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The purpose of the current study is to validate the Counseling Competencies Scale Revised (CCS-R). We used convenience sampling to recruit counselors and counselors-in-training (N = 156). Specifically, we had 130 female (83.3%) and 26 male (16.7%) participants, and the mean age was 33.16 (SD = 11.18), ranging from 20 to 62 years old. We used correlational analyses, ANOVA, and confirmatory factor analysis to understand the characteristics of the sample and assess the psychometrics of the CCS-R-K. Results showed the validity and reliability of the data, including the acceptable model fits and high alpha reliability coefficient values. We also found that the scores of the CCS-R-K were positively related to participants' years of clinical experience and educational levels. The CCS-R-K can be used as a measurement tool to objectively and comprehensively evaluate Korean counselors' competency in counselor education, contributing to cultivating counselors with the professional competencies required by our society. [ABSTRACT FROM AUTHOR]

The current study investigated the relationship between research self-efficacy, perceived research training environment and research productivity among 174 doctoral students enrolled in counselling programmes in universities across the United States. Results indicated that students’ research self-efficacy was positively correlated with their research productivity, and research training environment was also positively related to their research productivity. Moreover, students’ perceived research training environment was found to moderate the relationship between research self-efficacy and research productivity. Implications for programme faculty and doctoral research training are discussed. [ABSTRACT FROM AUTHOR]

We investigated the effect of careless or insufficient effort (C/IE) responses in a study using Amazon's Mechanical Turk. A factor mixture model was used to identify latent classes based on the pattern of responses with biases and examine the effect of C/IE responses on the fit of the theoretical model. [ABSTRACT FROM AUTHOR]

This article introduces a combined supervision model, the Integrative Developmental Model for Narrative Supervision (IDMNS), which incorporates the Integrative Developmental Model and Narrative Supervision Model. This model provides concrete guidelines for supervisors to incorporate narrative processes in clinical supervision while attending to supervisees' developmental needs. Specifically, the proposed tenets of the model include multicultural awareness, supervisory relationship, and narrative facilitation. The benefits and the limitations of the model are identified along with a case study of the IDMNS in practice. Implications for future research are discussed. [ABSTRACT FROM AUTHOR]

This study examined the association between parental perceived need for counseling or mental health care services and adolescents' subgroups of anxiety and depression symptoms (Anxiety-only, Depression-only, Anxiety-Depression, and None). Adolescent sample (N = 20,486, M = 14.69 years old, SD = 1.69) was drawn from the National Survey of Children's Health 2017–2018 (NSCH 2017–2018). A chi-square test was used to analyze the association between two categorical variables. The Chi-square test was statistically significant, Χ2(6) = 7,914.33, p <.01, V =.44. Adolescents from the Anxiety-Depression group received counseling or mental health care the most (80.94%), while 69.03% of those in the depression-only group and 44.86% in the Anxiety-only group received mental health services. Caregivers of adolescents with Anxiety-only tended to perceive the least need for counseling or mental health care, compared with those with depression or both, suggesting the need to enhance mental health awareness. [ABSTRACT FROM AUTHOR]

