Effects of an Interactive Smoking Cessation Coaching Program on Smoking in Female College Students / 기본간호학회지

Purpose@#This study aimed to examine the effects of an interactive smoking cessation coaching program on smoking cessation motivation, smoking knowledge, smoking shame, urine cotinine levels, tobacco craving and smoking abstinence self-efficacy. The conceptual framework of the study applied Cox’s interaction model of client health behavior for female college students who smoked. @*Methods@#This was a before-and-after experimental design study with a non-equivalent control group. The participants were smoking female college students, who were assigned either to an experimental group (n=22) or a control group (n=24). The interaction model of client health behavior was the theoretical basis. The core tactic of smart management and strategy for health was applied as a coaching technique. The experimental group attended 11 sessions of an interactive smoking cessation coaching program, (60 to 120 minutes per session) for 6 weeks, and the control group received education regarding smoking cessation after the program finished. The data collection period was from January 23, 2019 to March 7, 2019. @*Results@#This study showed differences in smoking cessation motivation (F=71.09, p<.001), smoking knowledge (F=20.77, p<.001), smoking shame (t=5.11, p<.001), urine cotinine levels (t=-9.58, p<.001) and smoking abstinence self-efficacy (t=11.68, p<.001). However, no difference in tobacco cravings (t=-1.57, p=.127) was found. @*Conclusion@#As a result of the interactive smoking cessation coaching program, statistically significant differences were found in smoking cessation motivation, smoking knowledge, smoking shame, urine cotinine levels and smoking abstinence self-efficacy. However, further research is needed because there was no statistically significant difference in tobacco cravings.

The Effects of the Smoking Cessation Program of Life Skill Training Using Flipped Learning for Middle School Male Students

Purpose@#The study is examined the effects of the smoking cessation program of life skills training using flipped learning for male middle school students. @*Methods@#The study was a nonequivalent control group non-synchronized design. The Smoking Cessation Program of life skills training using flipped learning is a Smoking Cessation Program that applied 5 stages of flipped learning such as before class, introductory class, during class, after class, and during work. Participants were 32 male students attending a middle school in D city, with 16 in the control group and 16 in the experiment group. Data collection was conducted from February 26, 2019 to May 14, 2019 for the control group, and from May 28, 2019 to August 19, 2019 for the experiment group. The collected smoking knowledge, smoking attitude, self-efficacy, basic psychological needs, and urine cotinine were analyzed by x2 test, independent t-test, two-way repeated measured ANOVA, and Fishers exact test using the SPSS 25.0 program. @*Results@#The experimental group showed higher smoking knowledge, smoking attitude, self-efficacy, basic psychological need, and urine cotinine negative response than the control group, and there were significant differences. @*Conclusion@#These findings indicate that the Smoking Cessation Program of life skill training using flipped learning is an effective intervention for cessation of middle school male students, and it has a positive effect on the increase in urine cotinine, and a physiological indicator of the cessation effect, and is effective in the success of smoking cessation.

Differences in the Working Environment and Health Outcomes according to the Employment Type of Delivery Workers / 한국직업건강간호학회지

Purpose@#This study aimed to identify differences in physical working environments, psychosocial working environments, and health outcomes according to the employment type of delivery workers. @*Methods@#This study was a secondary analysis of data collected from the Fifth Korean Working Conditions Survey (KWCS). Participants were 84 Korean delivery workers. Data were analyzed using the SAS 9.4 Version, x 2 test and Fisher’s exact test. @*Results@#Statistically significant differences were found according to the employment type of delivery workers (special types, wage) including “noise”, “vibrations”, “repetitive movements”, “supervisor support”, “colleague support”, “manuals on emotional expression”, “existence of trade union, works council or similar body”. @*Conclusion@#This study suggests the necessity of improving the working environment and health outcomes of delivery workers belonging to special employment types. In developing these, the laws and systems must be reorganized to enable the recognition of delivery workers as wage workers. In addition, delivery companies should be held responsible for managing delivery workers.

