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Smoking is a risk factor for gastric cancer (GC) and causes oxidative stress. Antioxidant vitamins may protect against oxidative stress. This study aimed to determine the association between dietary antioxidant vitamin intake and GC risk according to smoking status and the histological subtype. This case-control study included 286 pairs of patients with GC and controls aged 20–79 years enrolled at two hospitals from 2002 to 2006, matched by age (± 2 years), sex, hospital, and participation period (± 1 years). Dietary information was collected using a quantitative food frequency questionnaire (FFQ). When stratified by smoking status, increased intake of vitamin C (OR = 0.38; 95% CI = 0.17–0.84 for highest vs. lowest; P for trend = 0.033) and folate (OR = 0.28; 95% CI = 0.12–0.64 for highest vs. lowest; P for trend = 0.003) decreased GC risk in nonsmokers. Vitamin C (P for interaction = 0.043) and folate (P for interaction =0.015) levels were significantly associated with smoking status. Similar results were observed in nonsmokers with diffuse and mixed types of GC, but not in those with intestinal type of GC. Therefore, we found an inverse association between higher intake of dietary vitamin C and folate with the risk of GC among nonsmokers. These protective associations were strong in nonsmokers with diffuse and mixed types of GC. [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]

Purpose: To investigate the relationship between physical function and quality of life in multiple myeloma patients.Methods: In this retrospective cross-sectional study, data from patients with multiple myeloma (N = 63), who were referred to the department of Rehabilitation Medicine from October 2017 to May 2018, were reviewed. Patients were excluded based on the following criteria: acute illness, unstable medical conditions, impaired cognition or communication, refusal, or inability to perform the assessment. Physical function was evaluated with the Mini-Balance Evaluation Systems Test (Mini-BESTest), and the European Organization for Research and Treatment of Cancer questionnaires QLQ-C30 and QLQ-MY20 were used for the evaluation of quality of life. To evaluate fatigue and psychotic status, the Fatigue Severity Scale and Beck Depression Inventory were used. Patients were divided into two groups ("good-function group" and "poor-function group"), based on previously studied normative values of the Mini-BESTest. Clinical data was reviewed to interrogate the contributing factors of physical function.Results: Positive correlations were observed between Mini-BESTest scores and all domains of the QLQ-C30. The Mini-BESTest score was lower in patients with lower serum hemoglobin (r = 0.396, p = 0.001) and albumin levels (r = 0.440, p < 0.001), severe disease-related symptoms (r = - 0.39, p = 0.02), and depression (r = - 0.538, p < 0.001). Further, the poor-function group showed lower hemoglobin (p = 0.024) and albumin levels (p = 0.004).Conclusion: In patients with multiple myeloma, physical function had a significant relationship with quality of life. Low hemoglobin and albumin levels, severe disease- or treatment-related symptoms, and depression were related to decreased physical function, and thus consequentially exert an effect on quality of life in multiple myeloma patients. [ABSTRACT FROM AUTHOR]

Aim: To develop flipped learning classes by using film clips for undergraduate nursing students in an online nursing informatics course, based on the Analysis, Design, Development, Implementation, and Evaluation model, and to evaluate the effectiveness and students' responses to this method of teaching. Methods: Sixty‐four second‐year nursing students participated in the course. The nursing students' knowledge was assessed at the beginning and end of each of the five classes. Moreover, their intention to recommend the classes to other students and additional comments were elicited by using semistructured questionnaires. Results: Knowledge about each core concept of nursing informatics reflected significant improvement. Regarding the intention to recommend the class to others, 62 (96.8%) students answered "strongly recommend" or "recommend." Conclusion: Integrating flipped learning classes by using film clips in an online nursing informatics course improved the nursing students' knowledge and is a format that is desired by students. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop a smartphone-based injury-prevention application (S-IPA) for teachers working in child-care centers, and to test the satisfaction level of the users of the application (app). Through a literature review and needs assessment, an app compatible with the Apple iPhone operating system was developed. The app was verified and the mean total satisfaction with 7 features of the app was 7.76 (± 1.13) on a score of 1–10. The result of the S-IPA survey showed a positive response, indicating a high potential for use as a teacher’s educational guide, which would provide an effective information delivery system for the prevention of possible injuries at child-care centers. [ABSTRACT FROM PUBLISHER]

