The effects of a personalized nutrition intervention program on food security, health and nutritional status of lowincome older adults in Seoul city / 한국영양학회지

Purpose@#This study was conducted to assess the effects of a personalized nutritional intervention program on food security and health and nutritional status of elderly people in the city of Seoul. @*Methods@#A total of 372 elderly adults aged 65 years or above who resided in Seoul were enrolled in this study. Personalized supplementary food supply and nutritional education based on chronic disease status, disability and cooking ability were implemented for 4 months. To evaluate the effectiveness of the program, nutrient intake, food security status, anemia status, chronic disease management, and frailty status, and prevalence of malnutrition (Mini Nutritional Assessment) were examined. @*Results@#After the program, all subjects displayed significantly increased nutrient intake.Before the intervention, all subjects were in a state of food insecurity; however, after the intervention, 37.1% of the subjects were food secure. Moreover, the rates of being at risk of malnutrition and malnutrition in subjects were decreased and instead rate of those who improved to normal increased to 29.8% from 0% of normal rate before the prevention. The rate of subjects without anemia increased from 18.7% to 28.5% after the intervention. In addition, the rate of subjects with intensive or periodic management of chronic diseases decreased, while those with occasional management of chronic diseases increased from 0% to 4.6%. Furthermore, the rates of being at risk of frailty and frailty were decreased and the normal rate increased from 0% to 9.7% instead. Age group-based analysis showed that elderly people over 80 years showed less improvement in the management of the chronic disease status and the frailty status. @*Conclusion@#Personalized supplementary food supplies and nutritional education improved not only the nutritional status but also disease status in vulnerable older adults, and the effects were more significant in adults aged less than 80 years.

Operation and Process Evaluation of a Community Meal Program for the Elderly in Rural Areas during Agricultural Off-Season Perceived by Cooking Volunteers / 대한지역사회영양학회지

OBJECTIVES: This study examined the practices of a community meal program for older adults in rural areas during the agricultural off-season. METHODS: A survey was conducted from December 12 to December 22, 2016. Self-administered questionnaires were distributed to 150 cooking volunteers, who had participated in the community meal program in 50 villages. A total of 114 responses were returned from 44 villages and used for data analysis. In addition, in-depth interviews were conducted with the volunteers of eight villages. RESULTS: Most of the cooking volunteers were 50 years old or older and they participated in serving older adults meals for good will. The cooking volunteers perceived that the older adults in their community did not eat various foods, had difficulties in grocery shopping, and frequently consumed salty foods. During the agricultural off-season, 40.9% of villages served the older adults meals 6–7 days a week and 95.5% provided meals for lunch. An average of 21 to 40 older adults were served meals in each village. The cooking volunteers reported that the food preparation and meal service times were sufficient, recipes provided were useful, and menus met the preference of the older adults. At the end of the program, they felt proud of serving meals for older adults in the community. An increased awareness of healthy eating, interest in health, and consumption of nutritious meals, a decrease in loneliness among older adults, and the promotion of fellowship in the community were rated highly. The cooking volunteers expected additional support for cooking personnel and insisted that the program should be provided for the entire agricultural off-seasons. CONCLUSIONS: The community meal program during the agricultural off-season for the elderly in rural areas was effective in improving the dietary life of older adults, relieving their feelings of isolation, and promoting fellowship of the community. The volunteers felt workload due to a shortage of volunteers but answered that they were rewarded by helping older adults in their community.

Comparative analysis of dietary behavior and nutrient intake of elderly in urban and rural areas for development of “Village Lunch Table” program: Based on 2014 Korea National Health and Nutrition Examination Survey data / 한국영양학회지