A Structural Model on the Post-Traumatic Growth of Police Officers

Purpose@#The purpose of this study is to construct and test a structural model for the Post-traumatic Growth (PTG) of police officers. The conceptual model is based on Calhoun and Tedeschi’s PTG theory. @*Methods@#Data were collected from 269 police officers working at 10 police stations in Seoul from September 26 to October 9, 2017. The exogenous variable was traumatic experiences, and endogenous variables were pain perception, self disclosure, social support, deliberate rumination, and PTG. The collected data were analyzed in order to calculate the direct and indirect effects of factors affecting PTG using SPSS/WIN 23.0 and AMOS 21.0. @*Results@#The hypothetical model showed a good fit to the data: x2 /df=2.57, GFI=.90, CFI=.95, TLI=.91, RMSEA=.07, SRMR=.07. The hypothetical model showed a similar result with the data, and out of 10 paths, 7 were statistically significant. The model explained 36% of the variance in the PTG of police officers. The model confirmed that social support and deliberate rumination had a direct effect, and that self-disclosure had an indirect effect on police officers’ PTG. Conclusion: Nursing intervention programs to increase PTG of police officers should focus on deliberate rumination, social support, and self-disclosure. In addition, they should be accompanied by various crisis managements and consultations that can promote PTG.

A Structural Model on the Post-Traumatic Growth of Police Officers

Purpose@#The purpose of this study is to construct and test a structural model for the Post-traumatic Growth (PTG) of police officers. The conceptual model is based on Calhoun and Tedeschi’s PTG theory. @*Methods@#Data were collected from 269 police officers working at 10 police stations in Seoul from September 26 to October 9, 2017. The exogenous variable was traumatic experiences, and endogenous variables were pain perception, self disclosure, social support, deliberate rumination, and PTG. The collected data were analyzed in order to calculate the direct and indirect effects of factors affecting PTG using SPSS/WIN 23.0 and AMOS 21.0. @*Results@#The hypothetical model showed a good fit to the data: x2 /df=2.57, GFI=.90, CFI=.95, TLI=.91, RMSEA=.07, SRMR=.07. The hypothetical model showed a similar result with the data, and out of 10 paths, 7 were statistically significant. The model explained 36% of the variance in the PTG of police officers. The model confirmed that social support and deliberate rumination had a direct effect, and that self-disclosure had an indirect effect on police officers’ PTG. Conclusion: Nursing intervention programs to increase PTG of police officers should focus on deliberate rumination, social support, and self-disclosure. In addition, they should be accompanied by various crisis managements and consultations that can promote PTG.

Persistent Fifth Aortic Arch with Coarctation

Persistent fifth aortic arch (PFAA) is a rare congenital anomaly of the aortic arch frequently associated with other cardiovascular anomalies, such as tetralogy of Fallot and aortic arch coarctation or interruption. We report the case of a neonate with PFAA with coarctation who successfully underwent surgical repair.

Extracardiac Conduit Fontan Operation and Right Ventricular Exclusion Procedure for Right Ventricle Failure after Repair of Partial Atrioventricular Septal Defect

A 13-year-old girl, who had undergone the total correction of partial atrioventricular septal defect at the age of 4 years, was admitted with severe tricuspid regurgitation in echocardiography. She had received one-and-a-half ventricle repair during follow-up. Her right ventricle showed global akinesia, and the ejection fraction of the left ventricle was 25% with paradoxical interventricular septal motion. We performed right ventricular exclusion adjunct to the Fontan procedure. She is doing well two years after the operation without complications.