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]

Objective: To estimate the percentage of infants with large birth size attributable to excess gestational weight gain (GWG), independent of prepregnancy body mass index, among mothers with preexisting diabetes mellitus (PDM).Study Design: We analyzed 2004-2008 Florida linked birth certificate and maternal hospital discharge data of live, term (37-41weeks) singleton deliveries (N=641,857). We calculated prevalence of large-for-gestational age (LGA) (birth weight-for-gestational age≥90th percentile) and macrosomia (birth weight>4500g) by GWG categories (inadequate, appropriate, or excess). We used multivariable logistic regression to estimate the relative risk (RR) of large birth size associated with excess compared to appropriate GWG among mothers with PDM. We then estimated the population attributable fraction (PAF) of large birth size due to excess GWG among mothers with PDM (n=4427).Results: Regardless of diabetes status, half of mothers (51.2%) gained weight in excess of recommendations. Large birth size was higher in infants of mothers with PDM than in infants of mothers without diabetes (28.8% versus 9.4% for LGA, 5.8% versus 0.9% for macrosomia). Among women with PDM, the adjusted RR of having an LGA infant was 1.7 (95% CI 1.5, 1.9) for women with excess GWG compared to those with appropriate gain; the PAF was 27.7% (95% CI 22.0, 33.3). For macrosomia, the adjusted RR associated with excess GWG was 2.1 (95% CI 1.5, 2.9) and the PAF was 38.6% (95% CI 24.9, 52.4).Conclusion: Preventing excess GWG may avert over one-third of macrosomic term infants of mothers with PDM. Effective strategies to prevent excess GWG are needed. [ABSTRACT FROM AUTHOR]

This study identified the effects of a community-based cardiovascular disease prevention program (CVD-PP) on health behavior and modifiable cardiovascular risk factors in low-income Korean elderly with hypertension. Eighty-eight individuals completed the 3-month self-efficacy-enhancing interventions in which the control group received standard care. In the intervention group, there were statistically significant improvements in self-efficacy (t = 2.519,p = 0.016) and health behavior (t = 3.453,p = 0.001), and significant differences in diastolic blood pressure (t = –2.518,p = 0.018) between the two groups. This CVD-PP administered by visiting nurses may be effective in improving self-efficacy and health behavior and in reducing modifiable cardiovascular risk factors. [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]

Abstract Objective: Mutations in the GJB2 gene are a major cause of hereditary hearing loss. However, only a few studies have investigated carrier frequencies of GJB2 mutations in the general population. The aim of this study was to estimate the carrier frequencies of three GJB2 mutations, including 235delC, V37I, and G45E, in the general Korean population. Design: A standard questionnaire of self-reported hearing loss was used to identify and recruit subjects. Screening for three mutations was performed using an allele-specific polymerase chain reaction (PCR), PCR-restriction fragment length polymorphism, and direct DNA sequencing. Study sample: A total of 1256 unrelated healthy individuals were analysed in the present study. Results: Of the 1256 individuals, 24 had GJB2 mutations; 11 were found to be heterozygous for 235delC, 11 were heterozygous and one was homozygous for V37I, and one was heterozygous for G45E. One individual had a compound heterozygous mutation of 235delC/V37I. The allele frequencies of 235delC, V37I, and G45E mutations were 0.44%, 0.52%, and 0.04%, respectively. The carrier frequency of either the 235delC or V37I mutation was estimated to be 0.88% with 95% binomial CI, 0.44-1.56. Conclusions: These results will facilitate diagnosis of, and genetic counseling for, hearing loss in Koreans. Sumario Objetivo: Las mutaciones del gene GJB2 son una causa muy importante de pérdidas auditivas hereditarias. No obstante, solamente pocos estudios han investigado las frecuencias portadoras de las mutaciones del GJB2 en la población general. El objetivo de este estudio fue estimar las frecuencias portadoras de tres mutaciones del GJB2, incluyendo la 235delC, V37I y G45E, en la población general de Corea. Diseño: Se utilizó un cuestionario estándar de pérdida auditiva auto-reportada para identificar y reclutar sujetos. El tamiz de las tres mutaciones se realizó usando una reacción en cadena de la polimerasa alelo-específica (PCR), el polimorfismo de los fragmentos de restricción PCR y la secuenciación directa de DNA. Muestra de estudio: Se analizaron en este estudio 1,256 individuos sanos, no relacionados, (sanos en este estudio). Resultados: De los 1,256 individuos, 24 tenían mutaciones del GJB2; 11 se encontraron como heterocigóticos para el 235delC, 11 fueron heterocig ticos y uno fue homocigótico para V37I y uno fue heterocigótico para G45E. Un individuo tenía una mutación heterocigótica compuesta del 235delC/V37I. Las frecuencias de las mutaciones del alelo de 235delC, V37I, y G45E fueron del 0.44%, 0.52%, y 0.04%, respectivamente. La frecuencia portadora de las mutaciones tanto del 235delC como del V37I se estimó en 0.88%, con CI binomial del 95% de 0.44-1.56. Conclusiones: Estos resultados facilitarán el diagnóstico y el asesoramiento genético en casos de pérdida auditiva en la población de Corea. [ABSTRACT FROM AUTHOR]

