back pain and to identify factors associated with neuropathic pain component. Methods: Patients with low back pain who received treatment at our clinic were enrolled. Neuropathic component was assessed using the painDETECT questionnaire at the initial visit. PainDETECT scores and the results for each item were compared according to pain duration category (< 3 months, 3 months to 1 year, 1 year to 3 years, 3 years to 10 years, and ≥ 10 years). A multivariate analysis was used to identify factors associated with neuropathic pain component (painDETECT score ≥ 13) in low back pain. Results: A total of 1957 patients, including 255 patients who reported neuropathic‐like pain symptoms (13.0%), fully satisfied the study criteria for analysis. No significant correlation between painDETECT score and pain duration was observed (ρ = −0.025, p = 0.272), and there were no significant differences between median painDETECT score or trend of change in the proportion of patients with neuropathic component and the pain duration category (p = 0.307, p = 0.427, respectively). The electric shock‐like pain symptom was frequently reported in patients with acute low back pain, and the persistent pain pattern with slight fluctuations was predominant in chronic low back pain. The pattern of attacks with pain between them was much less common in patients with pain for 10 years or longer. Multivariate analysis revealed that a history of lumbar surgery, severe maximum pain, opioid use, lumbosacral radiculopathy, and sleep disturbance were significantly associated with a neuropathic component in low back pain. Conclusion: Time elapsed since current pain onset did not correlate with neuropathic pain component in patients with low back pain. Therefore, diagnostic and therapeutic approaches for this condition should be based on a multidimensional evaluation at assessment and not on pain duration alone. [ABSTRACT FROM AUTHOR]

Background: There are growing concerns about the impact of the COVID-19 pandemic on the mental health of older adults. We examined the effect of the pandemic on the risk of depression in older adults. Methods: We analyzed data from the prospective cohort study of Korean older adults, which has been followed every 2 years. Among the 2308 participants who completed both the third and the fourth follow-up assessments, 58.4% completed their fourth follow-up before the outbreak of COVID-19 and the rest completed it during the pandemic. We conducted face-to-face diagnostic interviews using Mini International Neuropsychiatric Interview and used Geriatric Depression Scale. We performed generalized estimating equations and logistic regression analyses. Results: The COVID-19 pandemic was associated with increased depressive symptoms in older adults [ b (standard error) = 0.42 (0.20), p = 0.040] and a doubling of the risk for incident depressive disorder even in euthymic older adults without a history of depression (odds ratio = 2.44, 95% confidence interval 1.18–5.02, p = 0.016). Less social activities, which was associated with the risk of depressive disorder before the pandemic, was not associated with the risk of depressive disorder during the pandemic. However, less family gatherings, which was not associated with the risk of depressive disorder before the pandemic, was associated with the doubled risk of depressive disorder during the pandemic. Conclusions: The COVID-19 pandemic significantly influences the risk of late-life depression in the community. Older adults with a lack of family gatherings may be particularly vulnerable. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test the effects of a child sexual abuse prevention education program using a hybrid application (CSAPE-H) by examining fifth-grade students' (a) knowledge for sexual abuse prevention and (b) self-protective behaviors against sexual abuse. A quasi-experimental, pretest /posttest design was used. Sixty-eight students from two schools participated. The intervention group (n = 48) received six sessions in CSA prevention education using the hybrid app, whereas the control group (n = 35) was taught using a lecture in a classroom environment. Between the two groups, there were significant differences in self-protective behaviors against CSA (t = 2.26, p =.027). In addition, educational satisfaction was significantly higher in the experimental group than the control group (t = 2.41, p =.019). A CSAPE-H may be effective for elementary school students, especially for self-protective behaviors. [ABSTRACT FROM AUTHOR]

This study aimed to compare perceptions of spiritual care among patients with life-threatening cancer, their primary family caregivers, and hospice/palliative care nurses. Data were collected using both structured and unstructured approaches. Structured questionnaire data were examined using statistical analysis methods, and unstructured data were examined using content analysis to compare the 3 participant groups. The questionnaire revealed that among all 3 groups, spiritual care was commonly perceived to relate to "having the opportunity for internal reflection," "finding meaning," "encouraging hope," and "listening to and being with patients." Content analysis of the unstructured data revealed 5 themes: "Caring with sincerity," "Strengthening spiritual resources," "Alleviating physical pain and discomfort" (among patients and primary family caregivers only), "Improving spiritual care service," and "Multifaceted cooperation" (among hospice/palliative care nurses only). Our findings suggest that for patients with life-threatening illnesses such as terminal cancer, spiritual care should not be limited to religious practice but should also satisfy inner existential needs, for example, by encouraging hope, providing empathy, and helping patients find meaning in their circumstances. [ABSTRACT FROM AUTHOR]