PURPOSE: We conducted comparative analysis of dietary behavior and food and nutrient intakes of Korean elderly in urban and rural areas using the 2014 Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: This study was conducted on 1,239 participants (urban elderly: 867, rural elderly: 372) aged 65 years and over who participated in the health examination and nutrition survey in the 6th 2014 KNHANES. Dietary behaviors, including skipping meals, eating out frequencies, and food and nutrient intakes were analyzed using 24-hour recall data. Analysis of complex sample design data through SPSS 19.0 was used for the analysis. RESULTS: The rate of skipping dinner was higher in urban (6.5%) than in rural elderly (3.6%) (p < 0.05), and the frequency of eating out per week of urban elderly (1.73) was higher than that of rural elderly (1.35) (p < 0.001). The rural elderly consumed a greater amount of grain compared to urban elderly, whereas consumption of water, seaweed food, and dairy products was lower in rural than in urban areas (p < 0.05). The rural elderly consumed significantly less highly unsaturated fatty acids, n-6 fatty acids, phosphorus, iron, vitamin A, carotene, niacin, and vitamin C in comparison with elderly in urban areas. Comparison of the percentages of Dietary Reference Intakes for Koreans (KDRIs) between the two groups showed that intakes of vitamin A and vitamin C were significantly lower in the rural elderly than in urban elderly. CONCLUSION: The elderly in rural areas showed unbalanced food and nutrient intakes compared to the elderly in urban areas. Therefore, customized nutrition education according to residential areas should be developed and provided to rural elderly to improve their health and nutritional status.

Microbiological Assessment of Home-Delivered Meals for Children from Low-income Families during Production and Delivery

The purpose of this study was to assess the microbiological quality of home-delivered meals during production and delivery for children from low-income families. Production flows from a facility in Seoul that provides home-delivered meals were analyzed and the time-temperature of the food was measured. Microbiological assessment was performed for the production environment, personal hygiene, and food samples at each production and delivery step based on the process approach. It took 2 hours or longer from completion of production to meal delivery. An aerobic colony count (ACC) and coliform were not detected at knives, cutting boards, and dish towels. However, ACC (at pre-preparation, preparation, and packing areas) and coliform (at the preparation area) were detected on the hands and gloves of employees. Air-borne bacterial counts varied according to day and preparation area (ND~6 CFU/plate/15 min). Food temperatures, on the completion of production and meal delivery, fell into temperature danger zones. ACC and coliform counts of raw ingredients did not decrease after pre-preparation (washing and sanitizing) for menus involving food preparation with no cook step. ACC decreased after cooking step for menus of food preparation with cook step, but the ACC of the stir-fried and seasoned dried filefish fillet on the completion of cooking was too numerous to count due to improper heating. The ACC of seasoned young Chinese cabbages (a menu with complex food preparation) increased during delivery (from 2.5 log CFU/ml to 5.0 log CFU/ml). This qualitative assessment of foodborne pathogens revealed that B. cereus was detected in vegetable and meat product menus. These results suggest time-temperature control is necessary during production and delivery and management guidelines during production of home-delivered meals are provided for safe production.

Knowledge, Self-Efficacy, and Perceived Barriers on the Low-Iodine Diet among Thyroid Cancer Patients Preparing for Radioactive Iodine Therapy

The purposes of the study were to assess knowledge, self-efficacy, and perceived barriers on a low-iodine diet among thyroid cancer patients and to identify strategies for nutrition education. A self-administered questionnaire was developed based on a review of literature and pilot-tested. A total of 121 female thyroid cancer patients participated in a survey and 117 responses were used for data analysis. An average knowledge score of the thyroid cancer patients was 4.5 point (available score: 0-10 point). Majority of the respondents knew that seaweeds such as lavers, brown seaweeds, and sea tangles contain large amount of iodine. However they mistook the low iodine diet as a low salt diet and were not aware of foods and seasonings that are allowed on the low iodine diet. While self-efficacy related to consuming various fruits and vegetables, to choosing potatoes and sweet potatoes for snacks, and restricting consumption of eggs, milk and milk products, and processed foods was rated highly, self-efficacy for preparing foods without using sea salts was rated low. The self-efficacy score increased as their interest on the dietary life and perceived cooking skills were greater. Most perceived barriers toward practicing the low iodine diet were related to preparation of the low iodine menus. As their interest in the dietary life and cooking and perceived cooking skills were greater, the patients perceived barriers on practicing the low iodine diet less. While the patients showed higher self-efficacy and lower barrier perception on selecting foods low in iodine and restricting food high in iodine, they showed lower self-efficacy and higher barrier perceptions on preparing low iodine meals. Clinical dietitians should recognize the gap between what the patients should know and what they really know and identify strategies on how to improve self-efficacy and reduce perceived barriers on the low iodine diet. Recent literature and the findings of the study reveal that incorporating cooking classes into nutrition education for thyroid patients is effective to enhance self-efficacy and to reduce perceived barriers on the low iodine diet.