The Clinical Outcomes of Damus-Kaye-Stansel Procedure According to Surgical Technique

BACKGROUND: The Damus-Kaye-Stansel (DKS) procedure is a method for mitigating the risk of systemic ventricular outflow tract obstruction (SVOTO). However, there have been few reports on which surgical technique shows a better outcome. The objective of this study was to compare the outcome of the DKS procedure according to the surgical technique used. METHODS: We retrospectively reviewed 12 consecutive patients who underwent the DKS procedure from March 2004 to April 2013. When the relationship of the great arteries was anterior-posterior, the double-barrel technique (group A) was performed. If the relationship was side-by-side, the ascending aortic flap technique (group B) was performed. RESULTS: There was no early mortality and 1 late mortality in group B. There was no statistically significant difference in the median peak pressure gradient of preoperative subaortic stenosis in both groups: 14 mmHg (range, 4 to 53 mmHg) in group A and 15 mmHg (range, 0 to 30 mmHg) in group B (p=0.526). Further, a significant postoperative pressure gradient was not observed in either group A or group B. More than moderate postoperative neoaortic regurgitation was observed in 1 patient of group B; this patient underwent neoaortic valve replacement 66 months after the DKS procedure. No one had a recurrent SVOTO during follow-up. CONCLUSION: The DKS procedure is an effective way to minimize the risk of SVOTO, and there is little difference in the outcomes of the DKS procedure according to the surgical technique used.

Job Competencies and Educational Needs Perceived by New Community Health Practitioners

PURPOSE: This study was performed to identify job competencies and needs for job education perceived by new community health practitioners. METHODS: This study used a qualitative research design. Eight new community health practitioners participated in this study. Data were collected through in-depth interviews and analyzed using content analysis. RESULTS: Five job competencies were identified in this study, including primary care, public health management, interpersonal relationship, teaching and counseling, and leadership. The contents of job education that they needed were management of major symptoms and chronic diseases, understanding and prescription of medications, emergency responses and care, management of endemic diseases, planning and management of public health programs, writing official documentsand computer works, and leadership training. The learning methods they preferred were connecting theory and practice, situation- or case-based learning, skill- or practice-based learning, and increased opportunities of clinical practice. CONCLUSION: The findings of this study provided the direction of job education for new community health practitioners. Job education for new community health practitioners needs to consider the job competencies and educational needs identified in this study.

Reliability and Validity of the Korean Version of the Copenhagen Psyco-social Questionnaire Scale / 한국직업건강간호학회지

PURPOSE: This study aims to test the validity and criteria-related reliability of the Korean version of the Copenhagen Psyco-social Questionnaire version II (COPSOQ-K) assessing the psychosocial working environment. METHODS: The COPSOQ-K was developed through forward-backward translation techniques, and revision based on feedback from focus groups. Survey data were collected from 311 office workers who worked in one workplace. An internal consistency reliability was estimated by Cronbach's alpha. The impacts of the COPSOQ-K scales on job satisfaction, self-rated health, stress, sleeping troubles, burnout, and sickness absence were analyzed with multiple regression model or multiple logistic regression model, adjusted age and gender using SAS version 9.3. The Pearson correlation coefficients between the COPSOQ-K scales and Korean job stress and its subdomain were identified. RESULTS: Cronbach's alpha of COPSOQ-K scales was adequate or good (0.66~0.87). The major COPSOQ-K scales predict job satisfaction, self-rated health, stress, sleeping troubles burnout, and sickness absence. The major COPSOQ-K scales were correlated with Korean job stress and its subdomain. CONCLUSION: The COPSOQ-K scales have satisfactory reliability and criteria-related validity. The COPSOQ-K scales will be useful for the future studies and practices associated with psychosocial working environment.