Background: Breast self‐examination is a convenient and effective way to detect breast abnormalities. Based on Dale's Cone of Experience theory, we hypothesized that the combination of a smartphone application with hands‐on practice would have a greater impact than using a smartphone application alone. The purpose of this study was to compare the effects of different educational methods on (a) knowledge, (b) attitudes, (c) skills, and (d) students' satisfaction with the learning methods. Methods: We conducted a pre‐ and post‐test quasi‐experimental design and developed a smartphone application using a video clip. One experimental group received smartphone‐based education, another group received smartphone‐based education combined with hands‐on practice, and the control group received a one‐time classroom lecture. We administered a pre‐test, provided intervention, and conducted a post‐test. Results: Among the three groups, the knowledge and attitude of the experimental groups were significantly higher than that of the control group. In addition, the group using the combination of the smartphone application and hands‐on practice showed the highest score changes in skills and satisfaction with the learning methods. Conclusions: Smartphone application use combined with hands‐on practice could be an effective education method for breast self‐examination. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the learning effects of debriefing methods used in the simulation of prematurity care by measuring: (i) academic self‐efficacy; (ii) confidence in performance; (iii) self‐assessed communication skills; and (iv) satisfaction. We employed a quasi‐experimental design with three experimental groups that experienced instructor‐directed, self‐directed, and video‐assisted, self‐directed debriefing, respectively. Participants were 146 senior nursing students from three nursing schools. To compare learning effects, the same developed scenario for prematurity care was applied to all three groups. Significant differences were observed in the mean scores for the study variables among the three groups. The post‐hoc analysis showed that the video‐assisted, self‐directed debriefing group obtained the highest mean score difference for confidence in performance, self‐assessed communication skills, and satisfaction with the debriefing method. Thus, video‐assisted, self‐directed debriefing could be the most effective debriefing method for students. [ABSTRACT FROM AUTHOR]

Reducing functional decline is an essential treatment goal in older adults after hip fracture surgery. The current study examined different effects of functional decline–related factors according to activities of daily living (ADL) and instrumental ADL (IADL) in older adults after hip fracture surgery. A total of 120 participants were included. In quantile regression, preoperative walking and fear of falling were significantly associated with ADLs in the 25th percentile ADL group. Fear of falling was the only significant factor in the poorest IADL group (25th percentile). Efforts should be made to reduce fear of falling after hip fracture surgery. Preoperative walking status was significant in patients with poor ADL after hip fracture surgery; therefore, walking status should be taken into consideration when planning rehabilitation care in this group, so that the best possible ADL outcomes can be attained. (6),312–320.][Research in Gerontological Nursing, 12(6),312–320.] [ABSTRACT FROM AUTHOR]

This study aimed to examine the reliability and validity of a scale to assess the competence of Korean nurses who provide spiritual care for patients with terminal illnesses. The reliability and validity were examined using Cronbach [alpha] , item analysis, and exploratory factor analysis. The participants were 248 hospice nurses working at 40 hospices and palliative hospitals in South Korea. The results showed that the reliability was high, as indicated by a Cronbach [alpha] of.942. The exploratory factor analysis revealed 6 dimensions (assessment and implementation of spiritual care, professionalization and improvement of the quality of spiritual care, personal support and patient counseling, referral to professionals, attitude toward the patient's spirituality, and communication) with 27 items. The 6 factors explained 68.20% of the variance in the Korean version of the Spiritual Care Competence Scale. From the results, the Korean version of the Spiritual Care Competence Scale may serve as an appropriate measure for provision of spiritual care for patients with terminal illness. In addition, it may be useful in assessing hospice and palliative nurses' ability for spiritual care. [ABSTRACT FROM AUTHOR]

This study aimed to examine the effects of a sexual education program (SEP) focused on sexual media literacy (SML) for school nurses. A quasi-experimental, pre-/posttest design was used to examine SML knowledge, awareness, reinterpretation skill, and self-efficacy. A total of 66 school nurses participated. The experimental group (n = 35) participated in an 18-hr SEP that focused on SML, while the control group (n = 31) did not. The experimental group showed significant improvement in knowledge (t = 6.47, d = 1.62, p <.001), awareness (t = 5.08, d = 1.19, p <.001), reinterpretation skill (t = 4.81, d = 2.28, p <.001), and self-efficacy (t = 8.29, d = 1.38, p <.001) as compared to the control group. The SEP developed in this study may be an effective educational intervention for school nurses. [ABSTRACT FROM AUTHOR]

Educational outcomes, such as knowledge, confidence in performance, ability in nursing practice, and satisfaction with learning methods in caring for children with croup, were compared between groups of students that received education through simulation combined with pre-education, simulation only, and pre-education only. In this quasi-experimental design, the educational intervention for the experimental group was the pre-education modality. Data from a convenience sample of 127 senior nursing students were drawn from three nursing schools in South Korea. There were significant differences in the mean scores of knowledge, confidence in performance, satisfaction with the learning method, and ability in nursing practice between the three groups. Pre-education with simulation significantly enhanced students' knowledge, confidence in performance, ability in nursing practice, and satisfaction with learning methods compared with pre-education or simulation alone. Simulation strategies should focus more on enhancing nursing students' learning outcomes. [ABSTRACT FROM AUTHOR]