Although cigarette smoking remains the most prevalent form of tobacco use in girls and in women of reproductive age globally, use of non-cigarette forms of tobacco is prevalent or gaining in popularity in many parts of the world, especially in low- and middle-income countries. Sparse but growing evidence suggests that the use of some non-cigarette tobacco products during pregnancy increases the risk of adverse pregnancy outcomes. In this paper we review the literature on the prevalence of non-cigarette tobacco product use in pregnant women and in women of reproductive age in high-, middle-, and low-income countries and the evidence that maternal use of these products during pregnancy has adverse health effects. In addition, we communicate findings from an international group of perinatal and tobacco experts that was convened to establish research priorities concerning the use of non-cigarette tobacco products during pregnancy. The working group concluded that attempts to develop a public health response to non-cigarette tobacco use in women are hindered by a lack of data on the epidemiology of use in many parts of the world and by our limited understanding of the type and magnitude of the health effects of these products. We highlight research gaps and provide recommendations for a global research agenda. [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]

Abstract: Heat shock protein 90 (Hsp90) is a ubiquitously expressed integral cellular protein essential for regulating proteomic stress. Previous research has shown that Hsp90 regulates critical signaling pathways underlying chronic pain and inflammation. Recent discovery of membrane bound ectopic Hsp90 (eHsp90) on tumor cells has shown that Hsp90 induction to the plasma membrane can stabilize disease-relevant proteins. Here, we characterize eHsp90 expression in a mouse model of inflammation and demonstrate its role in nociception and pain. We found that intraplantar complete Freund adjuvant (CFA) induced robust expression of eHsp90 on the cell membranes of primary afferent nociceptors located in the L3-L5 dorsal root ganglia (DRG), bilaterally, with minimal to no expression in other tissues. Complete Freund adjuvant-induced increases in eHsp90 expression on lumbar DRG were significantly greater in females compared with males. Furthermore, exogenous Hsp90 applied to primary Pirt-GCaMP3 nociceptors induced increases in calcium responses. Responses were estrogen-dependent such that greater activity was observed in female or estrogen-primed male nociceptors compared with unprimed male nociceptors. Treatment of mice with the selective eHsp90 inhibitor HS-131 (10 nmol) significantly reversed CFA-induced mechanical pain, thermal heat pain, and hind paw edema. Notably, a higher dose (20 nmol) of HS-131 was required to achieve analgesic and anti-inflammatory effects in females. Here, we provide the first demonstration that inflammation leads to an upregulation of eHsp90 on DRG nociceptors in a sex-dependent manner and that inhibition of eHsp90 reduces nociceptor activity, pain, and inflammation. Thus, eHsp90 represents a novel therapeutic axis for the development of gender-tailored treatments for inflammatory pain. [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]