Multicultural counseling competencies (MCC) in an intake interview is the most fundamental component of affirmative counseling practice for individuals that identify as lesbian, gay, bisexual, transgender, queer (LGBTQ), or other sexual-relational orientation or gender identity. Despite the importance of counselors' MCC in the area of intake interviews, little practical guidance exists to help counselors conduct multicultural competent intake interviews. This article provides practical guidelines and strategies for counselors to engage clients in multiculturally competent intake interviews. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the clinical characteristics and clinical course of Asian elderly-onset Crohn’s disease (EOCD) patients in a large well-defined cohort of South Korean IBD patients. Materials and methods: From the Asan inflammatory bowel disease registry, we identified 29 EOCD patients (diagnosed with CD in age of 60 years or over) out of 2989 CD patients (1.0%). After excluding two patients with unclear data, 27 EOCD were matched with 108 young-onset CD (YOCD) and 108 middle age-onset CD (MOCD) for the interval from symptom onset to diagnosis (±3 years) and follow-up duration (±3 years). Results: Females were predominant in the EOCD group (59.3%) compared to MOCD (31.5%) and YOCD (29.6%) groups (p = .012). In EOCD group, terminal ileal location was the most common (63.0%) at diagnosis, whereas ileocolonic location in other groups (57.4% in MOCD and 78.7% in YOCD, respectively) (p < .001). Patients with perianal fistula at CD diagnosis were less common (14.8% in EOCD vs. 28.7% in MOCD vs. 49.1% in YOCD, p < .001). During follow-up, thiopurines were used less frequently in the EOCD group (48.1% in EOCD vs. 87.0% in MOCD vs. 89.8% in YOCD, p < .001), but the risk for intestinal resection was comparable among three groups (p = .583). Conclusions: EOCD may have a better clinical course than MOCD and YOCD, as demonstrated by the similar risk for intestinal resection despite the less frequent use of thiopurines. [ABSTRACT FROM AUTHOR]

Objective: The effectiveness ofHelicobacter pyloritherapies has declined with an increase in antibiotic resistance. To overcome this problem, the efficacy of tailoredH. pylorieradication therapy based on antimicrobial susceptibility testing was compared with that of empirical second-line rescue regimens.Material and methods: Patients who had persistentH. pyloriinfection after the first eradication were recommended to undergo culture for determining the minimal inhibitory concentration (MIC) via gastroscopy, which increased the cost by 300%. Fourteen-day esomeprazole, tripotassium dicitrate bismuthate, metronidazole and tetracycline (EBMT) therapy or esomeprazole, moxifloxacin and amoxicillin (MEA) therapy was performed according to the results of antibiotic susceptibility testing. In case of refusal to undergo culture, the participants were treated with either 14-day empirical EBMT or MEA regimen for second eradication after explaining the complexity, side effects and costs associated with each regimen. This trial was registered at ClinicalTrials.Gov (NCT 02349685).Results: In the 219 patients included, the intention to treat (ITT) and per protocol (PP) eradication rates was 75.3% and 79.8% in the 14-day EBMT group (n=89), 70.8% and 72.4% in the 14-day MEA group (n=89) and 87.8% and 100.0% in the 14-day tailored therapy group (n=41), respectively. Based on the PP analysis, the 14-day tailored therapy group showed a significantly higher eradication rate than the 14-day EBMT or MEA group (bothp ≤ 0.001).Conclusions: Tailored therapy based onH. pyloriculture and MIC test could be an option as a second-line eradication regimen in the presence of high level of antimicrobial resistance. [ABSTRACT FROM PUBLISHER]

Objective. Antimicrobial resistance of Helicobacter pylori is most important factor in eradication success. GenoType HelicoDR test has been developed for rapid detection of antimicrobial resistance. The present study evaluated the clinical usefulness of GenoType HelicoDR test in Korea. Materials and methods. To detect 23S rRNA for clarithromycin resistance and gyrA mutations for fluoroquinolone resistance, both DNA sequencing after minimal inhibitory test (MIC) and GenoType HelicoDR test were performed in H. pylori isolates from the gastric mucosa of 101 patients. The eradication results of clarithromycin and moxifloxacin-containing triple therapy were evaluated by the 23S rRNA and gyrA mutations. Results. For 42 isolates with A2143G mutation by GenoType HelicoDR, 83.3% (35/42) of concordance rate was estimated with DNA sequencing method and 85.7% (36/42) for MIC test. For 43 isolates with N87K mutation by GenoType HelicoDR, 71.1% (31/43) of concordance rate was estimated with DNA sequencing and 88.4% (38/43) for MIC test. The sensitivity and specificity of GenoType HelicoDR test in determination of 23S rRNA mutation were 94.9% and 87.1%, and those of gyrA 98.2% and 80.0%. The sensitivity and specificity of GenoType HelicoDR test in determination of clarithromycin resistance based on MIC test were 55.0% and 80.0%, for fluoroquinolone 74.4% and 70.0%. Conclusion. GenoType HelicoDR test is useful to determine mutations responsible for clarithromycin or fluoroquinolone-containing eradication failure but has a limitation for the clinical applicability in determination of resistance. [ABSTRACT FROM AUTHOR]