Conclusion: Middle fossa approach (MFA) shows a hearing preservation rate of 86% and facial nerve function was preserved with HB grade I or II in 93%. MFA is a good treatment option for intra-canalicular vestibular schwannomas when surgical excision is needed. Background: Surgical outcomes of vestibular schwannoma have progressively improved with the advancement of microsurgical instruments. MFA is known to have better chances to preserve hearing, while it has limited access to the posterior fossa, limitation of tumor size, and higher risk of post-operative facial nerve weakness. Objectives: To investigate surgical outcomes and clinical efficiency of MFA in vestibular schwannoma. Methods: A retrospective study was done in 14 patients who underwent MFA for vestibular schwannoma in Asan Medical Center. Results: The median age at diagnosis was 46.3 years. At initial presentation, 57% of the patients had vertigo, 43% hearing disturbance, and 64% tinnitus. The mean tumor size was 9.7 mm. The tumors were completely resected in 86% of the patients. Hearing was post-operatively preserved in 12 patients and two patients lost their hearing following surgery. Facial nerve function post-operatively remained unchanged in 12 patients (86%). [ABSTRACT FROM AUTHOR]

Purpose: Various immunocompromised conditions increase the risk of meningitis caused by Listeria monocytogenes. However, the relative importance of these risk factors has not been well established. We determined the risk factors that predict meningitis due to L. monocytogenes compared to that caused by Streptococcus pneumoniae. Methods: A nationwide multicenter case-control study was conducted in Korea. Cases of meningitis caused by L. monocytogenes between 1998 and 2013 were included. Patients with pneumococcal meningitis were included as controls. Multivariate logistic regression analysis was used to predict the risk factors of Listeria meningitis. Results: A total of 36 cases and 113 controls were enrolled. The most significant predictive risk factor of Listeria meningitis was a prior history of receiving immunosuppressive therapy (odds ratio 8.12, 95 % CI 2.47-26.69). Chronic liver disease was the second most important predictive risk factor (OR 5.03, 95 % CI 1.56-16.22). Delaying appropriate antibiotic therapy by more than 6 h (hazard ratio 2.78) and fatal underlying disease (hazard ratio 2.88) were associated with increased mortality. Conclusions: Patients with a prior history of receiving immunosuppressive therapy within 1 month and chronic liver disease have 8.1-fold and 5-fold increased risk of meningitis by L. monocytogenes compared to S. pneumoniae, respectively. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study was to identify the physiological, psychological, and situational factors affecting fatigue among mothers of hospitalized children. Design and Methods This study used a cross-sectional descriptive design with a self-report questionnaire. Participants were 211 mothers with children younger than 6 years old who were admitted to general hospitals. Based on the theory of unpleasant symptoms, the physiological, psychological, and situational factors were tested using structural equation modeling. Results Mothers' fatigue was influenced by physiological ( β = .24), situational, and psychological factors ( β = .17), and situational ( β = .37) factors such as the mother's sleeping hours, the child's adaptation to hospitalization, anxiety and having support with their housework. These three factors explained 31.34% of the variance in fatigue. In particular, it was found that the psychological factors exacerbate the negative influence of the situational factors on fatigue. Moreover, the situational factors were most strongly related to mothers' fatigue, and they had an indirect effect via the psychological factors as a mediator. Practice Implications It is necessary to implement a nursing intervention that targets the controllable factors such as anxiety and children's adaptation to hospitalization that were identified in this study. Pediatric nursing care should not be limited to treating children's illnesses, but should be extended to providing family-centered care. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to develop an educational program to promote healthy life behaviors and to evaluate its potential effects on the health practices of fifth grade elementary school children. Methods: The program, which consisted of six categories (daily life and health, disease prevention and management, prevention of drug misuse and overuse, sexuality and health, mental health, and injury prevention and first aid), was developed based on the ADDIE model. A pretest–post‐test, one‐group, quasi‐experimental design was used with 85 elementary school students who voluntarily participated in the program. Results: A school‐based educational program, called the “Six Kid Keys,” referring to the six categories of healthy life behaviors, was developed. Significant pre–post differences in two of the six healthy life behavior categories (disease prevention and management, injury prevention and first aid) were found. Conclusion: A school‐based intervention that was aimed at changing habits related to healthy life behaviors could be effective for elementary school children. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test the effects of healthy life practice (HLP) education on reported health behaviors, including health promotion, disease prevention, and safety among fourth-grade elementary school students. A quasi-experimental, pretest/posttest design was used. The 101 recruited participants from two schools were assigned to the intervention group (n = 51) that received 10 health education sessions and the control group (n = 50) that did not receive the intervention. Significant differences in health behaviors were observed between the two groups (t = 2.563, p = .012), specifically for disease prevention (t = 2.178, p = .032) and safety (t = 2.711, p = .008). However, no significant between-group differences were observed in health promotion (t = .270, p = .788). Educational interventions aimed at changing HLP-related health behaviors may be effective for elementary schoolchildren. [ABSTRACT FROM AUTHOR]