Objectives This study aimed to identify factors influencing beliefs about intimate partner violence among Korean adults. Design and Sample This is a cross-sectional descriptive study that analyzed data from 466 adults. Measures Beliefs about intimate partner violence were measured using a self-report questionnaire with a total of 28 items consisting of four subscales: perpetrator's justification for beating women, blaming women for violence against them, perpetrator's responsibility for violence, and giving help to victims. Results Men and women had significantly different beliefs about intimate partner violence ( t = −7.19, p < .001). Some characteristics were identified that led to unhealthy beliefs about intimate partner violence. Four variables-gender, age, educational level, and witnessing parental violence-had an explanatory power of 20% with regard to beliefs about IPV ( F = 10.50, p = .000). Conclusions In South Korea, men, older individuals, and those with less formal education or who have witnessed parental violence need education to foster healthier beliefs about intimate partner violence. Nurses can play a vital role in efforts to decrease intimate partner violence. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this systematic review is to describe polysubstance studies and their prevalence estimates among pregnant people in the US. Methods: This review was not subject to protocol preparation or registration with the International Prospective Register of Systematic Reviews (PROSPERO) because outcome data were not reported. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist was followed. Four scientific literature databases were used to identify articles published from January 1, 2009 to June 3, 2020 reporting prenatal exposure to two or more substances in the US. A standardized process of title and abstract screening followed by a two-phase full-text review was used to assess study eligibility. Results: A total of 119 studies were included: 7 case–control studies, 7 clinical trials, 76 cohort studies, and 29 cross-sectional studies. Studies varied with respect to study design, time period, region, sampling and participant selection, substances assessed, and method of exposure ascertainment. Commonly reported polysubstance prevalence estimates among studies of pregnant people included combinations with alcohol, marijuana, and/or tobacco/nicotine. The range of prevalence estimates was wide (alcohol 1–99%; marijuana 3–95%; tobacco/nicotine 2–95%). Discussion: Polysubstance use during pregnancy is common, especially with alcohol, marijuana, and/or tobacco/nicotine. Future research to assess polysubstance use during pregnancy could help better describe patterns and ultimately help mitigate its effects on maternal and infant health outcomes. [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: The recruitment of monocytes to the brain plays an important role in the development of depression. However, the association between plasma biomarkers of monocyte trafficking and depression is unclear. This study is aimed to examine the effects of plasma monocyte chemoattractant protein 1 (MCP-1), intercellular adhesion molecule 1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1) on the risk of depression.Methods: Data were acquired from an ongoing prospective cohort study involving randomly sampled, community-dwelling Korean older adults, which has been followed every 2 years. We included 1539 euthymic older adults (age = 68.2 [5.6] years; 51.7% were women) without a history of major psychiatric disorders and dementia and neurological diseases. Geriatric psychiatrists diagnosed incident depression through a structured interview using the Korean version of the Mini-International Neuropsychiatric Interview.Results: Depression had developed in 134 (8.7%) participants during the follow-up period of 5.7 (0.8) years. The high-plasma MCP-1 tertile group showed twofold higher risk of depression than the low-plasma MCP-1 tertile group (hazards ratio = 2.00, 95% confidence interval = 1.27-3.13, p = .003). The association between high levels of plasma MCP-1 and future risk of depression was significant in the middle-plasma ICAM-1 and VCAM-1 tertile groups; the high-plasma MCP-1 tertile group showed about fourfold higher risk of depression than the low-plasma MCP-1 tertile group.Conclusions: Molecules involved in monocyte trafficking may be good candidates as diagnostic biomarkers and/or therapeutic targets for late-life depression. [ABSTRACT FROM AUTHOR]