Objective. The eradication rate of 10-day sequential therapy for Helicobacter pylori ( H. pylori) infection was not satisfactory in Korea, probably due to antibiotic resistance. To compare the treatment efficacy of 15-day and 10-day sequential therapy of conventional 7-day proton pump inhibitor (PPI) triple therapy for the treatment of H. pylori infection. Methods. A total of 332 patients with H. pylori infection were randomly assigned to receive either 7-day PPI triple therapy, 10-day sequential therapy or 15-day sequential therapy. Eradication rate, drug compliance, and adverse events were compared among the three regimens. Results. The eradication rates by intention-to-treat analysis were 64.3% (95% CI: 55.5-73.2; 74 of 115 patients), 72.1% (95% CI: 63.6-80.5; 80 of 111 patients), and 80.2% (95% CI: 72.5-87.9; 85 of 106 patients) in the 7-day PPI triple, 10-day and 15-day sequential therapy groups, respectively ( p = 0.032). The eradication rates by per-protocol analysis were 68.5% (95% CI: 59.6-77.4; 74 of 108 patients), 78.4% (95% CI: 70.3-86.5; 80 of 102 patients), and 89.5% (95% CI: 83.2-95.8; 85 of 95 patients) in the 7-day PPI triple, 10-day and 15-day sequential therapy groups, respectively ( p = 0.001). There were no statistically significant differences between the three eradication therapy groups in regard to drug compliance and adverse events. Conclusion. The 15-day sequential therapy demonstrated improved eradication efficacy compared with 7-day PPI triple and 10-day sequential therapy in Korea. [ABSTRACT FROM AUTHOR]

Objectives. The role of the Helicobacter pylori, nonsteroidal anti-inflammatory drugs (NSAIDs), and antiplatelet agents in the risk of peptic ulcer bleeding has not yet been established. This study was performed to identify the risk factors for peptic ulcer bleeding compared with non-bleeding peptic ulcer disease (PUD). Material and methods. A total of 475 patients, 265 with bleeding PUD and 210 with non-bleeding PUD were consecutively recruited. H. pylori status was determined by histology, rapid urease test, and culture. Exposure to NSAIDs, aspirin, and antiplatelet agents (clopidogrel and ticlopidine) within 4 weeks was obtained. Results. Compared with non-bleeding PUD, bleeding PUD had a higher proportion of male gender and current smoking, alcohol drinking, history of aspirin/antiplatelet use, and history of PUD. Whereas the proportion of H. pylori infection and history of H. pylori eradication in bleeding PUD were significantly lower than that in non-bleeding PUD. In multivariate analysis, male gender (OR 1.78, 95% CI 1.10-2.89), drinking alcohol (OR 2.08, 95% CI 1.29-3.14), aspirin/antiplatelet use (OR 2.35, 95% CI 1.45-3.82), and history of PUD (OR 2.46, 95% CI 1.36-4.46) remained independent risk factors for bleeding PUD. When H. pylori status and aspirin/antiplatelet agent use were combined, highest risk of bleeding peptic ulcers was found among H. pylori-negative patients with a history of aspirin/antiplatelet agent use (OR 3.03 95% CI 1.48-6.18) compared with H. pylori-positive patients with no history of aspirin/antiplatelet agent use. Conclusions. Patients with H. pylori-negative peptic ulcers who continuously took aspirin or antiplatelet agents had the highest peptic ulcer bleeding risk. [ABSTRACT FROM AUTHOR]