Conclusion:Seven-day administration of systemic steroids was more effective in preserving hearing for 12 weeks after cochlear implantation (CI) than a 3-day delivery. Objectives:To determine the effectiveness of extended delivery of systemic steroids to preserve hearing in guinea pigs after CI. Methods:Dexamethasone (4 mg/ml) was delivered parenterally via a mini-osmotic pump for either 3 or 7 days. A dummy CI electrode was inserted via cochleostomy approach in 8-week-old guinea pigs. Auditory thresholds were assessed from tone burst auditory brainstem responses (2, 8, 16, 24, and 32 kHz) at 1 day prior to CI, and 1, 4, and 12 weeks after implantation. Histologic evaluation of the cochleae was carried out. Results:No differences were observed in hearing thresholds among groups before CI. Significant hearing preservation was achieved at 8, 16, 24, and 32 kHz only in the 7-day infusion group compared with the control group at 1 week after CI. The same trend was maintained at 4 weeks (16, 24 kHz) and 12 weeks (16, 24, and 32 kHz). Histologic review of the 7-day infusion group revealed less fibrosis and ossification in the scala tympani and the preservation of more spiral ganglion cells, compared with the control group. [ABSTRACT FROM PUBLISHER]

Introduction. Frailty refers to a decreased physiologic reserve in geriatric patients and its importance in terms of treatment planning and outcome prediction has been emphasized in oncologic practices for older patients with cancer. We investigated the clinical implications of a head and neck cancer (HNC)-specific frailty index suggested by prospective clinical and functional evaluations of HNC patients. Materials and Methods. We analyzed data on 165 elderly patients with HNC who were prospectively enrolled in our hospital from 2010 to 2013. Pretreatment functional evaluations were performed according to all comprehensive geriatric assessment (CGA) domains. We additionally evaluated the patients' respiratory and swallowing functions using pulmonary function tests, voice handicap index (VHI), MD Anderson Dysphagia Inventory (MDADI), and other associated tests. Factors affecting the 2-year morbidity and mortality were also analyzed. Results. Respiratory and swallowing problems were major causes of 2-year morbidity. Pretreatment performance status, VHI ≥8, MDADI,70, dental problems, and chemotherapy were significantly associated with early morbidity and mortality (all p < .05). CGA-assessed frailty was found in 72 patients (43.6%) and was significantly associated with 2-year mortality (p = .027) but not with morbidity (p = .716). The high-risk group according to our new HNC-specific frailty index that included functional evaluations of respiration and swallowing showed significantly higher 2-year morbidity (p = .043) and mortality (p < .001). Conclusion. Pretreatment functional disabilities related to respiration and swallowing were significantly associated with early morbidity and mortality. The suggested index would be more useful for assessing frailty in elderly HNC patients. [ABSTRACT FROM AUTHOR]

Osteonecrosis of the femoral head (ONFH) is a complex and multifactorial disease that is influenced by a number of genetic factors in addition to environmental factors. Some autoimmune disorders, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and inflammatory bowel disease (IBD), are associated with the development of ONFH. Complement receptor type 2 (CR2) is membrane glycoprotein which binds C3 degradation products generated during complement activation. CR2 has many important functions in normal immunity and is assumed to play a role in the development of autoimmune disease. We investigated whether CR2 gene polymorphisms are associated with risk of ONFH in SLE patients. Eight polymorphisms in the CR2 gene were genotyped using TaqMan™ assays in 150 SLE patients and 50 ONFH in SLE patients (SLE_ONFH). The association analysis of genotyped SNPs and haplotypes was performed with ONFH. It was found that three SNPs, rs3813946 in 5′-UTR (untranslated region), rs311306 in intron 1, and rs17615 in exon 10 (nonsynonymous SNP; G/A, Ser639Asn) of the CR2 gene, were associated with an increased risk of ONFH under recessive model (P values; 0.004~0.016). Haplotypes were also associated with an increased risk (OR; 3.73~) of ONFH in SLE patients. These findings may provide evidences that CR2 contributes to human ONFH susceptibility in Korean SLE patients. [ABSTRACT FROM AUTHOR]