Effect of Psychosocial Work Environment and Self-efficacy on Mental Health of Office Workers / 한국직업건강간호학회지

PURPOSE: This study aims to assess the effects of psychosocial work environment and self-efficacy on stress, depression, and burn-out among office workers. METHODS: Survey data were collected from 331 office workers who worked in one workplace from April 10 to 30, 2012. The impact of psychosocial work environment and self-efficacy on stress, depression, and burn-out was analyzed with hierarchical multiple regression using SAS version 9.3. RESULTS: Work-family conflicts and emotional demands were identified as main factors influencing mental health. Other work environment factors influencing mental health were role clarity for stress, possibilities for development, meaning-of work, social support-from supervisors and job insecurity for depression, and social community at work for burn-out. Self-efficacy was correlated with most psychosocial work environment and factor with independent influence on stress and depression. The final models including general characteristics, psychosocial work environment, and self-efficacy accounted for 34%, 44%, and 36% for stress, depression, and burn-out respectively. CONCLUSION: To promote mental health in office workers, there is a need to decrease work-family conflicts and emotional demands and to improve work organization and job contents, social support, and self-efficacy.

The Association of Unintentional Changes in Weight, Body Composition, and Homeostasis Model Assessment Index with Glycemic Progression in Non-Diabetic Healthy Subjects

BACKGROUND: We performed a retrospective longitudinal study on the effects of changes in weight, body composition, and homeostasis model assessment (HOMA) indices on glycemic progression in subjects without diabetes during a four-year follow-up period in a community cohort without intentional intervention. METHODS: From 28,440 non-diabetic subjects who participated in a medical check-up program in 2004, data on anthropometric and metabolic parameters were obtained after four years in 2008. Body composition analyses were performed with a bioelectrical impedance analyzer. Skeletal muscle index (SMI, %) was calculated with lean mass/weightx100. Subjects were divided into three groups according to weight change status in four years: weight loss ( or =5.0%). Progressors were defined as the subjects who progressed to impaired fasting glucose or diabetes. RESULTS: Progressors showed worse baseline metabolic profiles compared with non-progressors. In logistic regression analyses, the increase in changes of HOMA-insulin resistance (HOMA-IR) in four years presented higher odds ratios for glycemic progression compared with other changes during that period. Among the components of body composition, a change in waist-hip ratio was the strongest predictor, and SMI change in four years was a significant negative predictor for glycemic progression. Changes in HOMA beta-cell function in four years was a negative predictor for glycemic progression. CONCLUSION: Increased interval changes in HOMA-IR, weight gain and waist-hip ratio was associated with glycemic progression during a four-year period without intentional intervention in non-diabetic Korean subjects.

Clinical Characteristics and Etiology of Travelers' Diarrhea among Korean Travelers Visiting South-East Asia

The morbidity of travelers' diarrhea (TD) is still high. This study examined the incidence of common pathogens and characteristics of TD among Korean travelers who visited South-East Asian countries. We performed a prospective study involving 479 Korean travelers with diarrheal disease from February 2009 to April 2009 and stool samples were examined and questionnaire surveys were done after arrival. Enterotoxigenic Escherichia coli (ETEC) was found in 36.0% of TD cases, as were the following: Enteroaggregative Escherichia coli (EAEC) in 27.0%, Vibrio parahaemolyticus in 13.1%, and Norovirus in 11.5%. The detected rate of classic TD was higher in men (P = 0.007), in patients who had a shorter duration trip (P = 0.023) and in patients who drank more than 1 liter of water per day (P = 0.037). Positive stool culture rates were higher in men (P = 0.005), in hospitalized patients (P = 0.013). and in those who consumed impure water or raw foods (P = 0.033). A higher severity of disease corresponded to a significantly higher culture positivity rate (P = 0.029). We should consider the possibility of other pathogens in addition to ETEC in patients with TD who visit South-East Asia. Travelers need to educate about risk factors associated with TD.