Objective. Helicobacter pylori infections are acquired primarily during childhood, but also occur in adults. As no published estimates are available on the seroconversion rate of H. pylori in the Korean population, the purpose of this study was to evaluate the incidence and prevalence of H. pylori infection in male Korean employees. Material and methods. Levels of anti- H. pylori IgG were measured by ELISA, and gastroscopic findings were checked in 588 employees of the Subway Corporation (aged 40–60&ThickSpace;years, male) in 1997, 1998, 1999, 2000, and 2003. Questionnaire responses concerning socio-economic state, education level, and type of job were analyzed versus serologic test results. Results. Out of the 588 subjects, 455 (77.4%) were positive for anti- H. pylori IgG. Multivariate analysis showed that abnormal gastroscopic findings, especially duodenal ulcers, were more frequent in the H. pylori -positive group (17.6%) than in the initially H. pylori -negative group (9.0%) (OR: 1.71, 95% CI: 1.07–2.81). Among the multiple questionnaires, only the proportion of white-collar workers was significant; that is, it was lower in the H. pylori -positive group (44.6%) than in the initial H. pylori -negative group (57.9%) (OR: 0.62, 95% CI: 0.41–0.92). Seventeen of 133 subjects (12.8%) who were initially seronegative underwent seroconversion during a 6-year follow-up period, a seroconversion rate of 2.13%/annum. Conclusions. The seroprevalence of H. pylori infection in this study group was 77.4% and duodenal ulcer was more frequent in H. pylori -positive subjects, thus confirming the relationship between H. pylori infection and duodenal ulcer. Seroconversion of H. pylori infection in the Korean male employees was determined to be 2.13% per year, suggesting that new infections occur continuously even during late adulthood. [ABSTRACT FROM AUTHOR]

Objectives. There have been no reported data on the medical care cost of idiopathic peptic ulcer disease (PUD) compared with H. pylori (++) and/or NSAID (++) cases although H. pylori-negative idiopathic ulcers are increasing. The aim of this study was to investigate the direct medical care costs of PUD based on whether it was H. pylori infection/from NSAIDs or idiopathic. Material and methods. One hundred and seventy three patients with PUD comprising H. pylori and/or NSAID use-associated PUD ( n == 145) and idiopathic PUD ( n == 28) were prospectively enrolled in this study. The direct medical care costs were analyzed retrospectively for the patients with PUD during a one-year follow-up period. Results. The recurrence rate within one year was significantly higher in idiopathic PUD than H. pylori and/or NSAID-associated PUD ( p == 0.002). Direct medical care costs of idiopathic PUD ($$2483.8) were higher than in patients with H. pylori and/or NSAID-associated PUD ($$1751.8) resulting from longer duration of medication and higher proportion of endoscopic hemostasis and hospitalization. Conclusions. More clinical research is needed to improve outcome and reduce recurrence rate and medical care costs of idiopathic PUD. [ABSTRACT FROM AUTHOR]

Background and Aims: Performing an endoscopy out of hours confer significant burdens on limited health-care resources. However, not all on-call endoscopies lead to therapeutic interventions. The purpose of the present study was to analyze predictive factors for performing therapeutic intervention in patients with suspected gastrointestinal bleeding. Methods: We reviewed and analyzed electronic medical records regarding on-call endoscopy that were prospectively collected for quality control. The subjects were patients with suspected gastrointestinal bleeding who underwent on-call endoscopies at night, on weekends and on holidays between April 2013 and January 2017 in Seoul National University Bundang Hospital. To determine predictive factors for performing therapeutic intervention, the following variables were analyzed: symptoms, patient status, coexisting disease, laboratory findings and medications. To clarify the association between the likelihood of therapeutic intervention in on-call endoscopy and AIMS65 score, the included variables were divided by cutoffs. Results: A total of 270 patients (male: 72.6%, mean age: 62.6 years) with suspected gastrointestinal bleeding had on-call endoscopies and 153 (56.7%) patients had therapeutic intervention. Gastroscopy, colonoscopy and both endoscopic techniques were performed in 215, 42 and 13 patients, respectively. In the multivariate analysis, hematemesis (p < .001, odds ratio [OR], 2.484) and prolonged prothrombin time-international normalized ratio (PT-INR) (p = .033; OR, 1.958) were correlated with performing therapeutic intervention in on-call endoscopy. AIMS65 score with a cutoff of 2 was associated with the likelihood of intervention (p = .043). Conclusions: Hematemesis and prolonged PT-INR were predictive factors of therapeutic intervention when on-call endoscopy was performed in patients with suspected gastrointestinal bleeding. [ABSTRACT FROM AUTHOR]