Prostate-Specific Antigen Test Interval according to Baseline Prostate-Specific Antigen and Age

PURPOSE: The optimal interval at which to repeat prostate-specific antigen (PSA) measurement is controversial. We evaluated the probability of the serum PSA value increasing above specific cutoff values (4.0 ng/ml, 3.0 ng/ml, and 2.5 ng/ml) on annual follow-up visits in men with a lower baseline PSA than each cutoff value. MATERIALS AND METHODS: Between 2002 and 2006, a total of 14,459 men aged 40 to 79 years who underwent serum PSA determinations at least twice during health examinations at 11 medical centers were enrolled in this study. To reduce probable bias, we excluded men with pyuria, those with a baseline or follow-up PSA level of 10.0 ng/ml or more, and those with a history of medication with 5 alpha-reductase inhibitors. Serum PSA underwent logarithmic conversion to work out the normal distribution. The cumulative rate of freedom from increase in PSA above 4.0 ng/ml, 3.0 ng/ml, and 2.5 ng/ml was estimated with the Kaplan-Meier method according to baseline PSA range and age. The significance level was 1%. RESULTS: The rate of increase in PSA was lower in men who had a baseline PSA value in the low range and whose age was in the 40s or 50s. However, the cumulative rate of freedom from increase in PSA decreased as the PSA cutoff value was lowered. The optimal screening interval for men in their 40s and 50s whose baseline serum PSA level was 1.0 ng/ml or lower was 3 years when the significance level for PSA rising above 4.0 ng/ml was 1%. It was 2 years and 1 year, respectively, when the cutoff value was lowered to 3.0 ng/ml or 2.5 ng/ml. An annual PSA screening interval was recommended in men older than their 60s. CONCLUSIONS: The PSA test interval should be individualized according to baseline PSA, age, and PSA cutoff value.

Initial Experiences of Complete Primary Exstrophy Repair in Cloacal and Bladder Exstrophy / 대한비뇨기과학회지

We report here the short-term results of 3 cases of cloacal and bladder exstrophy that underwent complete primary exstrophy repair. One case was diagnosed as bladder exstrophy and the others were diagnosed as cloacal exstrophy. Complete primary exstrophy repair for all 3 cases was carried out within 24 hours after birth. There was no wound dehiscence within the follow-up period of 12 months. The complete primary exstrophy repair with positioning the bladder neck and urethra in the deep pelvic cavity achieves a satisfactory short-term result.

The Effectiveness of Adjuvant Chemotherapy in the Transitional Cell Carcinoma of Urinary Bladder with Lymph Node Involvement Treated by Radical Cystectomy / 대한비뇨기과학회지

PURPOSE: To assess the impact of adjuvant chemotherapy on the survival of patients treated surgically for a bladder transitional cell carcinoma (TCC). MATERIALS AND METHODS: We retrospectively analyzed the data from 243 patients with bladder TCC who underwent a radical cystectomy. The mean age of the patients was 61.2 years, with a median follow-up of 46.8 months. The influence of prognostic factors, including age, gender, tumor stage, grade and chemotherapy, on the 5-year survival rate were analyzed. The difference in the survival rates among the prognostic factors were analyzed by univariate and multivariate analyses. RESULTS: The overall 5-year survival rate was 72%. The significant prognostic factors for the 5-year survival according to the univariate analysis were lymph node involvement, tumor stage, age and chemotherapy. From the multivariate analysis, lymph node involvement was the most independent of the prognostic factors for survival. Patients with lymph node involvement had a worse prognosis than those without (p<0.001). Adjuvant chemotherapy in patients with lymph node involvement had a great impact on survival (p=0.001). CONCLUSIONS: When treating a bladder TCC with a radical cystectomy, lymph node involvement, tumor stage, age and chemotherapy were significant factors influencing survival. Adjuvant chemotherapy will provide a therapeutic role in invasive bladder TCC, with lymph node involvement, following a radical cystectomy.