Objective: The effects of mood disorders on mortality may be mediated by their effects on the risk of dementia, and interventions to reduce the occurrence of dementia may reduce their overall mortality. This study aimed to investigate the direct effects of depressive and bipolar disorders on the 6-year risk of mortality and also their indirect effects on mortality due to their effect on the risk of dementia. Methods: A total of 5101 Koreans were selected from a community-based prospective cohort study, and 6-year risks of mortality and dementia in participants with depressive and bipolar disorders were estimated by Cox proportional hazard analysis. The direct and indirect effects of depressive and bipolar disorders on the risk of mortality were estimated using structural equation modeling. Results: The depressive and bipolar disorder groups showed 51% and 85% higher 6-year mortality, and 82% and 127% higher risk of dementia, respectively, compared to euthymic controls. The effects of depressive and bipolar disorders on mortality were mainly mediated by their effects on the risk of dementia in a structural equation model. The direct effects of each mood disorder on mortality were not significant. Conclusion: Both depressive and bipolar disorders increased the risks of mortality and dementia, and the effects of mood disorders on mortality were mainly mediated through dementia. As dementia occurs later in life than mood disorders, measures to prevent it may effectively reduce mortality in individuals with a history of mood disorders, as well as being more feasible than attempting to control other causes of death. [ABSTRACT FROM AUTHOR]

The article discusses gestational weight gain (GWG) in the U.S. in 2012 and 2013. Topics include the The Institute of Medicine (IOM) GWG recommendations that promote optimal health by balancing risks associated with GWG and are specific to a woman's prepregnancy body mass indec (BMI), the prevalence of appropriate GWG and inappropriate GWG among pregnant women, and American College of Obstetricians and Gynecologists's recommendations for calculating a woman's prepregnancy BMI.

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]

This multicenter, randomized, double-blind, parallel-group phase III clinical trial aimed to investigate the efficacy and safety of a rosuvastatin + amlodipine combination compared with that of rosuvastatin or amlodipine monotherapy in hypertensive patients with dyslipidemia. A total of 106 patients of 15 institutions in Korea were randomly assigned to 1 of 3 treatment groups: rosuvastatin 20 mg + amlodipine 10 mg, amlodipine 10 mg, or rosuvastatin 20 mg. After 8 weeks of treatment, the mean ± SD of change in mean sitting systolic blood pressure (msSBP) was -22.82 ± 12.99 mm Hg in the rosuvastatin + amlodipine group, the most decreased among the treatment groups. The percentage of patients whose msSBP decreased ≥20 mm Hg or msDBP decreased ≥10 mm Hg was also highest in this group (74.29%). The mean ± SD percentage change in low-density lipoprotein cholesterol (LDL-C) level from baseline after 8 weeks was -52.53% ± 11.21% in the rosuvastatin + amlodipine group, the most decreased among the treatment groups. More patients in the rosuvastatin + amlodipine group achieved their target LDL-C goal at 8 weeks, compared with the other treatment groups (97.14%). No serious adverse events or adverse drug reactions were observed in all groups. In hypertensive patients with dyslipidemia, combination treatment with rosuvastatin 20 mg + amlodipine 10 mg effectively reduced blood pressure and LDL-C levels while maintaining safety. [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]

Background: Although the Mini-Mental Status Examination (MMSE) is the most widely used screening instrument for dementia, it has several limitations. Methods: We developed and validated a new scoring method of the MMSE, namely the short form of the MMSE (MMSE-S). Results: The MMSE-S was more robust to demographic influences than the MMSE. The influence of education, in particular, was smaller in the MMSE-S compared to the MMSE (p < 0.01). The diagnostic accuracy of the MMSE-S for very mild to mild dementia was also better than that of the original MMSE (p < 0.0001). Its specificity, in particular, was higher than that of the original MMSE. In Korea, we could improve the post-test probability for dementia from 46.88 to 64.76% by employing the MMSE-S instead of the MMSE. We also provided optimal cut-off scores for dementia stratified by age, education, and gender, which may further improve the diagnostic accuracy of the MMSE-S for dementia. Conclusion: Due to its good accuracy and brevity, the MMSE-S may contribute to enhancing the cost-effectiveness of and accessibility to dementia screening as well as early diagnosis and treatment of dementia, particularly in low- and middle-income countries. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]