The Association of Brachial-Ankle Pulse Wave Velocity with 30-Minute Post-Challenge Plasma Glucose Levels in Korean Adults with No History of Type 2 Diabetes / 당뇨병

BACKGROUND: Acute postprandial hyperglycemia is an important affector for atherosclerosis in subjects with glucose intolerance. We analyzed the relationship of brachial-ankle pulse wave velocity (baPWV) with fasting and post-challenge plasma glucose levels according to different time points during oral glucose tolerance test (OGTT). METHODS: In 663 subjects with fasting hyperglycemia, 75 g OGTT were performed to confirm the glucose tolerant status, and fasting, post-challenge 30-minute and 120-minute glucose levels were measured. Anthropometric measurements were done, and fasting lipid profiles were measured. baPWV were measured in all subjects and the relationship between fasting, 30- and 120-minute post-challenge glucose levels and baPWV were analyzed. RESULTS: Among the participants, 62.9% were prediabetes and 31.7% were diabetes. Mean baPWV value was significantly higher in subjects with diabetes compared with prediabetes group. In bivariate correlation analyses, age, blood pressure, total cholesterol, low density lipoprotein cholesterol, 30-minute and 120-minute post-challenge glucose levels showed significant positive correlation with baPWV value. In multiple regression analysis, 30-minute post-challenge glucose level was a weak but significant determinant for mean baPWV value even after adjustment for other confounding variables. CONCLUSIONS: Postprandial hyperglycemia, especially 30-minute glucose levels showed significant correlation with baPWV in subjects with fasting hyperglycemia. These results can imply the deleterious effect of acute hyperglycemic excursion on arterial stiffness in subjects with glucose intolerance.

Video-Assisted Thoracic Surgery Lobectomy for Non-SmallCell Lung Cancer: Experience of 133 Cases / 대한흉부외과학회지

BACKGROUND: We evaluated the feasibility and the efficacy of Video-Assisted Thoracic Surgery (VATS) lobectomy for treating patients with non-small cell lung cancer (NSCLC) and we compared the outcomes of VATS lobectomy with those of open lobectomy. MATERIAL AND METHOD: From 2003 to March 2008, 133 NSCLC patients underwent VATS lobectomy. The patients were selected on the basis of having clinical stage I disease on the chest CT and PET scan. The outcomes of 202 patients who underwent open lobectomy (OL group) for clinical stage I NSCLC were evaluated to compare their results with those of the patients who underwent VATS lobectomy (the VL group). RESULT: The number of females and the number of patients with adenocarcinoma and stage IA disease were greater in VL group (p<0.05). There was no operative mortality or major complications in the VL group. Conversion to thoracotomy was needed in 8 cases (6%), which was mostly due to bleeding. The chest tube indwelling time and the length of the postoperative hospital stay were significantly shorter in the VL group (p<0.001). The number of dissected lymph nodes and the size of tumor were significantly smaller in the VL group (p<0.001). For the pathologic stage I patients, there was no significant difference in the three-year survival rates between the two groups (p=0.15). CONCLUSION: VATS lobectomy is a safe procedure with low operative mortality and morbidity. VATS lobectomy is feasible for early stage NSCLC and it provides outcomes that are comparable to those for open lobectomy. Further long-term data are needed

The Relationship between Serum Retinol-Binding Protein 4 Levels and Coronary Artery Disease in Korean Adults / 당뇨병

BACKGROUND: A recently discovered adipokine, retinol-binding protein-4 (RBP-4), is reportedly associated with insulin resistance and metabolic syndrome. This study was performed to analyze the relationship between serum RBP-4 levels and coronary artery disease (CAD) in Korean adults. METHODS: In 235 subjects (mean age 58 years) in whom coronary artery angiograms were performed due to complaints of chest pain, serum RBP-4 levels were measured by enzyme-linked immunosorbent assay. Coronary artery angiograms were performed in all subjects and the severity of CAD was assessed by the number of stenotic vessels. The presence of metabolic syndrome was defined by AHA/NHLBI criteria with body mass index substituted for waist circumference. RESULTS: Coronary angiogram showed that 101 subjects (43%) had normal coronary vessel, 82 subjects (34.9%) had 1-vessel disease, 31 subjects (13.2%) had 2-vessel disease and 21 subjects (8.9%) had 3-vessel disease. Subjects with coronary artery stenosis showed a higher mean age (60.5 +/- 10.0 years), fasting glucose (123.3 mg +/- 45.0 mg/dL) and lower mean value for high-density lipoprotein cholesterol (HDL-C) level (49.0 +/- 13.2 mg/dL), although serum RBP-4 levels were not significantly different between those with and without CAD. Mean age and fasting glucose level increased significantly as the number of stenotic vessels increased, although serum RBP4 level showed no significant differences among the different groups. Among the metabolic parameters, only serum triglyceride levels showed a significant correlation with serum RBP-4 levels. CONCLUSION: There was no difference in mean serum RBP-4 levels between subjects with or without coronary artery disease in Korean adults. Further studies are warranted to draw a clear conclusion on the effect of RBP-4 on atherosclerosis.

