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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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]