This study determines the effect of simulation with team-based learning ( TBL) on newborn nursing care. This randomized controlled trial included 74 nursing students from one university located in Seoul, South Korea. Participants were categorized into two groups according to educational modality: one group involved both simulation and TBL, and the other involved simulation alone. Learning attitudes , academic achievement, and simulation performance were examined to assess effectiveness. The mean difference in learning attitudes between the two groups was non-significant. Low academic achievement differed significantly between the two groups (t = 3.445, P = 0.002). There was no significant difference in mean scores for simulation performance between the two groups. In this study, simulation with TBL was effective in improving learning outcomes. In current nursing education, various learning methods are employed within complex nursing situations and require flexibility and problem-solving approaches. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the association of a urinary tubular marker, liver-type fatty acid binding protein (L-FABP) and an inflammatory marker, serum/urinary YKL-40, with albuminuria in patients with childhood-onset type 1 diabetes (T1D). Methods: Twenty-nine patients with childhood-onset T1D and 32 controls were enrolled. Serum and urinary concentrations of YKL-40 and urinary concentrations of L-FABP were measured. Results: The serum levels of YKL-40 were not significantly different between the control group and the patient groups. However, the levels of urinary YKL-40/creatinine (Cr) were higher in the patients, even those with normoalbuminuria than in the controls ( p < 0.001). The levels of urinary L-FABP/Cr were not different between the control group and the patient groups. However, the level of urinary L-FABP/Cr in the microalbuminuria group was higher than that in the normoalbuminuria group ( p = 0.03). There were no associations between the levels of urinary albumin-to-creatinine ratio and urinary L-FABP/Cr or YKL-40/Cr. However, the urinary L-FABP/Cr level was significantly correlated with the hemoglobin A1C level ( p = 0.005) and the urinary YKL-40/Cr level ( p = 0.043). Conclusions: Urinary L-FABP/Cr and YKL-40/Cr may reflect renal injury in early stages of nephropathy in patients with childhood-onset T1D, even in the normoalbuminuric state. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to determine the number and characteristics of US State Registrars of Vital Statistics (Vital Registrars) and State Systems Development Initiative (SSDI) Coordinators that link birth certificate and hospital discharge data as well as using linkage processes. Methods: Vital Registrars and SSDI Coordinators in all 52 vital records jurisdictions (50 states, District of Columbia, and New York City) were asked to complete a 41-question survey. We examined frequency distributions among completed surveys using SAS 9.3. Results: The response rate was 100 % (N = 52) for Vital Registrars and 96 % (N = 50) for SSDI Coordinators. Nearly half of Vital Registrars (n = 22) and SSDI Coordinators (n = 23) reported that their jurisdiction linked birth certificate and hospital discharge records at least once in the last 4 years. Among those who link, the majority of Vital Registrars (77.3 %) and SSDI Coordinators (82.6 %) link both maternal and infant hospital discharge records to the birth certificate. Of those who do not link, 43 % of the Vital Registrars and 55 % of SSDI Coordinators reported an interest in linking birth certificate and hospital discharge data. Reasons for not linking included lack of staff time, inability to access raw data, high cost, and unavailability of personal identifiers to link the two sources. Conclusions: Results of our analysis provide a national perspective on data linkage practices in the US. Our findings can be used to promote further data linkages, facilitate sharing of data and linkage methodologies, and identify uses of the resulting linked data. [ABSTRACT FROM AUTHOR]

Objectives: Women with gestational diabetes mellitus (GDM) may be able to reduce their risk of recurrent GDM and progression to type 2 diabetes mellitus through lifestyle change; however, there is limited population-based information on GDM recurrence rates. Methods: We used data from a population of women delivering two sequential live singleton infants in Massachusetts (1998-2007) to estimate the prevalence of chronic diabetes mellitus (CDM) and GDM in parity one pregnancies and recurrence of GDM and progression from GDM to CDM in parity two pregnancies. We examined four diabetes classification approaches; birth certificate (BC) data alone, hospital discharge (HD) data alone, both sources hierarchically combined with a diagnosis of CDM from either source taking priority over a diagnosis of GDM, and both sources combined including only pregnancies with full agreement in diagnosis. Descriptive statistics were used to describe population characteristics, prevalence of CDM and GDM, and recurrence of diabetes in successive pregnancies. Diabetes classification agreement was assessed using the Kappa statistic. Associated maternal characteristics were examined through adjusted model-based t tests and Chi square tests. Results: A total of 134,670 women with two sequential deliveries of parities one and two were identified. While there was only slight agreement on GDM classification across HD and BC records, estimates of GDM recurrence were fairly consistent; nearly half of women with GDM in their parity one pregnancy developed GDM in their subsequent pregnancy. While estimates of progression from GDM to CDM across sequential pregnancies were more variable, all approaches yielded estimates of ≤5 %. The development of either GDM or CDM following a parity one pregnancy with no diagnosis of diabetes was <3 % across approaches. Women with recurrent GDM were disproportionately older and foreign born. Conclusion: Recurrent GDM is a serious life course public health issue; the inter-pregnancy interval provides an important window for diabetes prevention. [ABSTRACT FROM AUTHOR]