Objectives: The prevalence of upper gastrointestinal disease is expected to change following advances in socioeconomic status and improved hygiene in Korea. The aim of this study was to investigate the recent trends in upper gastrointestinal diseases based on endoscopic findings and Helicobacter pylori (H. pylori) seroprevalence in subjects undergoing health check-up at tertiary centers in Korea. Methods: A multicenter cross-sectional study was conducted at nine healthcare centers between September 2016 and June 2017. The subjects were evaluated using questionnaires, upper endoscopy and H. pylori serology tests. The results were compared with previous data in our study group obtained from eight tertiary healthcare centers in 2011 (n = 4023). Results: In total, we prospectively enrolled 2504 subjects undergoing health check-up. The prevalence of reflux esophagitis (RE) was 9.7%, which showed an increasing but insignificant trend since 2011 (8.8%). The prevalence of active and healing-stage benign gastric ulcer and duodenal ulcer (DU) was 1.6% and 1.2%, respectively, which confirmed a significant decrease since 2011 (4.1%; p < .001 and 2.2%; p = .005, respectively). The prevalence of gastric cancer was 0.5%, representing an increasing trend since 2011 (0.12%; p = .003). H. pylori seroprevalence was 51.3%, which significantly decreased from 2011 (59.8%; p < .001). In multivariate analysis, H. pylori seropositivity was a significant risk factor for DU (p < .001), whereas a significant protective factor against RE (p < .001). Conclusions: The significant decrease of H. pylori seroprevalence in the past five years altered the incidence of upper gastrointestinal disease. [ABSTRACT FROM AUTHOR]

Objectives: Cytomegalovirus (CMV) disease is more common in immunocompromised patients but may occur in people with normal immune function. In addition, CMV enterocolitis can aggravate inflammatory bowel diseases (IBD), but there was little knowledge of differences in clinical and endoscopic features of CMV enterocolitis between patients with IBD and without IBD. The aim of this study was to determine the difference in clinical implication in CMV enterocolitis between the IBD patients and non-IBD patients. Methods: This was a retrospective study of 82 patients with CMV enterocolitis based on the pathologic findings at two tertiary referral hospitals from 2003 to 2013. Clinical and endoscopic characteristics and clinical course were analyzed according to the presence of IBD. Results: Of the 82 patients, 25 (30.5%) had IBD and 57 (69.5%) did not have IBD. Hematochezia was more common in IBD patients (84.0% vs. 35.1%; p =.001), but fever and positive CMV antigenemia were more common in non-IBD patients (50.9% vs. 12.0%; p =.001; 54.4% vs. 28.0; p =.027). Endoscopic findings showed more ulcer with inflammation in IBD patients (68.0% vs. 35.2%; p =.005). Sixty-four patients were treated with antiviral agents and 12 patients who did not receive antiviral agents recovered spontaneously. All naturally healed patients were in normal immune status. Conclusions: Hematochezia is more common in IBD patients and fever/CMV antigenemia is more common in patients without IBD. In patients without IBD, the natural resolution of CMV enterocolitis is expected at least in normal immune function. [ABSTRACT FROM AUTHOR]

Here, we report the quantification of porcine endogenous retrovirus (PERV) copy numbers using real time PCR. After generating standard curves using plasmid DNA, copy numbers were determined for PERV pol and for a housekeeping gene, porcine estrogen receptor2 (ER2) with the same amount of genomic DNA. Using this method, we examined 6 pig breeds in Korea including two breeds of miniature pig, one domestic pig from Jeju, and imported pig breeds, Duroc, Landrace, and Yorkshire. All breeds showed PERV copy numbers ranging from 9 to 50. This method will be useful for monitoring of PERVs in a porcine xenograft. [ABSTRACT FROM PUBLISHER]