The Cutoff Value of HbA1c in Predicting Diabetes in Korean Adults in a University Hospital in Seoul / 당뇨병

BACKGROUND: Glycated hemoglobin (HbA1c) levels represent a 2~3 month average of blood glucose concentration. The use of HbA1c as a diagnostic tool for diabetes is gaining interest. Therefore, we determined the cutoff point of HbA1c for predicting abnormal glucose tolerance status in non-diabetic Korean subjects. METHODS: We analyzed the data from 1,482 subjects without diabetes mellitus in whom a 75-g oral glucose tolerance test (OGTT) was performed due to suspected abnormal glucose tolerance. We obtained an HbA1c cutoff point for predicting diabetes using Receiver Operating Characteristic (ROC) curve analysis. RESULTS: A cut-off point of 5.95% HbA1c yielded sensitivity of 60.8% and specificity of 85.6%, respectively, for predicting diabetes. There was a difference in HbA1c cut-off value between men and women, 5.85% and 6.05%, respectively. CONCLUSION: To use the cut-off point of 5.95% HbA1c for predicting undiagnosed diabetes in Koreans may be reliable. However, studies of different ethnic groups have reported disparate HbA1c cut-off points. Thus, ethnicity, age, gender, and population prevalence of diabetes are important factors to consider in using elevated HbA1c value as a tool to diagnose diabetes.

Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Future Risk of Diabetes Mellitus in Korean Men (Korean Diabetes J 32(6):498-505, 2008) / 당뇨병

No abstract available.

Avulsion of Aortic Commissure: Rare Cause of Aortic Regurgitation: 2 case reports / 대한흉부외과학회지

We reported here on 2 cases of aortic regurgitation (AR) that were due to avulsion of the aortic valve commissure. Aortic valvuloplasty was attempted in both cases. In the 1st case, valvuloplasty was performed with reattaching the commissure using the 5-0 polypropylene continuous suture technique. However, aortic regurgitation recurred and this lead to reoperation on the postoperative 14th day. The intraoperative finding revealed a completely re-detached commissure that required mechanical valve replacement. In the second case, we attempted to reattach the commissure using pledgetted multiple transverse mattress sutures with 5-0 polypropylene. Because the leaflet coaptation was incomplete, the aortic valve was replaced with a tissue valve.

Persistent Autonomic Dysfunction in Guillain-Barre Syndrome: A case report

Autonomic dysfunction is a common manifestation in Guillain-Barre syndrome (GBS), but it rarely persists. We report a case involving a 22-year-old man who presented with glove-and-stocking type sensory loss, symmetric weakness, urinary distension, orthostatic hypotension, decreased perspiration, and the syndrome of inappropriate secretion of antidiuretic hormone. He was subsequently diagnosed as having GBS with autonomic failure that persisted for more than six months, despite regaining muscle strength. Orthostatic hypotension progressively improved after rehabilitation and administration of midodrine and fludrocortisone. Extensive evaluation and management should be performed in patients with GBS because severe autonomic dysfunction is a major source of disability.