Patients infected with human immunodeficiency virus (HIV) may develop mental health problems such as anxiety and depression, which negatively impact of disease progression. We investigated factors associated with the prevalence of anxiety and depression symptoms among HIV-infected patients in Korea. A total of 840 HIV-infected patients who participated in the Korea HIV/AIDS Cohort Study from 2006 to 2012 were evaluated. Socio-demographic, epidemiologic, and clinical variables were obtained through standardized questionnaires. The State-Trait Anxiety Inventory and Beck Depression Inventory were used to assess the symptoms of anxiety and depression. Multiple logistic regression analyses were performed to identify factors associated with symptoms of anxiety and depression. The prevalence of anxiety and depressive symptoms among HIV-infected patients was 32% and 36%, respectively. Ex-smoker and persistent symptoms for more than one week within the past six months and diagnosis of HIV infection within one year were associated with increased anxiety symptoms (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.09–2.69; OR 1.52, 95% CI 1.09–2.11; OR 1.49, 95% CI 1.02–2.20) and current smoking and persistent symptoms were also associated with increased depressive symptoms (OR 2.10, 95% CI 1.31–3.30; OR 1.87, 95% CI 1.25–2.79). Marital status, current smoking, current drinking, and persistent symptoms were associated with both increased anxiety and depressive symptoms (OR 1.75, 95% CI 1.07–2.88; OR 1.66, 95% CI 1.06–2.61; OR 1.88, 95% CI 1.18–2.99). The prevalence of anxiety and depressive symptoms among HIV-infected patients is higher than those estimated for the general population. This study shows the necessity to evaluate symptoms of anxiety and depression and suggest psychological support for HIV-infected patients who smoke or have persistent symptoms or have sexual partner or drink. [ABSTRACT FROM AUTHOR]

Background Central sensitization plays an important role in the chronic pain experienced by osteoarthritis ( OA) patients. In this prospective observational study, we investigated the influence of the level of preoperative centrally mediated symptoms measured by the Central Sensitization Inventory ( CSI) on pain intensity after total knee arthroplasty ( TKA) for OA. Methods Ninety-eight female OA patients undergoing TKA were enrolled in this study. We assessed CSI scores, pain-related data, and other clinical data preoperatively. All patients received spinal anesthesia and postoperative epidural analgesia. Pain intensity (at rest and on movement) and rescue meperidine requirements were assessed during postoperative days 1 and 2. Also, pain intensity and patient satisfaction were assessed 1 month and 3 months after surgery. After the completion of all postoperative assessments, we separated the study population into a preoperative CSI score ≥40 and <40 group. We assessed pain-related data between the 2 groups at each assessment time. Results Ninety-one patients completed the postoperative assessments (a preoperative CSI ≥40 group; n = 44, CSI <40 group; n = 47). Patients with preoperative CSI ≥40 complained of a greater pain intensity ( P = 0.001) during postoperative days 1 and 2 and required a higher dose of meperidine rescue ( P = 0.003) than those with a preoperative CSI <40. The high CSI score group also showed a less favorable outcome in terms of pain relief on follow-up at 1 month ( P = 0.006) and 3 months ( P = 0.002) after surgery. In multivariate analysis, a preoperative CSI score ≥40 was the strongest determinant with 5.091 of the highest odds ratio (95% CI 1.324 to 19.523, P = 0.016) for predicting a persistent pain 3 months after surgery among demographic and pain-related variables. Conclusions OA patients with high levels of comorbid centrally mediated symptoms showed severe pain and increased analgesic requirements after TKA in the early postoperative period. Moreover, these patients seemed to be at higher risk of persistent pain, and a high CSI score was predictive of low patient satisfaction in terms of pain relief after surgery. [ABSTRACT FROM AUTHOR]

Background This study estimates the duration of sleep and its relationships with clinical correlates in a community sample of elderly individuals in Korea. Methods A total of 1924 individuals aged 65 and over were interviewed in Korea. Sleep durations were classified into five categories: 5.00 h or less, 6.00 h per day, 7.00 h per day, 8.00 h per day, and 9.00 h or more per day. Sleep disturbance was classified into four sleep complaints: difficulty initiating sleep, difficulty maintaining sleep, early-morning awakening, and non-restorative sleep. The Mini- Mental Status Examination, the Geriatric Depression Scale, and questionnaires about the presence of cardiovascular disease were employed. Results The most frequent self-reported sleep duration was 7.00 h. The mean sleep duration was 6.46 h. Female subjects, subjects between the ages of 75 and 79, and subjects with current depression were associated with sleeping for 6.00 h or less or 9.00 h or more. Subjects who lived alone and those with cardiovascular disease were associated with sleeping for 5.00 h or less. Subjects aged 80 and over, formally educated subjects, current smokers, and subjects with cognitive dysfunction were associated with sleeping for 9.00 h or more. Sleep disturbances according to sleep duration has a U-shaped distribution. We found that all sleep disturbances were significantly related to sleep durations of 6.00 h or less compared to sleep durations of 7.00 h. We also found that non-restorative sleep was significantly related to sleep durations of 8.00 h or more compared to sleep durations of 7.00 h. Conclusion A relatively high prevalence of short or long sleep duration was identified. Various sociodemographic variables influenced sleep duration. Depression, cognitive dysfunction, and cardiovascular disease were associated with short or long sleep duration. Careful attention should be paid to the health of elderly individuals who are short or long sleepers. [ABSTRACT FROM AUTHOR]

Background Because of its anatomical location and function, the obturator externus ( OE) muscle can be a source of pain; however, this muscle is understudied as a possible target for therapeutic intervention in pain practice. In this retrospective observational study, we evaluated the clinical effectiveness of the OE muscle injection with a local anesthetic in chronic pelvic pain patients with suspected OE muscle problems. Methods Twenty-three patients with localized tenderness on the inferolateral side of the pubic tubercle accompanied by pain in the groin, anteromedial thigh, or hip were studied. After identifying the OE with contrast dye under fluoroscopic guidance, 5 to 8 mL of 0.3% lidocaine was injected. Pain scores were assessed before and after injection; patient satisfaction was also assessed. Results Mean pain score decreased by 44.7% (6.6 ± 1.8 to 3.5 ± 0.9, P < 0.001) 2 weeks after OE muscle injection as compared with pain score before injection. In addition, 82% of patients (19 of 23 patients) reported excellent or good satisfaction during 2 weeks after injection. No patients reported complications from OE muscle injection. Conclusions Fluoroscopy-guided injection of the OE muscle with local anesthetic reduced pain scores and led to a high level of satisfaction at short-term follow-up in patients with suspected OE muscle problem. The results of this study suggest that OE muscle injection may be a valuable therapeutic option for a select group of chronic pelvic pain patients who present with localized tenderness in the OE muscle that is accompanied by groin, anteromedial thigh, or hip pain. [ABSTRACT FROM AUTHOR]

The objectives are to report the estimated prevalence of pregnancy complications and adverse pregnancy outcomes in a defined population of Alaska Native women and also examine factors contributing to an intensive and successful collaboration between a tribal health center and the Centers for Disease Control and Prevention. Investigators abstracted medical record data from a random sample of singleton deliveries to residents of the study region occurring between 1997 and 2005. We used descriptive statistics to estimate the prevalence and 95 % confidence intervals of selected pregnancy complications and adverse pregnancy outcomes. Records were examined for 505 pregnancies ending in a singleton delivery to 469 women. Pregnancy complication rates were 5.9 % (95 % CI 4.0, 8.4) for gestational diabetes mellitus, 6.1 % (95 % CI 4.2, 8.6 %) for maternal chronic hypertension and 11.5 % (95 % CI 8.8, 14.6) for pregnancy associated hypertension, and 22.9 % (95 % CI 19.2-26.5 %) for anemia. The cesarean section rate was 5.5 % (95 % CI 3.5, 7.5) and 3.8 % (95 % CI 2.3, 5.8) of newborns weighed >4,500 g. Few previous studies reported pregnancy outcomes among Alaska Native women in a specific geographic region of Alaska and regarding the health needs in this population. We highlight components of our collaboration that contributed to the success of the study. Studies focusing on special populations such as Alaska Native women are feasible and can provide important information on health indicators at the local level. [ABSTRACT FROM AUTHOR]

Based on their higher risk of type 2 diabetes, non-Hispanic blacks (NHBs) would be expected to have higher gestational diabetes mellitus (GDM) risk compared to non-Hispanic whites (NHWs). However, previous studies have reported lower GDM risk in NHBs versus NHWs. We examined whether GDM risk was lower in NHBs and NHWs, and whether this disparity differed by age group. The cohort consisted of 462,296 live singleton births linked by birth certificate and hospital discharge data from 2004 to 2007 in Florida. Using multivariable regression models, we examined GDM risk stratified by age and adjusted for body mass index (BMI) and other covariates. Overall, NHBs had a lower prevalence of GDM (2.5 vs. 3.1 %, p < 0.01) and a higher proportion of preconception DM births (0.5 vs. 0.3 %, p ≤ 0.01) than NHWs. Among women in their teens (risk ratio 0.56, p < 0.01) and 20-29 years of age (risk ratio 0.85, p < 0.01), GDM risk was lower in NHBs than NHWs. These patterns did not change with adjustment for BMI and other covariates. Among women 30-39 years (risk ratio 1.18, p < 0.01) and ≥40 years (risk ratio 1.22, p < 0.01), GDM risk was higher in NHBs than NHWs, but risk was higher in NHWs after adjustment for BMI. Associations between BMI and GDM risk did not vary by race/ethnicity or age group. NHBs have lower risk of GDM than NHWs at younger ages, regardless of BMI. NHBs had higher risk than NHWs at older ages, largely due to racial/ethnic disparities in overweight/obesity at older ages. [ABSTRACT FROM AUTHOR]

The article presents a study that determines the distribution of fragile X mental retardation 1 (FMR1) alleles and the prevalence of permutation (PM) and full mutation (FM) of the gene in Korean women. It describes the method of the study that uses polymerase chain reaction and Southern blot on 5829 of reproductive age. It notes the result of the study which indicates the carrier frequency in Korean women of reproductive age, which is lower than the Caucasians.

There is limited data on prepregnancy obesity trends specifically among low-income women, a population at high risk for obstetric complications. Using the Pregnancy Nutrition Surveillance System, we assessed prepregnancy obesity [body mass index (BMI) ≥ 30 kg/m] trends among women who participated in the Supplemental Nutrition Program for Women, Infants, and Children in 1999, 2004, and 2008. Prepregnancy BMI was calculated using measured height and self-reported prepregnancy weight. We report unadjusted contributor (state, territory or Indian tribal organization) specific trends, and both unadjusted and adjusted overall trends, to account for changes in maternal age and race-ethnic distributions, using 1999 as the referent. Of the 27 contributors in 1999, 2 had a prepregnancy obesity prevalence <20%, and 1 had a prevalence ≥30%. Of the 35 contributors in 2008, none had a prepregnancy obesity prevalence <20%, and 14 had a prevalence ≥30%. From 1999 to 2008, the overall prevalence of prepregnancy obesity increased among all racial-ethnic groups, except among American Indian/Alaskan Natives, where it remained high, but stable. Overall prepregnancy obesity increased most rapidly among Hispanics, and remained stable from 2004 to 2008 among non-Hispanic blacks. In 2008, prevalence was highest among American Indian/Alaskan Natives (36.1%) and lowest among Asians/Pacific Islanders (10.8%). The adjusted prepregnancy obesity prevalence increased from 24.8% in 1999 to 28.3% in 2008, a relative increase of 14.1%. Prepregnancy obesity among low-income women increased from 1999 to 2008 and varied by race-ethnicity. These data can be used by obesity prevention programs to better target high-risk women. [ABSTRACT FROM AUTHOR]

We examined factors associated with lifetime treatment of major depressive disorder (MDD) in a nationwide sample of Korean adults. Of the 6,510 subjects aged 18-64 years who participated in the Korean Epidemiologic Catchment Area study, 362 (5.6%) with a lifetime diagnosis of MDD were analyzed. Diagnostic assessments were based on the Korean version of the Composite International Diagnostic Interview administered by lay interviewers. Of the 362 respondents with a lifetime diagnosis of MDD, 117 (32.3%) had been treated for psychiatric problems. Treated individuals with MDD were more likely to have chronic episode(s), more symptoms of depression, insomnia, and suicidal ideation, and were less likely to have feelings of guilt. In addition, treated individuals were more likely to have comorbid anxiety disorders, especially obsessive-compulsive disorder, post-traumatic stress disorder, and generalized anxiety disorder. Treatment-seeking by individuals with MDD is affected by socio-cultural factors such as misconception and stigma of mental illness, as well as severity of depression and comorbid conditions. [ABSTRACT FROM AUTHOR]

Aim: This study examined the effects of a conscious sedation dressing on pain and anxiety in pediatric patients with burns. Methods: This was a quasi‐experimental study, using a nonequivalent control group. Using convenience sampling, the participants were assigned to two groups, an experimental group (n = 10), which comprised children who received a conscious sedation dressing, and a control group (n = 13), which comprised children who received general dressing care. To minimize the risk of contamination between the two groups, the sampling was sequentially performed. Results: The children in the experimental group showed significantly lower levels of pain (U = 3.29, d = 1.00, P =.003) and physiological responses, as evidenced by lower systolic blood pressures, diastolic blood pressures, pulse rates, and respiratory rates than the control group (systolic blood pressures: t = 5. 05, d = 1.22, P <.001; diastolic blood pressures: t = 2.12, d = 0.93, P =.046; pulse rates: t = 2.28, d = 1.00, P =.033; and respiratory rates: t = 2.47, d = 1.09, P =.022). Conclusion: The application of a conscious sedation dressing may alleviate pain and anxiety for pediatric burn patients. [ABSTRACT FROM AUTHOR]

In this study, we identified the factors influencing behavioral intention to undergo Papanicolaou testing among Japanese and Korean women in early adulthood. Their behavioral intentions were compared in this cross-sectional descriptive study. In total, 887 women (Japanese = 498, Korean = 389) aged 20-39 years participated in this study. Using a self-report questionnaire, knowledge, attitudes, subjective norm, perceived behavioral control, and behavioral intention were surveyed. There were significant differences between Japanese and Korean women's scores on all main variables. For Japanese women, all the variables moderately correlated with behavioral intention. In comparison, for Korean women, all independent variables, except for knowledge, moderately correlated with behavioral intention. Through a multiple regression analysis, age, undergoing Papanicolaou testing, attitudes, subjective norm, and perceived behavioral control were identified as significant predictors of behavioral intention among Japanese women. Among Korean women, job status, undergoing a Papanicolaou test, attitudes, subjective norm, and perceived behavioral control were demonstrated as significant predictors of behavioral intention. Health professionals should consider these factors to encourage Papanicolaou testing in women in early adulthood. [ABSTRACT FROM AUTHOR]